DR. FRANKOVICH SPEAKS: More on That New State Order, The Prospect of School This Fall and Much More Tackled In Today’s Media Question Time
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In today’s media availability, Dr. Teresa Frankovich — Humboldt County’s health officer — talks about that big statewide order handed down yesterday (and the county’s delay in implementing it). She also talks about the prospect of in-person schools opening in the fall, the evolving understanding of how the virus operates (and how to best protect one’s self), the president’s stripping of data from the Centers for Disease Control and more.

Video above. Questions and summaries of Dr. Frankovich’s answers below.

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Can you tell us a little bit about the state order that came out
Monday?

It was a surprise
and a disappointment for many, Dr. Frankovich says. Humboldt County
is doing fairly well right now. But the state has to consider the
sheer number of cases that are being verified statewide right now,
the rapid increase in cases, hospitalizations and ICU usage. And also the high percentage of
people who are testing positive.

This is an
“intermediate” measure, Dr. Frankovich says, designed to
keep us from having to have to go back to full shelter-in-place mode.
Counties are being asked to participate in this effort.

The state is trying
to take the riskiest activities — which are typically indoors — off
the table for the time being in hopes of slowing the spread.

What kind of
preparedness can people who suffer from debilitating illness do to
prevent a more serious onset of the virus such as respiratory, heart
or asthma problems?

“Obviously, we want [those] people to stay out of circulation as
much as possible,” Dr. Frankovich says. “Really, shelter in place
as much as possible, and reduce your risk of exposure.”

Also: Don’t neglect your regular treatment for those underlying
conditions, so that your body is in the best shape it can be should
you contract the virus.

What suggestions
do you have for people to boost their immune systems to be healthier,
and be prepared in the likelihood of infection?

Same things that we talk about all the time, says Dr. Frankovich –
healthy diet, exercise, getting plenty of rest. Also: stress
reduction. Do things that help you reduce stress.

The New York
Times
released an article yesterday that read: “Trump
administration strips CDC of control of coronavirus data.” What
does this mean and is it a dangerous move?

Dr. Frankovich says she has “grave concerns” about this. The
medical community – and others – have long viewed the CDC as
being the agency that vets and makes available the best possible
information. If the data that the CDC generally produces disappears
during this crisis, it will impair our ability to respond not only to
this pandemic, but future ones as well.

Dr. Frankovich,
some people appear to believe that the rate of transmission of a
virus is fixed. But differing strategies affect the rate of
transmission. Could you please explain how PPE availability,
especially for frontline healthcare workers, affects the rate of
transmission of a virus of this nature — which doctors and
epidemiologists now know is being transmitted by aerosolized
particles from basic human functions like exhaling, coughing, sneezes
and singing — and how the rate of transmission is able to fluctuate
in a community.

We’re learning more about the transmissibility of the virus all the
time, Dr. Frankovich says. Coughing, sneezing, singing – and even
just loud talking – can be riskier than other activities. Also,
some individuals seem to transmit the virus more effectively. Also,
it could be that some strains of the virus transmit more easily.

PPE? The facial coverings we use are intended to trap particles –
especially the large particles – that we all expel from our mouths
when coughing, sneezing, talking, or even breathing. If we all wear
masks, then we reduce the amount of virus that is out there, floating
around in the air.

You’ve talked
about cases within the cannabis community, and also how people who do not permanently reside here are not included in our total case
count. With both of these things in mind, how many positive cases
have actually been reported in Southern Humboldt? The county
dashboard has shown four cases for at least the last two weeks, which
quite frankly seems on the lower end compared to other areas.

The
case counts as presented on the county’s map are accurate, Dr.
Frankovich says – but people should remember that they show where a
person resides,
rather than where a person contracts the virus. People should not use
the map as a measure of how safe or risky their particular community
is.

Where do you
stand on schools re-opening this fall?

“I’m a pediatrician and a public health person, and I would love
to see kids in school,” says Dr. Frankovich. She says that they’ve
been working with schools to see how this might work in the fall –
organizing things in a way that we can have kids back in school.

