Santa Cruz County health officials said Thursday that hospitals remain relatively quiet, but they anticipate COVID-19 patients to top a “surge capacity” of 50 intensive care unit beds this month or in May. Santa Cruz Local hosts Kara Meyberg Guzman and Stephen Baxter explain the top five takeaways from a news conference Thursday with county health officials. The full news conference with reporters’ questions follows their introduction.

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Five takeaways from Thursday’s news conference with Santa Cruz County health leaders:

  1. The county is prepared to double its intensive care unit beds from 25 to 50 in anticipation of COVID-19 patients. Deputy County Health Officer David Ghilarducci said that hospitalizations are likely to surge past 50 COVID patients in ICU beds by the end of this month or mid-May. 
  2. Santa Cruz County health officials don’t know when to expect COVID cases to peak. It could be July, County Health Officer Gail Newel said. The later it is, the less strain on the county’s hospital system, she said.
  3. Santa Cruz County leaders extended and tightened restrictions to shelter-in-place rules through May 3. The rules aren’t as strict as the Bay Area’s, but that could change if residents don’t comply. 
  4. Santa Cruz County had 57 confirmed COVID cases as of Thursday morning. But that number is not a good gauge of the county’s progress because there have only been 450 test results as of Monday. County leaders said the key metric is COVID hospitalizations, which continue to rise. When hospitalizations decline, that means progress.
  5. New state guidance encourages residents to wear face coverings. Masks and face coverings have significant but limited value to reduce the spread of COVID-19.

TRANSCRIPT

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Kara Meyberg Guzman: This episode is sponsored by Santa Cruz Works, your connection to our area’s thriving tech and business community.  With over 5,000 members, Santa Cruz Works gives you access. The largest monthly tech events. Solutions for your startups and businesses. Connections to the hottest jobs. And the latest news about local companies: their stories, and best practices.  Subscribe free to the Santa Cruz Works weekly newsletter today. santacruzworks.org/podcast

[MUSIC]

KMG: I’m Kara Meyberg Guzman.

SB: And I’m Stephen Baxter.

KMG: And this is Santa Cruz Local. 

[MUSIC FADE OUT]

KMG: Today we’re going to play you tape from a news conference. The topic was the coronavirus. It took place Thursday. It was in a conference room of the Emeline campus of the Santa Cruz County Health Services Agency.

This press conference was different from any other press conference I’ve ever been to. First of all, everyone had to get their temperature screened before going in the room. We all sat more than 6 feet apart. There were about a dozen of us in the room. A handful of reporters and some county health officials.

Other reporters like you, Stephen, called in by phone.

SB: Right, I was on the phone. And we got to ask questions of the four county health people who were there. That was County Health Officer [Dr.] Gail Newel, Deputy County Health Officer Dr. David Ghilarducci, County Health Services Agency Director Mimi Hall, and then there was the county spokesman Jason Hoppin. 

The whole thing is worth listening to. But we’re going to summarize the top five takeaways.

Santa Cruz County Health Officer Dr. Gail Newel said her team doesn’t know when the county’s COVID-19 cases will peak. She spoke at a press conference April 2, 2020 at the Santa Cruz County Health Services Agency. (Kara Meyberg Guzman — Santa Cruz Local)

KMG: For me, the biggest takeaway was that the county does not have enough intensive care unit beds or ventilators to meet expected demand. Right now, we have enough. We have 25 intensive care unit beds, and they’re not all filled. Our county’s hospital system has the capacity to surge to 50 beds, if needed. 

Dr. Ghilarducci said it’s not a matter of if, but when, we exceed that surge capacity. He said the models show it could be around late April or early May.

SB: Keep in mind, when our hospitals overflow, that’s not necessarily the peak. That brings us to our second takeaway. Newel said we don’t know when our peak will be, in terms of cases.

If we’re doing well, maybe that peak’s as late as July. Really, the later the better. The more we draw out our demand for hospital beds, then the less strain on our hospital system.

KMG: So don’t be surprised if this shelter-in-place lasts for another few months. 

This week, the county extended and tightened the shelter-in-place restrictions. The current order lasts through May 3.

Our rules are not as tight as the rules in the Bay Area. Newel explains the difference between the orders. The point is — takeaway No. 3 — Newel said she might have to tighten our restrictions if people are not following the order. She said she’s willing to match the rules that the Bay Area has.

