Today, Dr. Josh Ennis, Humboldt County’s Deputy Health Officer, took a number of questions from the media on various aspects of the pandemic — hospitalization statistic-keeping, zip code tracking (again), symptoms of disease, surging case numbers nationwide and what they might mean for restrictions, rapid testing, kids and weddings.

Video above, rough transcript below.

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The Redheaded Blackbelt asks, “Dr. Frankovich has said that if county residents want to know the number of current hospitalizations in the county, they may check the state data workbook on hospitalizations by county (see screenshot and link below) to find that number. While it is not readily available on the county dashboard, it may be found by navigating the much more complex state data collection system. Please tell us if the current data shown by the state (see following screenshot) is an accurate reflection of current county hospitalizations, and can you please talk about the way this data is applied to the state and explain what the lag time may be in the data between county and state, and why these variations may exist?”

In general, the state-maintained database for hospitalizations is correct and as of today we know for a fact that it is correct. We have a parallel system that we use for investigations and tracking hospitalizations and so in general it is correct. I may counter that it’s one click — you click on hospitals and you click on our county, so navigating there is just a few clicks. There’s a lot more information, but it’s a pretty simple process to get there.

The Redheaded Blackbelt asks, “As a follow-up to the previous question, if the state dashboard is not reflecting accurately the hospitalization data, please identify what you see as the problem. For example on November 2nd the county COVID-19 case count jumped up by eight cases according to local data, suggesting that additional hospitalizations may have occurred over the Halloween weekend, while the state’s CDPH dashboard reflects zero available ICU beds in Humboldt County — of the regular ICU beds in the county which include four COVID ICU beds at St. Joe’s and total 14 regularly.”

I think I need to clarify a few points in here just to help people understand this better. Case counts are not the same things as hospitalization, so when we report out eight cases on this past Monday, for example — that includes all cases that came in Friday, Saturday and Sunday — it says nothing about hospitalizations, and so that is a completely separate report. They are not the same thing.

Secondly, the number of ICU beds is far more than is listed in this question prompt. At normal operations it’s probably somewhere around 20 or 22. There are plans to go far beyond that. And then lastly, this question asks about available ICU beds. That is asking how many beds have a nurse standing by ready to accept the patient, and because of, you know, supply and demand, it’s the practice of most hospitals to have slightly more beds available than the demand. And so they can staffed to the demand and so this number would be really misleading to key in on as you know what kind of capacity do we have.

KMUD News asks, “Last week on the county’s COVID-19 dashboard the town of Garberville reportedly had 10 recorded cases. However the dashboard now reads seven reported cases. Can you share information on the change?”

Sure. The ZIP code data comes directly from a state database called CalREDIE. As cases make their way into that state database and through the investigation process, as well as some of the efforts that the state pursues, there is data de-duplication, there is reassigning of cases to home jurisdictions based upon address of record. And because of things like this occurring, the numbers can bounce aroun — they can go up, they can go down, and so this is entirely separate from some of the stuff we look at at the local level with our local database.

And so because of this, acknowledging those limitations, it really can’t be used as a day-to-day measure of where there are hot spots. And again, I would just reiterate it says nothing about where the exposure occurred, it just tells you where they live.

KMUD News asks, “From your experience treating COVID-19 positive patients, have the symptoms of the illness changed since the beginning of the pandemic?”

The symptoms I think have not necessarily changed, just we’ve developed a much better understanding that these symptoms have a huge range of what they can cause or what people can experience as part of the illness. People can be completely asymptomatic or they can have what we initially thought was primarily a respiratory illness. We’ve seen everything in between. We know 80 percent of people do well, are fine, no symptoms, mild symptoms, and another 20 percent get much sicker. We just have a better understanding, I don’t think that has changed at all.

KMUD News asks, “Yesterday was one of the largest increases in COVID-19 cases nationally. Locally we are also seeing a rise in cases. Do you think our country and county are heading toward another shutdown?”

I don’t think I could speak for what’s going to happen across the country. I know that our county is definitely seeing an uptick as a result of this third wave across the country, and a majority of the cases are related to travel to states with lots of disease.

I think one thing we learned early on is that flipping the switch between lockdown and fully open is not practical. It’s extremely difficult for people to implement. And so,  you know, I think what we’re trying to facilitate is more of kind of a you know, a graded response ,and that’s reflected in the tier system that we see that the state has rolled out.

So there are kind of intermediate baby steps, so to speak, rather than just flipping a complete switch and going into total lockdown, which, you know, no one really wants. 

The Lost Coast Outpost asks, “Is rapid testing available anywhere in the county? If so, how would one access it? Is there any prospect of expanding the availability of rapid testing?”

I’m going to assume that this question for rapid testing, they’re referring to point-of-care tests. The point-of-care tests generally look for evidence of disease that’s different than what everyone cites as the much more accurate test, which is PCR-based.

In general, our county has adopted the position that the rapid point-of-care tests, because of what they’re looking for in the technology, they just don’t perform as well. And so if we’re gonna, you know, make decisions about asking people to stay at home in certain scenarios, if they’re infected or other people are exposed to the infected individual, we want everyone to feel confident in those results, and so we’ve generally supported more efforts around PCR testing.

Now, I will tell you that there are many outlying sites now that have their own machines and we have been supporting that, and so if someone wants to get tested, whether it’s rapid or not, I’d encourage you to go through your usual means of contacting your primary care provider. Everyone knows we also have a few other options such as the the OptumServe site, such as some of the pharmacies that are participating in non-clinical care testing.

So I know that’s not really answering the question to some degree, but there are more and more tests and they’re getting faster and faster using the good technology and so I’d encourage you just go through the normal routes you’d use for obtaining medical care. 

The North Coast News asks, “Can my child hang out with their friends at this stage of the pandemic in Humboldt?”

So, I might use this question as an opportunity to talk about children in education a little bit. You know, I think many of us who are parents are concerned about our children and their emotional and well-being, their social development, and I hear that. I feel that.

You know, there are a lot of questions that we can’t answer right now about what kind of effects this may have on children and so this may be a good opportunity to again talk about how we’re nine months into this, it certainly is not going to go away anytime soon and we really need hard a hard re-examination of how are we delivering education and how can we get kids back into school and do it safely for everyone.

The other part of this answer is that this the state’s been very clear about the guidance of three stable households being able to mix and keeping those households stable over time, just to minimize the risk of overlapping with multiple different households and having,  you know, a chain of exposures that rapidly grows in the wake of a positive case. 

The North Coast News asks, “What are the rules of a pandemic wedding in California?”

About two weeks ago the county put out guidance on this very issue. The state also has guidance on this in their Places of Worship Guidance. The thing to know is that all this is tier-based, and so it really depends upon which tier your county finds themselves in. You know, at one end it allows for some indoor, there’s gradual phasing out of capacity. The highest stage tier is outdoor only.

You can go online and look at the guidance that’s available. We have resources on the county website, you can also take a look at the CDPH Places of Worship Guidance.