Home / Health / In today’s media availability, Dr. Josh Ennis on school opening, testing and tracking, and why “active cases” are not a very important metric | Lost Coast Outpost

In today’s media availability, Dr. Josh Ennis on school opening, testing and tracking, and why “active cases” are not a very important metric | Lost Coast Outpost

Machine printout of today’s availability in the media with Dr. Josh Ennis, Humboldt County Assistant Health Officer, below. Video above.


Good afternoon. We’re here with Humboldt County Vice Health Officer Dr. Josh Ennis for accessibility in the media on 12 August. Thank you for being here with us.

Yes of course.

Thank you, and do you want to start by addressing issues to the community?

Yes, when I reviewed some of the questions today, I felt that it was important to just maybe say a little about current numbers, trends. You know from the beginning that we were really worried, overwhelming our care capacity. I think we have all seen that recently the numbers have started to trend upwards and at an increasing rate, and there is a lot of focus sometimes on the number of active cases. And what this number means are those who are actually isolated because they are considered contagious.

I think what you are missing when you enter that number is that for all the cases that we actually identify and place on isolation, there are probably a handful of other cases there that we have not identified. And if we were to take some of the best estimates out there from leading epidemiologists, they would estimate that there are probably ten cases for every confirmed case that we actually have. We can make the argument even if we wanted to say that we actually do very well in the test, and we keep the disease very low because of our societal reduction measures we could revise that number down as five, says. So somewhere in the order of five to ten times as many cases that we actually confirm are probably out there not tested for some reason.

And so when we think about how many cases are potentially floating out in the community, we can talk a little bit about how many hospital admissions we can expect by looking at cases at hospital admissions, and it̵

7;s somewhere in the order of about ten percent. And so in the last week we have seen three hospital admissions and it would suggest that we use the ten percent we multiply by ten that there are about 300 cases, and if you put it in relation to the number of active cases, it is just north of 50 – so there are about six times as many cases floating out there. So I think it’s very important not to enter this number. It does not catch everyone who has the disease. It catches a minority, and we’re starting to see it in the hospital a bit.

KMUD News asks: Mendocino County has called out volunteer contract trackers. Is there in Humboldt an immediate need for tracers for citizen contracts (perhaps more Spanish speakers?) And if so, how can members of society be educated and volunteered?

Yes, so from the beginning we knew that uh really the legs of our answer would hang on to a few things. One is testing, and the other is the ability to do large-scale investigation and tracking, and that’s how we’ve been working on it for months and we continue to build. We do not need volunteer contact trackers right now. We actively on board several people to help with investigation and tracking. We have also worked hard to increase our not only Spanish translation skills but also to hire people and include people who are Spanish as a mother tongue to help with the investigation and tracking efforts.

KMUD News asks: Information on how the coronavirus spread has been weak since the outbreak began. Can you share current information? (for example, does it live on surfaces or is it just airborne, can it travel in water, does it die in sunlight?)

Yes, so you know there’s a lot we do not know but I can tell you what we know. I would say that the majority of the transmission takes place via respirators. Okay and so these are bigger drops that a worm will catch, and each drop potentially carries, you know, tens, hundreds of thousands of viral particles. And so if the drops are larger, the face coating will catch them. And that’s the vast majority of the transfer. Can it spread with what we call fomites or surfaces that you have touched? Yes it is certainly possible, but it is a small minority. Are air droplets dispersed through airborne route aerosols that linger in the air for hours afterwards? There may be some suggestions that look at specific scenarios that suggest it is happening. I would say that if it does, it is a minority of cases where the airflow is poor, or there is some kind of either procedure in the hospital that gives a lot of pressure around the airways, or if you feel like doing an activity where there is lots of screams, screams, screams, powerful exhalation. They may be more likely to produce aerosol, but the vast majority appear to be respiratory droplets.

Lost Coast Outpost asks: Humboldt State University is returning soon from the summer trip, which means that at least several hundred and probably thousands of people will move back to the county, many or most from areas with higher infection rates. than our own. What measures does public health and the university take to minimize the risk to the student community and to the county as a whole?

So HSU has been in contact with public health planning in recent months. I have been less involved in these discussions so I can not comment on the details of the plans but they have been in contact with each other mainly through Dr. Frankovich and they continue the conversation this week.

Redheaded Blackbelt asks: Photos were taken by a student of Fortuna High and published on social media that apparently showed young people closer than the 3 to 6 recommended feet. Photos caused a lot of controversy. If parents and students are worried, rather than posting on social media, is there a process they can follow through public health? And can you describe it?