She also said she’s not going to loosen our shelter restrictions until she sees a drop in COVID hospitalizations.

SB: Takeaway No. 4. Santa Cruz County had 57 COVID cases as of Thursday morning. However, that number is not necessarily a good gauge of how far COVID has spread in our community. The county had only received results from about 450 tests as of Monday. That’s not very many tests.

Because testing is so limited, health officials said they’re looking at a different number. The metric we should be looking at, they said, is hospitalizations for COVID cases. And the number of COVID patients in intensive care.

They expect to see those numbers rise in the next few weeks. And then hopefully go down.

KMG: Toward the end of the news conference the health officials talked about masks and face coverings. Last takeaway: There’s a new state guidance and the health officials said it’s not a bad idea for the general public to wear face coverings.

In fact, businesses should encourage it for their employees.

So that’s our five takeaways. 

The tape starts with Santa Cruz County Health Officer Gail Newel.

GAIL NEWEL: Good afternoon, as I understand it, this is the first of a series of weekly press conferences, so we can keep you all up to date on a regular basis with what’s happening in Santa Cruz County with COVID-19. 

I’m Dr. Gail Newel. I’m the Health Officer for the County of Santa Cruz. And with me is Mimi Hall, Health Services Agency Director, and we will be joined shortly by my Deputy Health Officer Dr. David Ghilarducci who is overseeing our alternate care sites and clinical task force coordination for clinical services response. 

As of this morning, we have 57 confirmed cases, including the death of the Santa Cruz County resident. One case is a pediatric case under the age of 18, 43 cases are 18 to 64 and 13 cases are over 65. Females make up 30% — 30 cases at this time and males, 27. 

A couple of notable things have happened since our press conference on Sunday. One is that an extension and clarification of shelter-in-place orders have been released, starting with the six big Bay Area counties, and then we followed suit at the end of the day on the same day on March 31st. 

And I’m happy to answer questions about those today, they – the Santa Cruz County order is different from the big six Bay Area counties and less restrictive in some senses. 

So it’s important that the public understand the differences between my orders and the orders of the big six and why I chose to do it that way, with consultation with my team. 

In addition, I think the public is clamoring to know about the recent state guidance about face coverings and what that means. So I’m happy to talk about that as well today. 

Anything else from you, Mimi, at this point?

Santa Cruz County Health Services Agency Director Mimi Hall said that the county does not have enough ventilators to meet projected demand. She spoke at a news conference April 2, 2020 at the county’s Emeline campus. (Kara Meyberg Guzman — Santa Cruz Local)

MIMI HALL: The only other thing that I would add in some of you may know that we’ve been working hard on expanding our care capacity across the county. So we have our ultimate care site, ready to go in terms of logistics, so the cots, the beds, what equipment is there and we’re working on staffing up right now. 

And we hope that, so the soft opening is done but we need people to staff it. We hope we can get them in place by next week. We’re also looking at additional alternate care sites, because it’s — if what we’re seeing and what we’re projecting is going to happen in terms of number of cases and disease curves, it’s important for us to have one, maybe even two additional alternate care sites ready to go.

HOPPIN: So why don’t we start with a couple questions in the room and then we’ll go online and — Kara?

KARA MEYBERG GUZMAN: Hi, I’m Kara Meyeberg Guzman from Santa Cruz Local.

I want to know about testing capacity. Do you have numbers on tests that have been administered so far, you know, this week, perhaps, weekly, and is it trending up?

NEWEL: Our testing capacity is increasing, particularly for some high risk groups. So I’m happy to report that now that Quest Lab and perhaps others are offering an expedited process for patients who are inpatient in the hospital, so admitted to the hospitals, or healthcare workers. 

And that’s a broad definition of health care workers. 

And Quest is pledging a 24 hour turnaround time on their results for people in those categories. And we’ve had good success with using that service so far. 

As of Monday, I heard numbers from my team of around 150 tests, have been done through the Santa Clara [County] public health lab for our residents, and a number around 300 for commercial lab testing. 

But we only know commercial lab results numbers once we receive the results of those because we don’t have any way of knowing how many tests have been ordered through the commercial labs.

DREW ANDRE (KION): How many people have recovered or have there been any people who’ve recovered yet?

