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July 23 Lake County COVID-19 Update

Summary:
• 166 Total Confirmed Cases, to date
• 25 Active Confirmed Cases (“Active” means COVID-19 positive, currently being monitored by Public Health staff)
• 1 Currently Hospitalized
• 140 Recovered, 1 Death
• 5 of 6 neighboring counties are on the State’s Watch List, and the 6th, Mendocino, will proactively restrict activities starting Friday, July 24, at 11:59pm.
• What we can do to maintain Local Control and keep businesses open: hand washing and hygiene; social distancing; limiting social gatherings, particularly indoor activities with individuals outside of your immediate household; masking; complying with Health Orders, which are designed to limit risk
• Masks work, and evidence is mounting that non-N95 face coverings are appropriate for even many individuals with underlying chronic lung disease.

Lake County, CA (July 23, 2020) — Despite documentation of 29 new cases since my July 16 report, COVID-19 activity remains manageable in Lake County.

166 cases have been confirmed since the onset of the pandemic.  25 are active.  Only 1 person is presently hospitalized, and they are at an out-of-county facility due to the need of subspecialty care.  140 have recovered, and we continue to mourn the loss of 1 individual.

Given the degree to which all of our surrounding counties, and a growing number of suburban and rural communities throughout California, have been affected, we have been fortunate. 

Maintaining this status will depend on all residents taking action to avoid inadvertent transmission of the virus. 

It will also depend on the sustained availability of clinical and other staff to provide medical care, contact tracing and case management services.  Over the life of the pandemic, a relatively small group of people have invested hundreds of hours of overtime to ensure our communities are safe and businesses can remain open. 

Unfortunately, the preponderance of the evidence suggests we will be living with COVID-19 for quite some time, and more support will be needed to continue to sustain our local response.  If you are available, have relevant training or experience, and believe you can help, please write to MHOAC@lakecountyca.gov, and let us know.

Business Activities Restricted in All Surrounding Counties
COVID-19 has markedly affected neighboring Sonoma, Napa, Yolo, Colusa, and Glenn Counties, and all remain on the State’s Watch List.  They are already seeing a greater level of State intervention and State-imposed restriction of business-related activities.  Once a County is placed on the Watch List, local Schools are prevented from opening until the situation improves and the County remains off of the Watch List for 14 days:
https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/CountyMonitoringDataStep2.aspx

Local school districts are currently making plans for the upcoming school session, and a great deal of effort is going into making the best choices for students, families, and teachers.  These decisions are extremely challenging this year, due to the need to try to balance the educational and social needs of the students with the health of families and school staff.  Many of the state’s school districts have already decided to provide distance-based learning, only, at the start of the school year.  The evidence is currently mixed on how school openings affect the number of cases in a community, but with the significant rise in cases and hospitalizations overall, most locales are opting not to move forward with in-school learning, for now.

Mendocino County has recently taken proactive steps to add restrictions, some of which take effect at 11:59pm tomorrow (7/24), in the hope of maintaining greater local control.  While they reported 105 Active Confirmed Cases as of July 22 at 6pm, and have now confirmed 3 COVID-19-related deaths (1 this week), Mendocino County has thus far remained off of the State’s Watch List:
https://www.mendocinocounty.org/Home/Components/News/News/5181/3242

What Can We Do to Maintain Local Control and Keep Businesses Open?
The effects of the COVID-19 pandemic on our local, state and national economy have been pervasive, devastating and profound.

The most recent confirmed Bureau of Labor Statistics (BLS) national data (pulled the week of June 7-13) reported 2.9 million cumulative permanent job losses, 588,000 in June, alone.
https://www.washingtonpost.com/business/2020/07/02/june-2020-jobs-report/

Lake County’s unemployment rate for June 2020 was 14.2%, compared to 4.8% in June 2019, and 5.8% in February of 2020.  Unemployment peaked in Lake County at 16.7% in April, during the most restrictive phase of the Stay-at-Home Order, and has been modestly declining in the months since:
https://www.bls.gov/web/metro/laucntycur14.txt
https://www.pressdemocrat.com/article/business/june-unemployment-decreases-to-11-5-in-sonoma-county/?sba=AAS,

Right now, our local economy is open to a greater extent than those communities representing more than 90% of California’s population (i.e., residents of the 35 counties on the State’s Watch List):
https://abc7news.com/california-covid-reopening-schools-ca-where-can-reopen-counties-not-on-watch-list/6329163/

We all want it to stay that way, and to be successful, we must recognize that each COVID-19 infection has the potential to cause an outbreak.  Because individuals can spread the virus prior to the onset of symptoms, we must take proactive measures, even when we think we are totally healthy.

The following measures are proven to slow the spread of COVID-19:
• Hand washing and hygiene;
• Social distancing;
• Limiting social gatherings, particularly indoor activities with individuals outside of your immediate household;
• Masking; and
• Complying with Health Orders, which are designed to limit activities that carry disproportionate risk

Taking precautions that promote public health will benefit our local economy, as well, and help local businesses endure the COVID-19 crisis. 

The vast majority of people and businesses are already doing their part. 

For anyone that may still believe COVID-19 concerns are overblown and masks and other safety measures are unwarranted: I am asking for your help. 

Putting on a mask may save your friend’s job, or keep a vulnerable individual from experiencing severe illness or even death.  Our local economy and the well-being of many in our communities depends on all of us taking actions to keep each other safe.

Face Coverings Work, Non-N95 Masks Safe for Even Many Individuals with Underlying Chronic Lung Disease
There is increasing evidence face coverings have a meaningful effect on the spread of COVID-19, and are even safe to wear for many individuals with underlying chronic lung disease:
• Centers for Disease Control (CDC) Director Robert Redfield was recently quoted in the Wall Street Journal, stating the pandemic could be brought under control  in 4-8 weeks if, “we could get everybody to wear a mask” (https://www.wsj.com/articles/face-masks-really-do-matter-the-scientific-evidence-is-growing-11595083298)
• 2 Missouri stylists recently tested positive for COVID-19. Because the stylists and their clients wore masks, 0 of their 139 clients contracted the virus (https://www.cdc.gov/mmwr/volumes/69/wr/mm6928e2.htm)
• A recent joint statement by leading respiratory medicine groups noted, “Individuals with normal lungs, and even many individuals with underlying chronic lung disease, should be able to wear a non-N95 facial covering without affecting their oxygen or carbon-dioxide levels” (https://www.prnewswire.com/news-releases/american-college-of-chest-physicians-american-lung-association-american-thoracic-society-and-copd-foundation-statement-on-importance-of-patients-with-chronic-lung-disease-wearing-facial-coverings-during-covid-19-pandemic-301095501.html)

What does it mean when a COVID-19 case is considered “Active?”
We received a question this week regarding what constitutes an “Active” COVID-19 case.  Individuals in this category have been documented as COVID-19 positive with appropriate laboratory testing, and are currently being monitored by Public Health staff.  Case investigations and Contact Tracing are undertaken when individuals are identified as COVID-19 positive, and staff continue to check in and provide education during the infectious period.  Hospitalized patients continue to be listed as Active Cases, even after they complete their COVID monitoring status, if they tested positive at the time of admission.

More information can be found here:
https://www.cdc.gov/coronavirus/2019-ncov/covid-data/faq-surveillance.html
https://covid19.ca.gov/contact-tracing/
https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/covid-19-terms
https://www.cdc.gov/coronavirus/2019-ncov/lab/cdc-lab-work.html

Thank you for continuing to do your part to keep your communities and the vulnerable safe.

Gary Pace, MD, MPH

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