Yes, so throughout the planning process, this has been left to the decision of the local needs determined by the districts themselves Public Health can in no way dictate or mandate what needs to happen at each individual school, that is it is simply too many to think about and the needs are different depending on the community itself and so if there are concerns I would encourage parents to contact the school administration, we have been very clear that if certain conditions can not be met it is unsafe to reopen schools for instruction on site and eventually will to become the school administration responsible for implementing the plans. If for some reason that turns out to be ineffective or if there is greater concern, someone is certainly welcome to call JIC at 441-5000 and perhaps go through what the concerns are specifically and if there are alternative ways to try to make things as safe as possible.

Redheaded Blackbelt asks: A staff member at a Fortuna nurse tested positive for COVID, were patients exposed? Has there been any subsequent spread to the staff?

So whenever there is a confirmed positive case in a nurse, it notifies the State of California Department of Public Health that it is a weekly test until there are no new cases in 14 days. I can confirm that no further cases have been identified and we are working on the nursing facility involved to test essentially all staff and all patients in the coming weeks and we have not yet identified any further cases.

The Times-Standard asks: How is the estimated percentage of the population tested for current infection calculated? Is it based on the total number of tests performed or the total number of people tested? If it is the latter, how is it ensured that people who take several tests do not count twice?

So here it is only based on the total number of tests, there are cases where the same person has a repeat test for many reasons. It seems to be a minority, but that is when time turns out to be a larger percentage because perhaps part of the population seeks reconsideration due to concerns about repeated exposure and so that they are counted twice. Early on we looked manually and it turned out to be in the order of just a few percent um which was a couple of months ago uh I do not know what percentage it is now um it is probably a good time to evaluate how we report that number at this point. Thanks.

The Times-Standard asks: Can you describe the problems that the county has with effective disease control? What plans are there to improve the statistics?

Yes, so the county’s dashboard is divided into three separate categories um, it’s disease spread, healthcare capacity and then the last one that I think this issue comes to, the effectiveness of disease control and what we are talking about are measures to mitigate the community talk about the investigation and tracking and making sure we have the ability to increase as needed, making sure people provide the information they need, getting test results on time so we can intervene. And last week we moved it from level two to level three. Now it had no bearing on the overall alert level but it tells in other ways and that’s the way we felt things would move. The spread of the disease would move first, there would be a certain time and then the effectiveness of disease control would be moved next and then we would see the healthcare capacity move last. And so this is expected and so what is it, where does it come from? Well, I think last week we had a couple of double-digit days reporting positive. We had nine, one day 10, another day 25 the next day, and we have built our investigation team from a point of being only three people and we have increased it to 41 people I think at this point. Some of them are part time, they are not full time and so you can imagine when there is a huge bolus, a huge increase in cases suddenly in a few days as it takes some time to clear out and distribute that amount of new cases. You know that all 41 people do not work at the exact same moment in time and so the process is just that it is slower when you get so many cases in such a short time. So to improve this metric, it will further increase our capacity for investigation and tracking.

North Coast News asks: Fortuna high school students went back to person classes this week. Photographs were shown by students who appeared to be sitting nearby, not placed on desks or six meters apart.

• Who is responsible for the schools following the reopening instructions to ensure student safety?

• Can the county demand that schools be closed if they cannot ensure proper social distance and COVID security measures take place?

• What happens if the school does not have enough PPE (such as masks, cleaners, etc.). Are PPE expenditures expected to come from their own budgets to ensure students’ safety and compliance with the county’s orders, or are government funds available?

Yes, so maybe I will deal with it in parts, I know for who is responsible for making sure that the schools agree with the resumption uh plans. I think I have already talked to this and it is really the school administration if there is really any concern I think parents need to take it back to school and try to solve it with the school administration. Of course, you can also try to send a message to the school supervisor. With 70-plus schools, public health cannot handle each individual school individually. When it comes to closing the school due to proper social distance, COVID precautions, you know I think there is a huge societal benefit to having personal school instruction especially with younger children, so I think we have to try hard to do this work as a community but we have been very clear that the reopening to instruction on site should only take place if it can be done in a way that follows the guidance as now. And to keep everyone as safe as possible when it comes to PPE uh I think the state has made direct outreach to the school districts, they have also provided PPE to them and there is a way for schools to request PPE directly from state. They can certainly also come to the county, there is a process to provide PPE at county level but the schools, in my understanding, have a direct path to PPE through the state.

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