NEWEL: At this time, we haven’t declared anyone recovered, partially because we don’t have the testing capacity to do serial testing or every day testing on every case. We would be overloading our public health lab partners to do that. And our commercial lab turnaround fund is not quick enough to make that a feasible prospect. So we’re following these cases based on clinical symptoms and we’re trying to be very careful about declaring them as recovered. We don’t want them back out in public and shedding virus.

NICK IBARRA (SANTA CRUZ SENTINEL): Just from the testing side, what’s your evaluation now of the testing availability? You talked a little bit about this on Sunday, and how you said that, that, you know, the tests that have been promised from federal and state sources for  months, hadn’t quite panned out. What’s your evaluation right now — what that picture looks like, in general for testing with commercial apps with the Santa Clara labs.

NEWEL: I haven’t heard of any government assistance in our area for testing capacity. I do know that Dominican Hospital is hoping to be up and running for some very limited point-of-care testing perhaps as early as this week, and next week increasing that capacity. In addition, right here on Emeline campus in our clinic lab we also ordered equipment and supplies to begin testing. And we hope to have that up and running in the next couple of weeks.

IBARRA: And is that adequate for an effective public health response in this county right now?

NEWEL: Well, again, we’ve really moved past that containment phase, the containment phase is where we needed to identify the folks who were — had the virus and then keep them out of the population. At this point, we know that the virus is spreading throughout the community. And so testing is not the key focus of our efforts at this time. It would be interesting to know from a from a data collection point of view, but it’s not a focus of our efforts. 

HOPPIN: So I’ll come back to the room. Let’s get some online questions. I want to respect the people that stayed home to the practice distancing, please unmute your phones if you have any questions. Anybody on the call? Have a question? 

JACOB PIERCE (GOOD TIMES): Yeah, this is Jake from The Good Times. Does the County have a clear plan for its next steps in terms of COVID-19 response or is the Health Services Agency evaluating it goes.

NEWEL: Oh, we are so busy with our planning and preparation and putting those into place. We have a huge team just in Health Services Agency alone in our Department Operations Center. I think we’re up to 180 or so spots in our department operation center, and each of those is two to three people deep. So we have literally hundreds of people. In addition, our County Administrative Officer and his staff are working around the clock on plans as well at the County level, and the Human Services department are essential partners for us in terms of housing and hotelling. And all of us are working diligently and across all spectrums and area of the community to respond.

HOPPIN: Any other phone questions?

NEWEL: And thanks today for physical distancing, we appreciate it.

PIERCE: Of course, yes, thank you for for making it easy to do it. What criteria will need to be met for Santa Cruz County to either lift or soften its Shelter in Place Order like increased testing or better contact rating for instance, or a better understanding of the virus, would all that combined even be enough?

NEWEL: We’re not going to significantly loosen any shelter-in-place restrictions until we see a peak in our curve of case rates and then it drops. So we need to see a significant decline in the number of cases before we consider lifting shelter in place restrictions. 

HALL: And, Jake, this is Mimi — one thing that I want to add, because there seems to be so much focus on testing, is that it’s true that our testing won’t discover every single case. But hospitalized cases and ICU cases are a function of community spread. So those numbers, those folks always get tested. And that gives us an idea of whether or not we’re at the peak or coming to the downside of the curve.

HOPPIN: Any other phone questions?

PIERCE: Yeah. Just to follow up on that. If you have increased testing, does that let us move back, if we have increased testing and the number of active cases starts to go down, number of new cases start to go down — we’ll get — even if this — we’re talking like sometime over the summer, would that allow the county shift its strategy back from mitigation back toward more containment.

HALL: The most important people to test are those who are hospitalized, or healthcare workers, and those who have severe symptoms. And so increased testing community wide isn’t going to help us in that respect. We make the assumption that if you’re in the community of mild illness, that you’re positive. It may not be but you should treat yourself that way. And my point is that we have adequate testing for those who come into the healthcare facilities as inpatients, or severe illness for our healthcare workers. And those give us a good indication of whether we’re coming down on that downside of the curve. 

HOPPIN: Thank you, Jake. Can we get another phone question?

REPORTER: Okay, so first I just missed the case breakdowns beyond the one pediatric case. Could you repeat the case count for the rest of the age groups?

