Today was Dr. Teresa Frankovich’s last day as Humboldt County’s health officer. Frankovich was hired to the nominally part-time position shortly before the pandemic began and resigned — technically — at the beginning of September. Events turned the job into something she had not signed up for.
Deputy Health Officer Dr. Josh Ennis will fill the position until next week, when the Board of Supervisors is expected to name a permanent new successor. Frankovich will be sticking around; in the future, she’ll serve the county as a deputy health officer, on the part-time basis she was originally hired for.
Today she took questions from local media outlets, and she has been doing since nearly the beginning of the pandemic, and she said farewell to the county with a very moving exhortation to her fellow citizens to keep the faith for just a little while longer. It looks very likely that the end is in sight.
Video above; rough transcript below.
Hello. As some of you may be aware, today is my last official day as the Health Officer for Humboldt County. Next Tuesday, Dec. 8, the Board of Supervisors will have approval of the new health officer on their agenda. Until then, Dr. Ennis, deputy health officer, will provide coverage. On Dec. 14, I will be moving into my new, part-time supporting deputy health officer role. We will be doing media on Friday to provide information about the transition, and the incoming health officer. Before I respond to today’s questions, I just want to say again how grateful I am for having had the opportunity to serve as the health officer for Humboldt County.
I have found out the hard way that the fastest way to learn what is at the core of your new community is to face a pandemic together. I don’t recommend this approach. But the gift has been seeing the incredible heart of this place, the way most of us have recognized this as the moment to practice what we teach our children about kindness and the responsibility we all have to one another.
And as hard and exhausting as this has been, I would do it all again, because it has been a privilege to be able to do important work, and to do it alongside and on behalf of people I deeply respect and admire. Every day I am literally surrounded by my personal heroes at Public Health and the EOC who have given their all to this effort for 10 months now, and still show up every day to do it again. This includes every person supporting this effort, and all of those holding down the fort on everything else that still needs to get done. For a very long time, longer than every other large county, we held COVID-19 at bay.
Finally, as most of the country and the state surged in cases, we began to see the impossibility of keeping COVID forever outside our gate. But the time gained has made us far better prepared than we would have been last spring. As of next week, we will have tripled our Optum capacity, including a mobile unit that will test five days a week in locations across the county.
This asset, together with our outstanding internal lab, will bring testing capacity to well over 3,000 specimens per week, more than 100 times what we could do at the start of the pandemic. In addition, our new regional testing partnership with UIHS and Del Norte County, is finalizing its preparations and is expected to begin adding to our capacity sometime this month. Our stellar contact investigation team has been expanded and refined over time. Together, we have made the move to a state contact tracing platform, bringing increased efficiencies to our process, new tools and additional staffing to meet the growing response need.
Our alternate care site preparations are nearly complete through the dedication of our EOC team and our partner in this effort, St. Joseph Hospital. I see this as an incredible safety net for our community as we watch what is playing out across the country and in parts of California. We still hope to never need it, but it will be there if we do.
Our Joint Information Center team continues to do what it has done in extraordinary fashion from the start, helping to ensure everyone in the community has the information they need to navigate through this pandemic. Those in the community who have called for information are met with warmth and civility and answers to their questions in real time.
Finally, to all of you, the journalists in our community, who have worked so hard to inform the public throughout the pandemic, I extend my deepest thanks. We’ve all been talking about COVID and living with COVID for a long time and it would be tempting to move on and drift away in coverage, but you have steadfastly hung in there, following the science and bringing it to Humboldt residents, and for that I am forever grateful. Your dedication has helped to keep our friends and relatives safer.
We’re entering a challenging period in this pandemic, with surging cases and threatened hospital capacity statewide. It’s going to take concerted effort by all of us, and continued sacrifice, to move through this wave with fewer severely ill individuals, and fewer lives lost. But the vaccine is coming, data suggests it will be safe and effective and is likely to be the thing that propels us forward out of this pandemic and the enormous toll it has taken on all parts of our community, children, families, businesses, schools, and the most vulnerable across the county. But I am hopeful we will celebrate its end soon, and we’ll celebrate it together, all of us, healthy and together. It will be a most amazing day.
The North Coast Journal asks, “On your last day as Humboldt County’s full-time health officer, what advice would you offer your successor?”
Wow. Well, um, I think the biggest thing is really listening and asking questions. I think we have developed an incredible amount of expertise here, within our Public Health department, within our EOC, and with our state experts. And I think forging relationships, asking questions, and being willing at the end to take all the information and make a decision that may not be the popular one, but is the right one to do, I think is probably most important. That and reading everything you can read is essential.
The North Coast Journal asks, “What have been the most rewarding and challenging aspects of the job for you personally?”
