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Above is the video from Humboldt County Health Officer Dr. Teresa Frankovich’s media availability, released on Wednesday evening. And below you can read the (at least partially corrected) YouTube-generated transcript of the video:
Good afternoon, we’re here with Humboldt County Health Officer Dr. Teresa Frankovich for the August 18th Media Availability. Thank you for being here with us. Would you like to start off by addressing the community?
Yes I would. I just want to mention that since I last spoke with you all, an email exchange between myself and Humboldt State University President Tom Jackson has been published. I’m sure there will be a few questions about that today and I will take this opportunity to address the elephant in the room — and after that we’re moving on.
The opening of schools, both K-12 and higher education, have been high-charged, and [there are] ongoing discussions, which are all about timing in a COVID landscape. The reason is that we know gathering people from different households increases risk, and there are challenges in trying to structure the environment to minimize risk.
Universities and colleges not only gather students from different households but also from different counties, most with higher prevalence of COVID than Humboldt because almost all areas of the state have higher level levels of prevalence, and as we have seen, this movement has been a driver of transmission across the state. It is why we have repeatedly asked residents here to stay close to home and to not bring family and friends here, because we have seen the impact locally.
Certainly many HSU students are year-round Humboldt residents, but on August 7th I was informed that up to 850 additional students would begin arriving on the 15th for residence in dorms and would arrive over [the span of] about a week while an additional, unknown number of students would be arriving to off-campus housing throughout the month.
In light of our current epidemiology, I was concerned and expressed that concern to the HSU planning group. Later that day, the state released guidance for higher education and reopening. This affirmed my concerns. It was clear that with our increasing case counts, multiple outbreaks, current testing capacity and need, as well as contact investigation demands, we did not meet state recommendations regarding on-site instruction.
Let me make one thing clear: This is not a case of “othering.” It is a case of trying to make safe choices for the entire community in the midst of a pandemic. This is about trying to juggle competing needs for testing resources across skilled nursing facilities, agricultural settings, tribal communities, local public schools, businesses and organizations, and the community as a whole.
State resources have not been able to be utilized to date so our local laboratory is currently shouldering the entire responsibility on its own. Insinuations of racism and flat-out allegations of incompetence have been directed toward me and this incredible health department that I proudly represent simply for stating the facts. That has been disheartening to say the least.
I admit the timing and asking for a pause was terrible, as timing often is in a pandemic. There is no doubt about that. But partners talk and try to figure out what might work. They find solutions. That is what we are doing now alongside our HSU partners.
I support and celebrate education in all settings. I moved to Humboldt in part because it is a university community and I love all of what that brings to an area. I welcome the students who are arriving excited about the year to come. All of us at public health will do our very best to serve these newest members of our community. And now, onward.
Reporter Daniel Mintz of the Mad River Union, the Independent and KMUD News asked, “In an August 11th email to HSU you stated that you believe on-site instruction cannot be accomplished safely at this moment in time. Since then you have said HSU is planning to go ahead with on-site instruction and public health will be partners and provide support. Do you still believe on-site instruction at HSU cannot be done safely and can you describe the degree of risk on-site instruction poses at this point?”
I think the bar is high. I think it’s going to be challenging based on the environment in which we find ourselves currently. I think the staff at HSU have done a lot of planning around this in terms of structuring classrooms and environments to help facilitate safety. I think there is certainly risk in this setting as we’re seeing play out in universities in other areas of the country, but we will be working with them to minimize the impact for the university to minimize transmission in our community.
Reporter Daniel Mintz asked, “In your emails with HSUm its president claims that you made ‘prejudicial statements’ about students and he said, ‘It seems irresponsible to assume that students from outside the country are a threat, particularly in a county that remains fully open for travel and tourism.’ What is your response to his claim of prejudice? And does the risk level of reopening the university’s housing and in-person instruction differ from travel and tourism?”
So I think for the most part this is already answered in my opening statement. I would just point out in terms of travel and tourism, you know, certainly we find travel and tourism that is certainly also a risk. However, again I just point out that the the biggest driver we have seen of cases locally has been either residents traveling outside the area or bringing family and friends here to stay. And so I think it there are some differences in level of risk. And then of course when you add aggregate housing in, it just adds to the mix. So they’re not completely analogous.
The HSU Lumberjack asks, “During your email exchange with president Tom Jackson, you stated concerns with the plans for dorm living and the start of in-person classes this coming September. With the first confirmed cases of a student and staff member, how confident are you in HSU’s plan to continue with the semester?”
The reason we wanted to do screening, testing with students is because we knew statistically speaking it was likely that we would identify a small number of cases, estimating probably five cases, perhaps a bit more. And so it is not surprising to me to have identified a case. The reason even relatively small numbers of cases are important is because when you have those cases in this sort of setting, in a congregate setting, it’s just much easier for transmission to occur, similarly to what we see in households.