NEWEL: Sure, it’s on our website but I’ll tell you again: there’s one pediatric case — so under age 18,  43 who are 18-64 and 13 who are 65 or older. 30 females 27 males.

REPORTER: And then, my other question was, I know that the county set up an online system for donating and I was curious like, are donations coming in of supplies and how stocks are holding up.

Santa Cruz County spokesman Jason Hoppin said donations of surgical masks were ‘rolling in’ to the county health services agency on April 2, 2020. (Kara Meyberg Guzman — Santa Cruz Local)

HOPPIN: They are. I know that we had two days ago — this is Jason Hoppin — two days ago I think we had 58 people fill out the form, but I have not checked in the last 48 hours. So I have seen there were surgical masks out there today. So they are rolling in I don’t have any numbers for you at this point, but I could probably get them together.

MEYBERG GUZMAN:  This is a question for Mimi. Can you talk about hospital capacity, what’s happening in our hospitals right now? Are we seeing an influx of patients and what are we doing to rise to meet that?

HALL: Sure. And I also invite Dr. David Ghilarducci, our deputy health officer to answer as well. What I can say is Dr. Ghilarducci, Dr. Newel and I and some other staff have visited Watsonville Community Hospital as well as Dominican and they’re actually really quiet right now. Because they’re doing what the rest of the healthcare system is doing, which is putting off elective surgeries, putting off non-essential procedures, knowing that we’re all preparing for surge.

So the capacity is really good right now, for that specific reason, it’s intentional. The other thing that I’d like to say is that each of the hospitals have a plan in place to increase their bed capacity, whether it’s med-surge beds, regular beds, ICU beds, and so there are plans in place to do that. And those don’t get triggered until there’s a need, but each each facility is aware of when they reach a certain point of capacity and when they need to expand. And then when they’re full, that triggers our alternate care sites opening. So Dr. Ghilarducci –

KMG: Can you also mention numbers, like numbers of beds, surge capacity. 

DAVID GHILARDUCCI: You know, I — excuse me, Dr. Ghilarducci here. I don’t have the exact numbers in front of me. But I can tell you that both hospitals are working hard to probably roughly double their capacity both in ICU and inpatient. There’s some variability between the two acute-care hospitals. We also have the Sutter Maternity Center, which has some capacity.

And then we’re also in the planning stages of opening an alternate care site, which would serve as a kind of relief valve for hospitals with lower acuity patients that could, you know, transition from hospital care to home care in there. So there’s lots of plans. There’s even two or three tiers behind the alternate care site of different facilities that we’re looking at.

MEYBERG GUZMAN: Where is that alternate care site and how many ICU beds do we currently have in the county?

Dr. David Ghilarducci, Santa Cruz County deputy health officer, said the county has a surge capacity of 50 intensive care beds. The need is projected to outstrip that, he said at a COVID-19 press conference April 2, 2020 at the county Emeline campus. (Kara Meyberg Guzman — Santa Cruz Local)

GHILARDUCCI: ICU beds — I’m going to use the term ICU beds and ventilators together, and we have a surge capacity of about 50.

On a normal day, non-pandemic day, that is normally about 25. So it’s roughly gonna double collectively.

As far as the sites, one site that is, has been publicly identified right now as the Simpkins [Family] Swim Center, which you might be aware of. There’s another site that is still in the works, and I don’t think we’re ready to — are we ready to see the contract? 

HALL: I received the contract. I haven’t signed it yet. I just got it in my inbox.

GHILARDUCCI: OK. So well, we’ll be announcing that very shortly.

ANDRE: Is that, is that surge capacity enough? And also, on top of that, when do we expect it to see that surge or peak here? So ballpark estimate?

GHILARDUCCI: Shall I? So we don’t really know — we have been doing a lot of modeling, looking at data. It’s severely hampered by the lack of widespread testing. And that’s one of the sort of data inputs.

But we can say that we think that the social distancing orders, the shelter-at-home orders that we’ve had in place now for a couple of weeks, are probably having a significant effect. I think that the population here in Santa Cruz County is very responsive. They’re very socially conscious. And they’ve been largely adhering to those orders.