Well I think the most rewarding has clearly been the people I’ve been working with and the community, there’s no doubt. Obviously there have been some people who are not supportive about what we’ve been doing, but it is, I believe, a minority of people. The vast majority of our community has been extremely supportive and helpful in moving us forward, and that has been incredibly rewarding. I think the single most challenging issue has been the lack of national policy on COVID-19 response, and the political divisiveness that arose out of that and I think it has made this more complicated than it had to be, and I think it’ll be a lesson learned going forward.
The North Coast Journal asks, “Reflecting on the past eight months, what do you consider to be the county’s biggest successes and shortcomings in responding to COVID-19?”
Well, you know the successes I think are pretty evident. I think the infrastructure we’ve been able to build, in a cooperative way across the community, speaks for itself. I think it’s really been an amazing, amazing team effort to accomplish that. The shortcomings, I think when we go back and look at all the response, I’m sure we’re going to find things we could have done quicker or better, it’s inevitable, and we’ll learn lessons from that. Hopefully we will not need them for a long time, but we’ll learn from it. But overall I’ve been tremendously impressed by what Humboldt’s been able to do.
The North Coast Journal asks, “What do you envision your role in Humboldt County’s pandemic response will be moving forward?”
Well I will be here as long as I’m needed, I will be working in a support role, part time, which will allow some of the flexibility I needed, so I look forward to contributing, and to being here when it’s done.
The North Coast Journal asks, “The governor warned yesterday that need in Northern California hospitals is projected to eclipse capacity by Dec. 24 if current infection rates continue. Do local models and projections show a similar trend? If infection rates continue, when do you anticipate local hospitals will run out of beds or the healthcare workers needed to staff them?”
I think that if we continue at the current pace, we may have issues prior to the 24th on a statewide basis, but locally we don’t actually construct models, our numbers are small enough that it makes it somewhat challenging to have something that’s predictive, but we do watch what’s happening across the state with our local data. I certainly have concerns about the impact on health care capacity locally with the case rate increase that we’re seeing right now. I think our hospitals have built an incredible amount of increased capacity, I think they have brought on increased equipment, including things like ventilators, as in many other places, we will need to staff all of that to provide adequate care. But my hope is that with some of the measures we have taken preventatively, with sort of ratcheting down our activity locally, that we may be able to prevent moving that far. But we have to prepare as if that may happen some time in December.
The North Coast Journal asks, “Some California hospitals are already in danger of exceeding available capacity. To your knowledge have there been any discussions about transferring patients into the county from other areas?”
Well certainly through our hospital-wide system, there are requests made through our Emergency Response, and for beds, if a facility is having difficulty, so we see those all the time. For the most part, those are in areas that are quite far from us and logistically not appropriate for transfer. So we haven’t really looked at transfers to our facility at this time.
The North Coast Journal asks, “You and Dr. Ennis have spoken repeatedly about available healthcare workforce being a likely limiting factor in efforts to increase local hospital capacity to meet a surge. Can you speak to current efforts to expand workforce capacity and where they stand?”
We continue efforts with our partners, discussions about how we will pull workforce into this. One thing I do want to point out is that again, we’ve designed the alternate care site to be very low acuity, really meant to be a valve, a pressure valve for the hospital, to take people who are nearly ready to go home, and provide a little bit of care for a day or two until they are ready to do so. So our staffing levels will not need to be very high to be able to accomplish that, and that will make staffing overall much easier. We’re counting on all of our health care friends in the county to step in and help when we need that, and we also have our disaster service volunteers that we will be looking at as well. In addition, the state potentially has assets, depending on what’s happening, and the state of course is able to ask the federal government as well. So, it’s a work in progress.
The Times-Standard asks, “Has Humboldt County seen any impact of the surge on local testing capabilities? If so, how? And is this being addressed?”
Well we’ve certainly seen an increase in testing volume and the need for that, and so we are very fortunate to have that Optum expansion to help meet that need. We’ve been ramping up internally hugely as well, I think our lab had over 1,200 specimens last week that they received. And we continue to work on our regional testing partnership to increase testing further. Finally we are receiving some rapid tests that we can help to distribute to acute care settings, so that they will have some ability to test symptomatic people in front of them, with a rapid point of care test, and these tests perform very well, actually for symptomatic individuals. So that should improve capacity as well. But we’re definitely feeling the strain.
The Times-Standard asks, “Where is Humboldt County at, as far as acquiring freezers to hold COVID-19 vaccine?”
We’re very fortunate because our partner, Providence St. Joseph Healthcare, procured ultra-low temperature so that we’re able to use those for storage of vaccines and the capacity there should actually serve the community well. It’s a great benefit for our community and we really appreciate that. So, we’re working collaboratively with them. These first doses will be targeted for healthcare workers and we hope to see these actually very soon in December.
