Coronavirus

Experts give takes on pandemic during county’s virtual town hall

Santa Clara County Supervisor Joe Simitian held the first of three scheduled “telephone town halls” April 5, fielding questions from among the thousands of listeners from Los Altos to Los Gatos about local and national response to the coronavirus crisis. 

Also leading the discussion were local U.S. Rep. Anna Eshoo; Dr. Sara Cody, the county’s public health officer; Dr. Yvonne Maldonado, chief of infection control at Stanford University; and Dr. Mark Adams, chief medical officer at El Camino Hospital.

Both Cody and Maldonado used the phrase “cautiously optimistic” to describe how they feel about the county’s handle on the virus.

“The early action we took here will help us avoid a worst-case scenario,” Cody said, referencing the six-county shelter-in-place order enacted March 17 and updated March 31. “It does look like the outbreak is growing more slowly compared to other areas, but we are by no means out of the woods.”

“We’ve been tracking number of cases coming into our hospital – our indication is that the curve seems to be flattening at this point,” Maldonado said.

Santa Clara County has the highest number of reported coronavirus cases in the Bay Area, with 1,380 as Thursday. It has the third highest number of cases in the state, behind Los Angeles and San Diego counties, and the second most deaths at 46, behind Los Angeles.

Many factors go into these numbers, Cody noted.

“We were one of the first places in the country to report a case, in early February,” she said, noting the county was reporting cases early on.

She added the county sees lots of travel to and from Asia, and specifically Wuhan, China, where the outbreak began.

“You have to remember a lot depends on testing capacity,” Maldonado said. “The more people you test, the more cases you can identify. … Some counties are larger than others – (there are) almost 2 million in Santa Clara County.”

As medical communities around the world work on solutions, Cody said social-distancing and shelter-in place practices are “slowing things down. That’s giving our acute-care hospitals and other facilities additional time to prepare, so when and if the most vulnerable among us get sick and require hospitalization, those resources will be available.”

Adams said the Mountain View-based El Camino Hospital is handling patient capacity well at this point.

“Because we have cut back on our elective surgeries and other procedures, (we have that) extra capacity,” he said. “We’re keeping close track of the number of ventilators, the number of rooms – so far, we’ve been very fortunate that we’ve maintained plenty of capacity. At least for us, for now, it’s not a concern. … We don’t expect to see the catastrophes like New York City or New Orleans, where the capacity got quickly exceeded.”

Testing delays

One caller raised the question of getting an antibody test – one determining whether patients have the ability to fight off the virus.

Maldonado said Stanford just received approval from the U.S. Food and Drug Administration for such a test. “but we’re just starting to figure out how to get it into a clinical setting. We would start with (testing) health-care workers first. … It’s not going to happen right away. The main issue is to keep yourself in isolation.”

More of a priority, Maldonado indicated, was people first being tested to see if they have the virus. Those tests remain in short supply, Cody said.
“Where we are with testing is not where we want to be,” Cody said. “We had anticipated with the commercial sector coming online, there would be widespread testing available. To be perfectly blunt, that is not the case. … There are not enough tests, so we are still having to prioritize testing for people who are symptomatic.”

Federal perspective

Eshoo, who chairs a House of Representatives subcommittee on health care, fielded a question from Simitian on federal delays in coronavirus test distribution.

“There are many levels of dysfunction,” she said. “I think the most consequential failure involved a breakdown in the efforts to develop a diagnostic test that could be mass produced and distributed across the country. … The time it took to accomplish this in our country may have been more costly to American efforts, I think, than any other failing. The (Centers for Disease Control and Prevention) developed and sent out tests, except the tests they developed and sent out were faulty and had to be recalled. We lost almost four weeks on the heels of that debacle. … We’ve been playing catch-up ever since.”

Eshoo touched on the recently approved $2.2 trillion relief package, citing five pillars – funding for hospitals and clinics; cash transfers for qualifying citizens; added unemployment insurance; funding for small businesses; and additional funding for state and local governments.

“We’re going to have to do more,” she said, noting the funds for forgivable loans for small businesses are already exhausted.

Eshoo said the bill covers those who either have to stay home because they’re sick with the virus or those who are caring for those who are sick.
One caller, who worked for a government assistance agency, pointed out she was hearing from people who were getting eviction notices even though the county has a moratorium against evictions through May 31.

Simitian said the situation underscores the importance of publicizing the fact that the protection exists and that renters understand their rights.

Although time was limited for questions during the 90-minute town hall, callers had the option of leaving questions at the end of the event with the promise that Simitian’s office would follow up with answers. Simitian said his office received approximately 100 messages.

Poll

In a Town Crier interview on Thursday, following the town hall, Simitian said approximately 1,300 of the estimated 8,000 listeners who called in participated in a poll. They ranked options on what concerned them most.

A majority, 54%, were concerned about hospital surge capacity; another 21% about at-risk elderly residents; 20% about the loss of jobs and the economy; and 5% about the loss of educational opportunities with the physical closure of schools.

Taking note of the number of callers concerned about hospital capacity, Simitian said feedback from the town hall revealed that people were informed and engaged on the issue.

“It’s an unusual problem we have,” he said of the virus. “We need to rely on members of the general public to help solve the problem. We need surge capacity. The public understands that pretty clearly now.”

Simitian said forums like the telephone town hall are important vehicles for information exchange.

“If we want folks to comply, we have to give them information to remind them why it’s important (to social distance and stay at home),” he said. “We can’t be successful if members of the public don’t buy into it.”

Two more Simitian-led telephone town halls are scheduled 11 a.m. April 26 and May 17. Simitian’s office will publish fliers in advance of the events with a phone number for residents to call in.

 

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