And I believe we’ve really flattened the curve, a term you’ve probably heard before, in terms of slowing down that increase, but what does that increase going to happen? A rough guide is we think we’re maybe two or three weeks behind Santa Clara County. That’s a very rough guide.

We think that the hospitals will probably start spilling over about two to three weeks after that, because Santa Clara isn’t quite there yet, but they’re very close. The — we talk about ICU beds, we talk about ventilators, the machines, the physical objects — but one of the critical things that we’re worried about is the people to, to staff, those people that are qualified: respiratory therapists, intensive care physicians, the nursing is huge.

And so all of these machines and beds and rooms are really useless without the people that will be behind that. 

So we’re — we’re anticipating that we’re planning on how to expand that part of the capacity as well.

ANDRE: But right now we don’t know if there’s enough?

HOPPIN: Another. One more in the back of the room, then we’re gonna go back to the phone.

ANDRE: Well, you just started with saying you don’t know if there is enough, is that fair to say right now, we just don’t know if we have that surge capacity? 

HALL: May I make a comment about that? We’ve done we’ve done modeling. And the modeling is as good as the data that you have to put into it. 

And because we’re so small, and our numbers are so small, we have large what — usually you hear the word “confidence interval,” when you project it’s called a “credibility interval.” We have a wide swath of credibility in our interval. 

So I haven’t had a chance to talk with you today. But this morning, I talked with some of my counterparts around the state and we’re talking about the fact that if we had regional modeling, it would give us a better idea of what we need. 

And so we do have that agreement and I think yesterday or epidemiologist in the Bay Area, there’s something called ABAHO that Gail is a member of, Association of Bay Area Health Officers. 

So we are working on, working together because it doesn’t make any sense for Napa to do their own modeling, us to do our own modeling, Sonoma to do theirs because disease spreads throughout a region. So that’s coming. 

Part of the reason that we’re reluctant to release numbers is because the data is so limited that we put into that modeling. So we’re preparing for the worst. 

I got this question the other night on a town hall call: Do we have enough ventilators? And my, my answer was no, we don’t have enough. So that’s why it’s so important for us to focus on the prevention side, stay at home, wash your hands, don’t go out if absolutely not necessary, because that’s the biggest thing that the public can do to make sure that we have enough ventilators and beds for people.

REPORTER: Well, thank you. Thanks for being here. This is, this is awesome. I’m assuming that the 450 tests more or less that Gail, you mentioned earlier, that they’re all PCR-based tests — curious if there’s any interest in expanding that to the serological tests that are kind of in the pipe and rapidly being approved.

NEWEL: We anticipate that our community will respond as other communities are with increased testing capacity, including antibody testing, although we don’t know what the antibody tests mean now, we don’t know how to interpret them yet in terms of immunity, but eventually we will get the same testing that other communities are developing as well.

HOPPIN: Okay, on the phone. Are there any questions and we’ll come back to you, Jondi. Any more?

ADRIANA FREDERICK SUTTON (UNIVISION): Yes, I have one. Can you hear me?

HOPPIN: Yes, go ahead. 

FREDERICK SUTTON: Okay. This is Adriana from Univision. Thank you for being there. My first question, when do you expect Santa Cruz County will be experiencing the peak the highest? That’ll be number one and the second one: I’ve been hearing a number of versions, but I just want to know from you guys, if somebody had already had the virus and has recovered, can that person get the virus again?

NEWEL: I’m going to start with your second question first and say that the shorter answer is yes, that there have already been cases documented of people who have had this virus once and then they get the virus again. 

We don’t have enough data on enough cases to know exactly how much immunity someone might have. We think it might be something similar to the seasonal flu, where, as you know, you can get the flu even more than once in a season and you can get the flu every season. And that’s why we need to have new flu vaccines every year. 

So we don’t know enough to answer about immunity yet. There does seem to be some immunity, but it certainly is far from perfect. 

And the first part — the first question was about the peak. Well, as Dr. Ghilarducci mentioned we expect to see an increase in cases. So a climb up that curve in about two to three weeks because that’s what Santa Clara has experienced. And then we expect to see the beginning of a rapid increase, perhaps two to three weeks after that. 

We don’t know when we might peak. If we’re fortunate, and we have been successful in our efforts to shelter in place, to wash our hands, to cover our coughs, then perhaps we may have a peak as late as July. 

