Dr. Ian Hoffman, Humboldt County Public Health Officer, took questions from local reporters today. Most of the questions had to do with Supervisor Rex Bohn’s request for his board to sign on to a letter asking the state to devolve pandemic-related economic decisions to the counties, but there were also a few questions about vaccination and the recently discovered variations of the virus.
Video above, rough transcript below.
From the North Coast Journal: “Based on Humboldt County’s epidemiological data, do you think any consideration should be given to loosening local COVID-19 restrictions at this time? Why or why not?”
I think I’ve said many times, and hopefully it’s been clear, that our data locally suggests we should be in the purple tier. That has not changed at all, in fact it’s only worsened, and so no, I do not think there should be any loosening of restrictions at this time.
From the North Coast Journal: “Is implementing COVID-19 guidance and restrictions by zip code a viable proposal? Why or why not?”
It’s certainly not one that Public Health is taking or has looked at, I think there are logistical concerns, you know the way that people move about in our community is not only within their ZIP code, ZIP codes are quite small areas, so that’s why we’ve gone with a county-wide approach.
From the North Coast Journal: “Do you see value in a statewide approach to COVID-19 restrictions? Why or why not?”
I think again I’ve been very clear on this, that we do think the statewide approach has value, and would continue to follow that approach.
From the North Coast Journal: “Do you feel it’s important for local officials to maintain a consistent, unified message regarding the efficacy and importance of local and state health orders and guidelines? Why or why not?”
I think it is helpful if we can all be on the same page t o put that out there. Obviously there are folks who don’t always agree, and we try to bring people to the table to have that discussion before we put policy out there, so we are always trying to work towards a unified message, but sometimes the communities we’re representing aren’t unified in that approach, so we’ll continue to work towards bringing people to the table and talking and trying to get everyone on the same page.
From the Redwood News: “You’ve mentioned in the past that our local data wasn’t in line with the State’s tier assignment for Humboldt County…i.e., us being in the red vs. purple tier. Some local leaders are talking about the Healthy Communities Resolution that essentially calls for freedom from the State’s covid regulations, and also objects to the tier assignment system. What does Public Health think about this resolution? Does the County have any plans to deviate from the State’s tier assignments and focus on more local regulations?”
So lots in that question, I’ll start with the local data not being in line. Whenever that’s happened, it’s that our data locally suggests that things are worse here, not better, so in those circumstances we’ve talked about being more restrictive than the state, not less restrictive. The recent red tier movement was mostly because of the state’s blueprint, was entirely because of the state’s blueprint and the equity metric gave us credit for taking care of disadvantaged populations, and having lower COVID rates in those parts of our society here in Humboldt County. So I think we will continue to follow that, and if we see a message locally that looks like it should be more restrictive, talk to our leaders and see if there’s an appetite for a stronger health order versus just recommendations, just like we did recently. I think that those would be the only plans to deviate from the tier system at this time.
From the Lost Coast Outpost: “The Board of Supervisors on Tuesday will consider a resolution brought forth by Supervisor Rex Bohn asking the state for more local control over COVID-19 regulations, including the ability to implement zip code-specific regulations and reopen schools. Would this resolution be helpful to Public Health? How would it change the county’s approach, if at all?”
So I think the ZIP code, we already addressed, and in terms of schools, schools have always been supported by Public Health to remain open when it is safe to do so. So from the beginning of this pandemic, in March, my predecessor Dr. Frankovich, Dr. Ennis, they worked with the schools to try to keep them open. There were many local decisions made by school boards, teachers, families who didn’t feel that that approach was what they wanted to do. The state approach has also encouraged opening of schools and trying to support it. And so it was not until recently that we moved to the purple tier that there were restrictions on reopening any schools. But from March until November, any school that wanted to open was encouraged to open, and we tried to support that as best as we could at Public Health.
From the North Coast News: “We are seeing that some vaccines aren’t being utilized across the U.S. despite the high demand. Is Humboldt using their full allotment? And, when will the county be getting their next allotment?”
Yeah, so as I’ve been saying, we get allotments each week, and that can vary from week to week. So we’ve had weeks of getting thousands of doses, some weeks of getting hundreds of doses. Not all of it has been used, but I think we are online to use up, all of what we have on hand in the next few weeks, and hopefully we are beginning the phases of looking into the next steps of Phase 1B as we wrap up Phase 1A. And you know, I think that we’ve been told by the state that, for at least the next probably month or two months, the amount we’re getting is likely to be fairly consistent of first doses, and that has been about one to 2,000 on average every week, and so I’m hopeful that we will continue to get that one to 2,000 doses each week in the coming months.
From the Two Rivers Tribune: “With all concerns regarding the efficacy of vaccines and mutated strains of the virus, and possible false-negatives caused by the variant strains, Please share your biggest concern of impacts of what the variant strains can cause the county, do we think they have arrived already?”
So with these new strains there’s always, this is a virus that has continued to mutate and always will mutate. One of the things about Coronavirus is that it’s fast moving and mutates very quickly. Most of those mutations die out, some of them catch on.
You know with regards to ones that have affected testing or vaccine, we have not seen any significant evidence to that, certainly we’ll keep people apprised if that is the case. In terms of whether that is circulating significantly here, I think it’s highly unlikely, we do know that there have been cases in the state of California, but we have no evidence to suggest that it’s here in Humboldt County at this time. The epidemiological data that’s being done, surveillance at a nationwide level, suggests that only one in 1,000 people who have been infected with the Coronavirus recently have these variants.
So it’s a pretty low likelihood, but again if we are not able to control the spread of the virus, just like it did in London and in England, it could take hold much more quickly, so there are a lot of efforts being done nationally and in the state of California and locally here in Humboldt to do surveillance for these variants and try to get ahead of it before it takes a strong hold.