So I think that the presence of this case doesn’t change our plan going forward except that we want to make sure we are doing the testing and trying to monitor progress on isolation quarantine should it occur.
The HSU Lumberjack asked, “With students moving back in, sharing common spaces such as kitchens, bathrooms and eventually classrooms, what are some things that must be done to ensure that they stay safe?”
So, again, the HSU planning team has put a lot of effort into trying to make the environments as safe as possible in similar ways to what schools do in our K-12 system, and so I think that the designation of single-room dormitory living has been really helpful so that the students are not sharing that close a space for prolonged periods of time. Certainly cleaning and some of those things are considerations that they have planned for, and so I think they’re working on constructing an environment that is as safe as possible considering the pandemic that we’re in.
The North Coast Journal asks, “Given the public health lab’s currently limited capacity of about 120 tests a day, how do you plan to triage the testing needed at HSU, almost 800 people twice over a 14 day period, with other testing needs locally?”
Well, as I mentioned at the outset, it’s a challenge right now for sure. There are a lot of competing needs in the community and our laboratory is being quite taxed right now, and so they are working very hard at getting specimens completed in a timely way within that 72-hour time frame that we aim for.
And so what we are talking with HSU about is the possibility of using some commercial lab resource for the follow-up testing so that all of that is not placed on the public health laboratory and that will help increase our capacity for everything else.
The North Coast Journal asks, “Given the reservations you expressed about HSU’s plan to reopen campus housing and on-campus instruction, do you have those same concerns about local K-12 schools that have opted to begin the year with in-person instruction? Why or why not?”
Well … as I stated, whether we’re talking about K-12 schools or universities or colleges, there are concerns about bringing people together. I think the difference in the K-12 schools is obviously we’re not talking about congregate housing, and we’re also talking about children coming to school and going home. We’re taking away a lot of that ability to intersect during the school day that we see on campuses as part of normal life. And so I think they’re not quite analogous in terms of risk. And we’re addressing their needs individually, as separate entities.
The Redheaded Blackbelt asks, “Looking at the breakdown in case origins, can you tell us roughly, of the section identified as ‘Contact to a Known Case,’ can you estimate what percentage of those cases result from travel versus via community spread?”
Well, I’m sorry, I don’t really have an estimate for you today on that.
The Redheaded Blackbelt asked, “According to a data worksheet made public by the state, Humboldt has zero beds ready to accept patients and identifies each of the facilities type as Skilled Nursing Facility for surge planning. Can you please explain if this is accurate and if indeed our local surge capacity is reliant of SNF capacity to handle an overflow of COVID patients?”
So we generate our data sets locally and so when I look at this I guess I’d have to look at that site and see specifically what they’re addressing, but I do think it’s important to know that a lot of times when we’re looking at bed capacity in a hospital, we’re looking at staffed bed capacity. That means how many boots are on the ground that day to manage patients. Well certainly hospitals staff according to their census, so it does not mean that there aren’t additional beds available. It simply means they haven’t staffed for those beds for that day, so it’s really important to look at some of those distinctions when you’re monitoring some of these graphs or tables that are available.
SNF capacity has not been part of our surge planning per se in terms of taking hospital overflow. Our alternate care site, should our hospitals become overwhelmed with patients and need to be able to move some patients off site, our alternate care site is what we would be using for that purpose — moving people who have very low acuity needs, aren’t quite ready to go home, but really don’t need high-level hospital care, putting them in an alternate care site to make that transition is really the plan.
Now certainly, in the event of a surge and us having a lot of strain on our health care system, it’s important that our SNFs are protected, that we’re not seeing outbreaks in that setting, that we’re able to move patients who need to go from a hospital bed to a SNF bed expeditiously. That’s just an important part of our planning process. But they are not part of the process for overflow.
The Redheaded Blackbelt asks, “Has the OptumServe location renewed its contract with Humboldt County? And if not ,will the Redwood Acres location be reconfigured for analternate testing facility? If the Optum site is going to renew, will they be using the anterior, shorter and less-invasive Q-tip-style swabs going forward?”
Really good question. The Optum site currently has a contract with the state that will go through the end of September. We don’t know what will happen with that contract after that time. It would be an option for the county to use Optum ongoing, but we are actually looking at building alternate testing capacity that is not Optum-related, and so we’re hoping with the plans that we have in place that that would be operational in October. But we still have a few hoops to get through to be able to ensure that that is going to be a good possibility.
What we’re looking for is the ability to test in multiple areas of our county and we want the ability to have a quick turnaround time under testing. So we’re working with a lot of community partners on how to structure this and make it operational for our community, and I think it actually will provide good capacity for our public, which would be wonderful.