And I know that that sounds harsh, that the public doesn’t want to hear that we may be doing this for months, but that would be a really good thing in terms of our hospital capacity, our ventilator capacity and a decreased number of deaths.

HOPPIN: Any other phone questions?

STEPHEN BAXTER: Could you talk about — this is Stephen Baxter with Santa Cruz Local — can you talk about state guidance on face masks and face covering.

NEWEL: Oh, I was hoping you would ask. [laughter] This is a really — masking is a really controversial subject and very complex. If we didn’t have a scarcity of resources, then we would clearly ask everyone to mask. But we can’t do that. We need to preserve masks for healthcare workers only. 

Now, the California Department of Public Health did issue guidance last night, saying that face coverings may be of some use to the public, that what we’ve learned from other countries show that face coverings might slow the curve down by as much as three days in a curve which sounds not significant, but it is very significant. 

And so there is guidance from the state that the public may opt to wear face coverings. Now the State is clearly saying these should not be medical grade masks. They should not be masks at all, unless they’re not crafted for healthcare workers. 

So very, very important that we preserve our mask supplies, and all of our personal protective equipment supplies for our healthcare workers. But if the public chooses to wear face coverings, as I see at least one of you in the room today has done, that, that should definitely be allowed and even encouraged.

GHILARDUCCI: I was gonna say I might add that the masking really when I wear a mask, I’m protecting you from me. And I’m not protecting me from you. So it’s really important to maintain the social distancing as Dr. Newel said. Hand hygiene is super important. So don’t forget those sort of basics that we’ve talked about.

HALL: The California Department of Public Health Director Dr. Sonia Angell clearly stated that the only measures that are evidenced based to reduce community transmission are physical distancing, handwashing staying at home when you’re sick, good respiratory hygiene: meaning covering your coughs and sneezes, and face coverings or masks. 

Actually, it’s face covering. So there’s a difference between masks, are is the term that we use for professional, healthcare professional masks. 

Face coverings are the term that we use for something homemade, something cloth, something that’s not professional or medical grade. But the utility of those really is as Dr. Ghilarducci said, for — now that there’s — there’s some early research out that the CDC has put out that you may be asymptomatic and infectious 48 hours before, before, before you can test positive or show symptoms. So that’s the utility of the face coverings. 

I don’t know if we’ve confused the issue more, but I just want to make sure that people know that the evidence-based doesn’t support it. However, it’s not a terrible practice to do.

HOPPIN: Anything else on the phone before we go back to the room.

PIERCE: Yeah, yeah. Jake again from Good Times. This is the second time that the Bay Area government announced they’re putting their shelter in place origin and Santa Cruz did the same a few hours later. Is Santa Cruz included in that Bay Area planning? What’s it like for Santa Cruz to communicate with those Bay Area counties?

NEWEL: So the ABAHO group that I’m a part of the Association of Bay Area Health Officers is 13 counties plus the city of Berkeley. And the — the two shelter-in-place orders have been developed by what they have self named themselves the “Big Six” of ABAHO. 

So it’s the largest six counties. And they felt that it would be easier for them along with their county council, their attorneys, to work in a smaller group to make a decision and to come to agreement because they wanted to have the exact same wording in their orders, than it would for all 13 counties to come together. 

And I think as a result, we have crafted an order this time around, that is a little bit different than the Big Six counties. And that, I think, is an advantage to Santa Cruz County because we aren’t experiencing some of the same social pressures and crowding that the Big Six counties have.

HOPPIN: Jondi.

JONDI GUMZ (TIMES PUBLISHING): I’m interested to hear about the differences but also I wanted to ask about the accuracy of the test, because I have read that there was a report from the government in Spain that the tests they were using had a 30% accuracy. So I’m wondering if you have experience from the ABAHO group or the Big Six group where they would have a lot more cases, and they would have a better idea on the accuracy.

NEWEL: Well, as most of you know, that first test that was developed through the Food and Drug Administration by the United States government was flawed in their manufacturing. And if that had indeed been released, that would have only had a 40% accuracy. 

So our government, although it has delayed testing by ensuring quality, our government has been very much on top of quality of current testing standards. And so as a result, the testing that’s done in our public health labs, and at the state and national level at the CDC has been very good in terms of both specificity and sensitivity. 

