Dr. Josh Ennis, from Thursday night’s forum on reopening the economy.

Today Humboldt Deputy Public Health Officer Dr. Josh Ennis took a number of questions from the media on modeling the pandemic locally, staffing up for an expected surge in COVID-19 cases and building out additional facilities, caring for the elderly going forward, and much more.

Here’s an MP3 audio recording of his answers:

Dr. Josh Ennis answers media questions. April 30, 2020.

Below: A paraphrases summary of the questions asked and Ennis’ responses, with a timestamp corresponding to the audio above.

(0:00) What is the margin of error on the two different projections for Humboldt’s COVID hospitalizations?

Great question. Perhaps the question refers to the state’s model, which projects out a “cone of uncertainty”? Unfortunately, Humboldt County does not have the capacity to run its own model as many times as the state runs its, and so the local projections referenced in his presentation Thursday night came without a quantifiable “cone of uncertainty.” They were based on one run alone.

“There is a lot of uncertainty,” Ennis says. “I can’t quantify it at this time.”

(1:55) Can you talk about what factors, data or conditions are used to build these models, and in what ways they are likely to change over time?

These models are enormously complex. They take into account such things as the incubation period of the disease, the infection period, the rate of spread from one person to another, and many other factors. Science has a reasonable grasp on some of these factors of the disease, but a lot of them are still based on educated guesswork. A lot of the unknowns are due to our still-limited limited testing capacity.

(4:00) Talking about “alternate care sites,” that are being built to handle a projected “surge” of cases – can you give us an update on where these sites are, what sort of capacity they’ll have, and when they’ll be done?

There are currently plans for two alternate care sites. There’s been a lot of attention placed on the Redwood Acres site, but there’s a second one that’s being built in partnership with Mad River Hospital. This will be at the Mad River campus, but outside the normal parts of the complex that handle patient care.

The details of the operations at the second site — at Redwood Acres — is still being worked out with partners. Overall, though, we’re hoping to have about 150 extra beds in place. We’re also still trying to increase the ICU capacity, and the ventilator capacity.

(7:45) You have mentioned that we’re trying to triple ICU capacity locally, as well as an overall expansion of hospital beds. What are we doing to make sure that we have the workforce to staff such an expansion?

This is the most critical component of our planning, and probably the place where we face the most significant limitations. The county has been talking with all the local health care providers to organize and inventory their workforces. We’re also looking within the community, as well as with state organizations, and at telehealth providers.

(10:20) Today’s Los Angeles Times has a story about the possibility of monitoring the COVID-19 prevalence in a community by sampling municipal sewage systems. Could this approach be applied in Humboldt? Could it give us early warning of an outbreak?

This is something that has been discussed here in Humboldt, and we’re aware of other counties does this. Lake County was looking at this. When we last talked about it, we felt that it was a little too preliminary to invest much time and effort into it. It could have a role to play in our more population-dense areas, but the technology seems a little too preliminary right now – especially given that we are so rural.

(11:50) It seems that the Redwood Acres facility is close to being completely set up, but it seems that it won’t be needed for some time – if at all. Is it staffed? Is it serving any role in the interim?

It’s not completely set up yet – there is a lot of infrastructure that needs to go in there, still. It’s not staffed with any medical personnel, but staff from the Office of Emergency Services is still working to get it where it needs to be.

(13:10) Are there any risks to keeping local beaches open? If beaches are kept open, how can people safely congregate while following the health officer’s guidelines?

A lot of this is moot, since the governor didn’t shut local beaches after all, but the usual rules apply – keep six feet between yourself, stay within the bubble of people you normally interact with, minimize the risk of transmission to others. As long as we do that, there should be no call to shut the beaches here.

(15:20): The San Francisco Chronicle recently reported that even after the general stay-at-home order is relaxed, restrictions on seniors will likely remain long into the future? How do you see that playing out for Humboldt seniors?

Seniors are among the groups of people at the most risk for severe disease or death, and the county’s efforts right now are focused on protecting people at highest risk. We’re especially focused right now on working with skilled nursing facilities to develop processes to protect residents and to get more comfortable with infection protection measures that will help limit spread of disease, should a case develop within their facilities.

The county has been developing systems to support people to support people who are under quarantine orders, and hopefully we can leverage those systems to support seniors in the future.