Miller Report for the Week of June 22, 2020
By William Miller, MD – Chief of Staff at MCDH
As of this writing on Tuesday evening, June 23rd, today ten additional new cases of COVID were identified in our county bringing the total number of confirmed cases up to 72, with one patient currently hospitalized elsewhere. Of these 72, the Ft. Bragg area only represents one case. Probably, most of this increase is due to expanded testing in Ukiah. According to the county health department, we have tested just over 9,400 persons here in the county. Compared with other parts of the US and California, this is only a modest rise. The exponential increases seen in the Los Angeles area, as well as parts of the US, cannot be attributed to just an increase in testing. This is because, in those areas, the number of hospital and ICU admissions along with COVID related deaths is also increasing exponentially. Thus, the disease is increasing, not just the number of positive tests results.
As shelter-in-place requirements continue to be rolled back, we will see an increasing number of cases here in Mendocino County. Eventually, we will see more cases here on the Coast. We should not be alarmed by this. It is what we know must eventually happen as we move to restart our economy, so much of which is based on people traveling in and out of our communities.
As long as we continue to be mindful, wear face coverings, wash hands frequently and social distance, then the increase in cases should remain gradual and it will be a situation that we can cope with. Unfortunately, there is no way around the reality that there will be people who get infected by this virus and that some of those people will not survive the infection. What we have hopefully achieved by the measures of shelter-in-place is not only a flattening of the curve, but also creating a situation where we will be better able to take care of the people who do become sick.
Consistent surveillance testing of our community is of increasing importance and remains frustratingly difficult to establish. The problem is largely the continued lack of availability of the supplies to perform the test. Our County Supervisors, Ted Williams and Dan Gjerde, along with Dr. Naomi Doohan of the Health Department have been working with Adventist Health – Mendocino Coast (formerly Mendocino Coast District Hospital), Mendocino Coast Clinic and the City of Ft. Bragg, to find a way to bring large scale surveillance testing here to the Coast and do so soon. It is our goal to be able to perform 200-300 tests per week on a consistent basis. Currently, it has been in sporadic batches of 100. So, for the moment, consistent, large scale surveillance testing is coming, but not quite here yet.
Fortunately, we have been more successful in setting up medical testing here on the Coast. Currently, we can test anyone who is symptomatic upon the order of their primary care provider. We currently are testing all admissions to the hospital who have symptoms and in the next few days will expand that to all patients admitted to our hospital regardless of symptoms. We are also currently testing all surgery patients. At this time, we are not offering antibody testing, because none of the tests available are reliable enough to distinguish between prior COVID infection from certain other coronavirus infections that cause the common cold. Additionally, it is unclear if having antibodies to COVID grants any type of reliable or long term immunity. However, there are several promising antibody tests being developed that may help better answer some of those questions and when they become available, then we intend to offer them.
While testing is very important and helps reduce spread through contact tracing when a person who is infected is identified, it cannot replace the value of those three simple things: face coverings, hand washing and social distancing. It may seem to some that such simple steps cannot be that important, but they are. Others may reject such recommendations because they intrude on our personal liberties. I am sure that most of us, my self included, are tired of hearing about them. However, they are, in fact, the most important thing we can do right now to protect ourselves and our community from this virus. So, thank you for listening once again to that message and for taking those simple steps to protect yourself and others.