So picking up as many cases as possible at the same time, not including too many false negatives or false positives. And so I think that the testing that we have in this country has been better than in many other countries, although it did result in a delay in our ability to test.

GUMZ: Do you think that better would be 50%? 60%? 80%?

NEWEL: Oh, the public health lab testing is closer to 90%.

HOPPIN: So we’re gonna do one more in the room. And then one more on the phone right there. 

REPORTER: Thank you. So to build off of the testing topic. I have some serious concerns with Quest Diagnostic’s ability to actually deliver on the 24 hour turnaround time. So I’m curious if that’s something that’s keeping you guys up at night and any sort of contingency plan to explore or expand to other private labs or you mentioned the public health as well.

NEWEL: All of the commercial labs were completely overwhelmed when they opened their doors. And, for example, Quest opened their doors with the capacity of 1,300 tests in our region per day. And they have received 10,000 to 15,000 tests on a daily basis. 

So as quickly as they try to ramp up their capacity, they’re receiving more and more tests. The same is true with the other commercial labs who are testing. 

And so we have had very slow turnaround times, as long as two weeks or more from some of those commercial labs. And some of the commercial labs have even sent batches back saying we no longer have the capacity to test.

HALL: I think her specific question is the expedited testing for the healthcare providers where there’s a whole different process.

NEWEL: So we were skeptical about that too, because of this, but so far, we’ve had results within 24 hours and as quickly as 12 in some cases.

HOPPIN: Anything else on the phone?

BAXTER: This is Stephen Baxter. What’s the — here’s a question, what’s the metric if you’re trying to get the public to be motivated and shelter in place through July perhaps, what metrics should the public look for to see progress in Santa Cruz County?

NEWEL: So we’re, we’re improving our website, we now have seven-day-a-week posting of our number of cases and the demographics associated with those cases.

And then we have a weekly website update plan that will give specifics around a breakdown of inpatient versus outpatient management, of which — I’m forgetting what the other breakdowns are going to be on that. I know it’s going to be gender, age, oh, the means, the means of acquisition of the disease. So we’ll tell you how many of those cases were from travel versus how many from known contacts versus community acquired or unknown.

HALL: And I think the metric that the public should be looking for is when you see the cases go down. And particularly hospitalized [cases]. So, so part of what we try are also hospitalized cases and ICU cases. So when you see that, you’re gonna see them go up in the next several weeks. And when you see those start to go down, that meanswhat we’re doing is working.

ANDRE: As there are more cases, are you guys gonna release area demographics to zoom you can tell where maybe there are hotspots and that sort of thing. As more cases come along?

NEWEL: That’s the plan, yes. 

MEYBERG GUZMAN: Can you also release numbers of test kits administered? Other counties are doing it.

HALL: So the hard thing for us is we’re not the only ones who do the testing. And we could do those, but there would be a delay. So all of the public, the private labs, they do testing on — they do their own testing, but they only give us the test when there are the results. So we don’t know how many they’re doing until it comes back to us. But that’s — 

NEWEL: The number I gave you earlier around 300 — that’s the number of results we’ve gotten back from commercial test labs. And we don’t have any way of knowing how many tests have actually been sent to the commercial labs.

IBARRA: Just going back and hospitalizations really quickly. You know, I’ve read a lot – I’m sure you guys have seen you know ProPublica put out a data set. Santa Cruz County has actually been cited in multiple reports as an example of a county with a really low ratio of hospital beds to residents.

And I don’t — I’m just wondering if you could reflect on that challenge. First of all, do you, do agree with that premise? Are we uniquely or disproportionately challenged in terms of hospital bed capacity? And could you just speak to that a little bit?

HALL: I will say one of the reports that I saw in ProPublica, said that we had six ICU beds —

GHILARDUCCI: In the NPR report, I think –

NEWEL: Per 100,000.

HALL: So Dr. Ghilarducci just talked about the capacity, that we have the capacity to expand to about 50. So what you see in a static report is based on what is planned for the community need at this point in time. 

So when there’s no pandemic, there’s no reason to have 50+ ICU beds. And so our healthcare system has the capacity to expand, and they’ve met — made plans to expand. So that’s an important thing to keep in mind when looking at those numbers.

IBARRA: But relative to other counts as a starting point, starting with fewer beds, is that more of a challenge for us to bring additional bed capacity on?