The Times-Standard asks, “Can Dr. Frankovich address what changes the county might be seeing with a new stay-at-home order this week?”
I really don’t know. I was in a discussion with health officers and public health directors across the state this morning providing feedback of what that could look like. The governor’s office is obviously planning with the state public health leadership as well. I don’t know what the final plan is going to look like, all I know is they are looking for basically some concrete time limited interventions that are likely to be effective, highly effective. We want to use lessons learned from our previous shelter-in-place to inform this.
The Lost Coast Outpost asks… “What’s the most important thing you’ve learned during the county’s management of the pandemic? What advice will you have for your successor?”
I think as I alluded to earlier, I think a big part of this is relationships. I was new coming into this position, so I needed to forge those relationships. We’ve had a relatively long period to do that and the nice thing is that we really have solidified those with our partners across the county. And that means in a time like this, we are better positioned to respond because we are all very connected. Those relationships are a resource that rural communities really have in spades. And that really helps us out in a time of crisis. So that is really a good lesson learned from this. The other thing i would simply say, is that I know our business community has taken a huge hit through this COVID pandemic. The length of it and the restrictions are just daunting and so i do think we need to do increasing work with outreach to and in support of our business communities to help them through this. Thank you.
The Lost Coast Outpost asks… “Yesterday, Gov. Gavin Newsom hinted that California may be prepared to introduce new emergency measures to slow the rapid spread of the virus. What sorts of additional measures available to the state would be most effective in accomplishing that?”
Again, we really don’t know what this is going to look like. It really, I would imagine, will be looking at sector by sector. What type of restrictions make sense. What would have the most sort of bang for the buck, in terms of what we’re doing. And asking of people. And again, learning lessons from previous interventions that we’ve used to see what might be most helpful. I expect we’ll hear something this week.
The North Coast News asks… “With the CDPH recommending this week that all hospitals have staff tested for COVID-19 weekly, have protocols changed at hospitals here in Humboldt County? Have COVID-19 infections among health care workers impacted hospital staffing negatively?”
So far we’ve actually been very lucky and had very little impact on our hospital setting in terms of healthcare worker infections. And I credit them with the precautions they’re taking and the prevention pieces they’ve put in place. But we’ve also benefited from the fact that we have had a relatively low prevalence of illness. So, those prevention measures are all going to be increasingly important. In terms of the hospital testing, this is a new recommendation from the state and there is a timeline for hospitals to begin implementing this. We are in discussions with the hospitals about what strategies we can use to meet this. It’s a big lift to test all healthcare hospital staff, or all hospital staff in our community.
The Redheaded Blackbelt asks… “How many supplemental hospital staff are, as of this moment, enlisted to work the overflow site in the event that our local ICU is at capacity in the immediate future?”
Well we don’t have a roster of people that are signed up to do this. We will at that time - we have to make certain planning assumptions which are that certain healthcare operations are not going to be functioning as normal. If we are in a surge situation, those folks become available to help serve in this effort. And we are again constantly updating and reviewing our volunteer network that we have as well. So, it’s again an ongoing conversation across the healthcare community about how we’ll do this, but we’re counting on our partners to really step forward when we need it.
The Redheaded Blackbelt asks… “We’re trying to understand the ICU occupancy information. How many patients are currently in the ICU in the entire county?”
Yesterday, according to the state site, we had zero ICU beds available (though we believe the county has a total of 18 overall but “only” 5 COVID hospitalizations. It is really challenging to read this online. The problem is that most of the numbers that are presented are related to staffed beds. And our hospitals staff according to census. So if there are more patients, they bring on more staff, which increases bed capacity. What I would say is that we really are seeing - we do have some COVID hospitalizations. We really have not seen that as a primary driver of our hospital occupancy at this point, but hospitals obviously have a lot of other patients who need care and that is one thing we’ve been talking about is that we not only have to be able to house COVID patients, but everyone else who may need care. People who have heart attacks, strokes, people who have other urgent situations that need care. So we are monitoring this constantly as are the hospitals.
The Redheaded Blackbelt asks… “Have the average wait times for COVID test results jumped? For instance, one woman was tested on the 17th and has not yet received her results.”
Well I know that the Optum site now is sending all of its specimens to the state lab in Valencia. That lab is contractually committed to really good turnaround times of about 48 hours, but we have to add in our transit. I’ve been actually seeing some really good turnaround times from that. So I’m surprised by this particular test result, but I do know as they first ramped up, there were some growing pains there. So it’s not impossible. I would just say that overall I’m actually really encouraged by what we’re seeing right now, in terms of turnaround.
Thank you Dr. Frankovich, and thank you for your service.