But the conditions with this pandemic change rapidly. Schools have
been developing contingency plans for all sorts of different
situations, and they’re trying to ready themselves to adapt to
conditions as they change.

“While I’m hopeful we’ll be able to have schools operate with
full site instruction, it’s not clear yet that that’s the case –
or that if we open in that way we’ll be able to continue through
the fall.

You have said
contract tracing is impacted by delays in testing and increased
social contacts lately. If contract tracing is strained now, how will
it not become a more dire situation if schools reopen for in-person
instruction?

“Our
contact tracing capability is really good,” Dr. Frankovich says.
“The things that we can control? We’re in really good shape.”
But as has been discussed, the testing part of it is a big challenge
right now.

As
we stand, Frankovich believes the county could manage it – maybe
depending on what new testing capacity the county can construct over
the next month or two.

What PPE is being
provided to the 31 school districts across the county and the
county board of education?

Dr. Frankovich says they need to talk to the schools to determine
what they need. The county has received a bunch of kid-sized facial
coverings, which is good. She anticipates that some teachers may
want to use face shields as well as facial coverings.

It’s summertime,
which also means the new school year is just around the corner. What
sort of guidance is Public Health giving local school districts and
administrations when it comes to reopening schools in the fall? Do
you think it’s feasible for kids to return at that time and if so,
what are your major concerns? Or is distance learning a more likely
possibility?

See above. But distance learning is not at all ideal, and they’re
certainly working toward a hybrid or full site model.

Governor Newsom’s
announcement to close a handful of business sectors this week appears
to be somewhat of a step back into the stay at home order. Do you
anticipate a “seesaw” pattern of reopening some business
sectors and closing them again as we progress through the summer and
into the fall?

We’ve
talked about this all along, Dr. Frankovich says – the potential
need for a pause or a rollback after opening. But even though we’re
subject to state rollbacks, if we can continue to manage the rate of
spread well we can at least avoid the need for local rollbacks.

What gives
Humboldt County the authority to delay implementation of a state
order that went into effect Monday?

The state order is in effect.
“I think there was a recognition that it was extremely short notice
for businesses,” Dr. Frankovich says. “Certainly I understand
that a restaurant who cannot open to outdoor service is suddenly
sitting with a refrigerator full of food. And that’s a problem.”

She says that the Sheriff was
recognizing that there was a need for people to have a day or two to
ratchet down.

For us,
given our COVID numbers, it was not an emergency. This gave us
latitude to accommodate the needs of local business owners.

Some business
owners forced to close indoor operations feel they have been
blindsided by the order to close and see it as unexpected. Does the
county have any way of warning these businesses about the closure
orders ahead of time, so they come as less of a surprise?

The county got very little notice about it, says Dr. Frankovich. The
situation is so fluid that it’s hard to do that. Dr.
Frankovich says that she is certain that the state was very reluctant
to issue this order, but felt that it was necessary.

Regarding
decisions to close businesses, roll back re-openings, and implement
local policy changes on this level, can you please clarify who makes
the final call on this? Between yourself and Sheriff Honsal,
which of you is higher ranking in terms of policy decision-making in
the context of this pandemic? Or is this decided in another way?

It’s
not a single person driving the operation, says Dr. Frankovich. They
have a policy committee that meets to discuss things. But as the
Health Officer, she has the authority to issue a health order, and
that order is law.

She
says that she counts on the cooperation of the Sheriff and other law
enforcement officials to ensure that state and local orders are implemented. The intent has been to frame this as educational. But
it’s important to have enforcement available for people who do not
behave responsibly.

Most
people have been responsible, Dr. Frankovich says. “And honestly, I
think our numbers reflect that,” she adds. “It’s not only the
hard work of contact tracers and people doing the testing in our lab
and all of that – it’s the actions of the majority of our
community that’s keeping us in relatively good position. And I
appreciate that.”

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