An important message from Lake County’s Public Health Officer, Gary Pace, MD, MPH.
Lake County, CA (March 26, 2020) – We have entered uncharted territory since the Coronavirus came to the Bay Area. In a little over a week, the schools have been shut down, most businesses have closed, many people have been furloughed from work, and most social activity has been eliminated. The economic impact will be felt for a long time to come.
The number of new infections in China has been dropping recently, presumably because of their major efforts to stop social contact and isolate people when they became sick. Northern Italy, and now Spain, are having real problems with exploding numbers of cases, probably at least partly due to a reluctance to limit travel and social interaction. New York has become an epicenter of infection in the U.S., but the push to clamp down on social contact may be somewhat slowing the spread.
Here in Lake County, we continue to have no confirmed cases. Our relative isolation has been a real benefit, and the efforts to “shelter in place” may have helped to slow the entry of the virus into the county. Since non-essential businesses have closed and social activity has been curtailed over the last few days, we have seen a huge drop in general activity in the county.
How long will this go on?
While we have some reference points, it is impossible to know how long the United States and our region will face Coronavirus spread. If we look at the global situation, China’s curve of infection started dropping fairly quickly after about a month of viral activity. They took extremely strong measures to stop the spread, probably more restrictive than anything we will be comfortable doing in this country.
Will we have to wait until all of the infection has passed before loosening up?
Again, we really don’t know at this point. We will probably at least need to see the infection rates dropping, and have strategies to protect the elderly and those with underlying medical problems from getting infected. Accessing a sufficient number of tests will help us determine who is infected, who is at risk, and how to manage the outbreak. While County Public Health staff and regional and state partners are diligently working to increase availability of tests, issues remain.
So, what about testing?
Testing continues to be a big issue in Lake County and throughout the region. We put a recent article from the LA Times on our website (https://www.latimes.com/california/story/2020-03-24/california-coronavirus-outbreak-testing), illustrating the challenges most jurisdictions are having in accessing coronavirus testing in California. On a recent call with regional Public Health officials, I heard it described as, “Like the Wild West” in California, because each county and local health care facility is fighting independently to get supplies and lab access. A much better solution would be for the state to step in, and help coordinate laboratory testing, but that doesn’t seem to be happening.
We recently assigned someone on our team to research possibilities for supplies, and to cobble together some strategies for getting tests to the community. Local hospitals have wisely been very careful to use their testing supplies only for the most serious cases, since they haven’t been able to get any materials through their usual supply chains. There are assurances at the state level things should become more available in the near future.
What problems is the lack of testing causing?
From an individual patient point of view, not being able to get tested unless one is extremely sick can be frustrating. If your medical provider won’t send you for a test, that is due to CDC recommendations and a limited supply of testing materials, not because they are not wanting to help you. We would very much like to test individuals with mild symptoms, but given the shortages, that isn’t possible. We did recently sample a small number of mildly symptomatic people, and all tests were negative.
In reality, the lack of testing poses challenges, but it doesn’t change what we need to do now as a community—prepare, stay home, keep social distancing. It is very likely the virus will arrive here in the coming weeks (if it hasn’t already), but any delays in its entrance are helpful for preparations, and buy time to get the supplies we need.
At this point, everyone is essentially “self-isolating.” If you are sick with fever and/or cough, even without testing, isolate yourself from family members, especially if they are elders or people with underlying medical conditions. The current recommendation is to stay away from uninfected people for at least 72 hours after the fever passes, and at least 7 days from the beginning of symptoms. Prior to returning to regular contact, any cough should be improving, and a mask should be worn when around other people until the cough is resolved. Contact your medical provider if you feel you need some help. Most clinics remain open, although there is a trend toward using telemedicine to see some patients.
Gaining further capacity to perform tests will help control the spread in our communities, and inform decisions to return to normal activity. At this point, social distancing and sheltering in place are the best community strategy; self-isolation, even with family, is important when someone is ill.
For more information, visit the Lake County Health Services Department’s website: http://health.co.lake.ca.us
If you still have questions, send an email request: MHOAC@lakecountyca.gov.
You can also call during business hours: 707-263-8174
Thank you, everyone, for your cooperation. Continued effective collaboration among our local healthcare providers, City, County and Tribal governments, and law enforcement, is essential, but limiting our collective risk requires everyone in Lake County to do our part.
Gary Pace MD, MPH