From the Lost Coast Outpost: President-elect Joe Biden has signaled that his administration will pursue a policy of shipping vaccine as quickly as possible, rather than holding back second doses for booster shots. At the same time, the California Health Department says that it is making a strong push to ramp up vaccine delivery over the coming days. How is county staff adapting to the push to deliver vaccine into arms faster?
Yeah, as of right now we have no directive or evidence to start delaying second doses, so we have started this week with second doses as they come in and as they were planned. In terms of how we are trying to adapt, we sent Public Health staff into skilled nursing facilities to vaccinate over the last few weeks to try to speed things along. We opened up a public health clinic last week that has greatly increased the capacity and our staff and myself have been working with local health leaders to encourage increasing the number of appointments for giving vaccines in the coming weeks.
From the Redwood News: Has Public Health done any surveys or polls to gauge how the community feels about getting vaccinated for Covid-19? Does PH have a general idea of how much of the community is interested in getting the vaccine when it’s rolled out to the general public? What would you say to those people who may be hesitant about getting vaccinated?
So yes, we have been doing surveys. We did survey all of our healthcare partners early on to see what the interest was and how many folks they would need. We recently rolled out a community survey to get that sort of feedback on a broader population of Humboldt County. And that is just starting to come in. From the general uptake of the vaccine nationally, we’ve seen places where you get upwards of 90% of people taking it and sometimes less. It averages around in the 60-70% range for most places in terms of uptake of how many were offered versus how many people took it. I think that for anyone that is hesitant for this vaccine, I would start by saying it’s a safe vaccine. It has been through its trials. We’ve now given it to millions of people here, as well as around the world - many millions more. And we haven’t seen great changes in that concern for safety. So it continues to be a safe vaccine. It’s also a highly effective vaccine - one of the most highly effective vaccines we’ve ever seen at 94% efficacy which is much greater than we could have ever anticipated. So if we want this pandemic to end, this is really the tool that we need to have this pandemic end.
From the North Coast News: Do you think that incarcerated people should have higher priority for vaccination over other elderly or high-risk groups? With Del Norte County so close and Pelican Bay — is it wise to prioritize those populations given outbreaks that can potentially affect the outside community?
We have not reprioritized in Humboldt County, incarcerated or other groups who are in the tier 1B. These are extraordinarily difficult decisions that have to be made. If we look at the numbers of people who are affected by this, the group 75 and older, absolutely have the highest risk of being hospitalized, having bad outcomes, and certainly of death. So, from the standpoint of protecting those that are at the highest risk from bad disease, that’s why we will prioritize those who are 75 and older in phase 1B. As more information comes out, if this does really look like a tool that will reduce the spread of COVID-19, those conversations could change - that going into areas where there is higher likelihood for spread. But right now, the vaccine is really a tool to protect the individual, not to protect the society.
From the North Coast News: With hospitals so overwhelmed in other parts of the state, and the CDPH ordering facilities with room to accept patients from those at capacity, will Humboldt County accept patients from out of the county into our hospitals?
As I’ve answered this before, we are not at a place right now. This is a possibility as things worsen across the state. So I would stay tuned and we’ll see how things go in the coming weeks with surges worsening in areas that are closer to us.
From the Redheaded Blackbelt: At this point, does Humboldt County expect to receive transfer patients from other regions, such as from the Bay Area where ICU capacity is at 3%? If so, would these be non-Covid patients, or would there be a possibility that Humboldt could be receiving COVID-positive transfer patients? Please elaborate on how those decisions to transfer an individual are made, and what factors are considered in addition to available beds?
So, also like I’ve mentioned before, I think if we are going to get transfers, they’re going to be from areas that are much closer to us like the Bay Area or potentially even closer like Mendocino, or Del Norte. The current state of affairs from the state, the only request for transfers have been COVID patients. As far as I know, those have only come from counties in the far southern reach of the state, many hundreds of miles away. We don’t know what that could look like locally though, as this push of hospital cases comes closer to our county. The decision to transfer is made on a lot of things. It’s not just based on bed availability, it’s really based on concerns for the stability of a patient. There are factors of cost of transferring patients over longer distances and then local conditions that are allowing that accepting facility to have the ability to also care for the patients there locally.
From the Two Rivers Tribune: What information can you give us regarding the amount of variant stains of COVID-19 which have been detected in the State of California, and what factual information can you provide in those regards?
So I think we’ve pretty much answered this in the previous question. There is the U.K. variant that is slightly more contagious in terms of its spread that is circulating here in California, at extremely low levels, has not been picked up at high levels yet. There has been none found in Humboldt County to date. As far as we know, these strains are no more deadly, or making people more sick than the other strains. They just seem to be a little bit more contagious, and that number has changed dramatically over the course of the past few weeks. It’s hard to pinpoint exactly how much more contagious this variant really is, but as we learn more about it, it seems like that number has come down each week, in terms of how much more contagious it is than the widely circulating variant.
From the Redheaded Blackbelt: Can you please update the community on networking efforts to rally additional nurses for expanded hospital capacity?
We have, as public health, started to collect information from our health care volunteers who want to help in the vaccine effort. These are EMT’s, paramedics, nurses, other folks in health care who want to volunteer for the vaccine effort. In terms of the hospitals, I keep in touch with the hospitals about their surge planning capacity. They definitely are watching their staff very closely. I don’t know of any volunteers for that level, but I do know that there is a lot of look at what our local capacity is and how we could pull in and rearrange things to use some of our local resources if we had a surge here in Humboldt County.