The Times-Standard asks, “Can you explain the process [whereby] students, staff and community members will find out cases related to school sites where in-person classes are being held? How much of the process is left up to the school districts?”
So, in developing guidance for the schools, we provided an organizational chart that really talks about what to do if a student is ill and goes home, what to do if a student is diagnosed with COVID, what to do if a student is in a household with someone who has COVID, that type of thing. So we have guidance there about management of that in terms of contacting public health, what testing needs to be done. There are actually template letters for families related to those exposures and possible exposures, so they actually do have quite a bit to work with.
Obviously, our liaison nurse will be working with the schools as well so that we can help them manage any cases there and all the questions and things that typically come up, as well as issues of isolation and quarantine.
The Times-Standard asks, “Is there an exposure threshold that the JIC weighs in notifications to the public?”
If this question goes to the idea of basically identifying businesses and such where an exposure may have occurred, I would say that in general in our investigations we don’t do that, unless there is a concern that there is a public intersection and we cannot identify the public that may have been exposed. So if we feel it’s important, it’s a high enough level of exposure that’s of concern, we have done that.
Again, as we go forward, there’s a tendency to do that less simply because there is so much more potential exposure across the community.
Redwood News asks, “With the recent rise in cases, how close is Humboldt County to being on the governor/state’s COVID-19 watch list? What would it take to push us past our current threshold and onto the list?
So our healthcare capacity is solid right now, and the things that would push us on to the watch list, the earliest thing probably would be our case counts. So we’ve talked before about this, that a case count of 25 per 100,000 [population] alongside a positivity rate of more than eight percent would put us on that list. We exceeded that 25 quite a while ago, but our positivity rate has remained low, relatively — in the threes.
The next bar the state uses is if you reach 100 cases per 100,000 [population], then you go on the list regardless of your positivity rate. And to give the community a sense of where we are, about two-and-a-half weeks ago, we were at around 30 cases per 100,000. !e are now at 62 per 100,000, so we’ve more than doubled that over that period of time. And that is an important consideration as we look forward. I’m very concerned about this increasing case trend. And so we are watching that very carefully.
Redwood News asks, “Right now we’re seeing the biggest increase in cases among younger people, i.e people under 20 and in their 20s. What are your biggest concerns about this age group? What would you like to say to them about the spread of COVID-19 and their risk moving forward?
It’s absolutely correct that this age group — not only locally but nationally — is seeing a large impact by COVID in terms of case numbers. I think part of that is simply the nature of that age, the fact that many individuals who are in their 20s, for instance, are in the workforce. They’re on the front line in a lot of service industries and places where they’re having a lot of exposure potential. Also in that age group there may be a bit more socializing and interaction than we see in some of the other age groups, particularly if you compare it, for instance, to seniors who as a group are tending to be more careful about sheltering in place and really reducing exposures.
So my message to individuals this age is, No. 1, if you’re out in the work workforce and such, I really appreciate that work that you’re doing. I would like everyone to be as safe as possible, and adhering to those things we’ve been talking about such as use of facial coverings and distancing are so incredibly important, even though it’s really difficult.
I understand in terms of friends, social interactions, all of that and I would also like to mention that oftentimes young individuals are asymptomatic and/or mildly symptomatic, so I do think it’s really important for people to pay attention to how they’re feeling, that some of the times those things where you’re just not feeling quite well and you might brush off, you really need to think about — because if you identify concerns and you can be tested, it can certainly prevent further exposures to individuals in your household or in the community.
North Coast News asks, “With recent wildfires, how could the smoke impact COVID patients, i.e the cluster in Hoopa where they are under a heat wave in conditions that are already challenging to breathe in?
The wildfires are obviously of concern and we worry about smoke impact for everyone. And of course individuals who may be having respiratory symptoms due to COVID would be put under more stress by that condition. I think that Hoopa, unfortunately, has had to become quite conscious of this because of wildfires over the years, and I think they are carefully watching their population. But it’s obviously a concern for all of us going forward.
North Coast News asks, “Can you explain why young adults seem to be getting COVID locally more than others?”
Again, it goes to the point we discussed: We have a lot of young individuals who are in our workforce out and about, and all the other factors that we discussed.
North Coast News asks, “Does the data show that you can catch COVID more than once?”
Well, recent data is really suggesting that it’s very unlikely that we are seeing re-infections, certainly within the three months after a COVID infection. The problem is this pandemic isn’t very old. We don’t have any really long-term data on whether reinfection is possible yet and so we’re going to be watching that carefully.
Some of the studies that are immunological that look at your body’s immune response to the virus seem to suggest that even though many people don’t get a strong antibody response to the virus, they actually may have some of the other pieces of their immune system — their T cells, for instance — that are aware of the exposure to the virus and are primed to sort of react if you become exposed again. So i think we’re going to have to wait and see a bit on how this plays out.