NEWEL: Well, what we saw was that the number that NPR posted on their national website of six beds per hundred thousand people is not an accurate number. 

So we know that we have 25 or so ventilator-ICU beds at our baseline with an ability to expand to 50. So that’s far more, even if you use the 25 beds. That’s far more than what they reported on the NPR site. And we’re not sure where they got their data. 

So we know at least locally, that data was not accurate.

MEYBERG GUZMAN: Dr. Ghilarducci, what does the modeling say about the number of ICU beds needed?

GHILARDUCCI: Yeah. Some projections that we have now show that it’s really not a matter of when we’ll exceed capacity, even the surge capacity. I mean, it’s not a matter of if, it’s a matter of when and you know, some projections we’re seeing it right now probably in — by the, by the end of April or mid May we may exceed capacity of our ICU and ventilator. 

It’s based on what we project to be the length of stay in the ICU and, and obviously, the, the number of cases that come in.

MEYBERG GUZMAN: But how many — what does the modeling say? What’s the actual number of ICU beds needed?

GHILARDUCCI: Oh, the actual number needed. I don’t have that number, but it’s larger than 50. I can tell you that.

HOPPIN: Thank you, everyone. Got to respect your time.

NEWEL: I want to talk about shelter in place. 

HOPPIN: Okay. We’re going to talk about shelter in place real quick.

[laughter]

NEWEL: So it’s important for the public to know that I did not institute as strict in order for Santa Cruz County as the Big Six counties did. But that I will do that if the county doesn’t voluntarily respond to my shelter in place. 

So for example, in the Big Six counties, it’s a requirement that every place of business complete, implement and post a two-page form that you can find at the end of the shelter-in-place order, mine as well, explaining in specifics how they are following the social distance requirements. 

And in Santa Cruz County, I am not making that, at this point, an obligation or a legal requirement. It is strongly encouraged and we want our businesses and our community to fill out that form and implement the measures and post it. 

But at this point, we’re asking, asking them to do it voluntarily. And hopefully they will do that so we don’t have to make it a legal requirement. 

I’ve heard good response so far. And I hope that that will continue. 

And another difference — very important, I think for Santa Cruz County — is that we have not experienced the same crowding at the beaches and in the public parks that other counties have. And that it’s so important to note that if we do experience crowding and people not following the social distance requirements, I will close the parks and the beaches. 

And at this point, I’m hoping that we continue to have good voluntary compliance, so that I don’t have to do that. It’s very important that the public get that message. 

GUMZ: I just want to back up on that, on the tracking that you’re doing of the people who pass away. I read a study by the Italian government that 75% of people who died had high blood pressure. So I’m just wondering if you’re tracking other underlying conditions along with that. 

NEWEL: We are. And a very good article just came out yesterday from what’s called the MMWR, the Morbidity and Mortality Weekly Report, you can find it on the Centers for Disease Control website. 

And it looks at the first US cases, the cases so far in the United States and how many of those had underlying health conditions and they cite three specific populations of people that have those underlying conditions that are — put them at risk, and it’s diabetes, chronic lung conditions, and cardiovascular disease. So those three groups have been shown now in a good study with good numbers to put people at risk.

HOPPIN: Adriana, can you mute your phone?

NEWEL: Thank you. Sorry. These are the challenges of remote work. 

MEYBERG GUZMAN: Thank you for doing this. 

NEWEL: Thank you all and see you next week.

KMG: For those of you who are on our email list: Send us your questions. We’ll try to ask them in our next press conference.

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[MUSIC]

We’re supported by our members. Thank you to all our members. Thank you especially to our guardian-level members: Chris Neklason, Patrick Reilly, Elizabeth and David Doolin and the Kelley family. 

Thanks to Trimpot for the music.

Thanks to Natalya Dreszer for the transcript. You can read that at santacruzlocal.org.

And thank you for listening to Santa Cruz Local.

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Kara Meyberg Guzman is the CEO and co-founder of Santa Cruz Local. ​Prior to Santa Cruz Local, she served as the Santa Cruz Sentinel’s managing editor. She has a biology degree from Stanford University and lives in Santa Cruz.

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Stephen Baxter is a co-founder and editor of Santa Cruz Local. He covers Santa Cruz County government.