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For those who measure despair by numbers, this past week’s harvest of metrics has been a bounty of mixed messages. The total number of COVID-19 cases jumped to 284 on Monday, up from 152 the last day of March. As disturbing as that increase seems, the number of patients hospitalized has flattened out and actually dropped a little in the past week, as have the number of patients consigned to intensive care units (ICUs). At the start of last week, those numbers hovered consistently at 37 and 17, respectively. Then they peaked at 40 and 18 late in the week. They now sit at 40 and 15.
These figures fall comfortably within the carrying capacity of the county’s five hospitals, which combined offer about 600 rooms and around 90 ICUs. Any comfort to be had, however, needs to be taken with more than a few cautionary grains of salt because of the large number of cases stemming from the Lompoc federal penitentiary.
The Lompoc prison now accounts for 63 cases, with more likely on the way. Penal facilities rank with cruise ships as fecund breeding grounds for the new virus, and some county emergency planners have described the federal prison as a potential “black swan” event. If so, it remains to be seen what burden those infected inmates and guards will place on the county’s health-care institutions. But if Lompoc’s lock-up were removed from the equation, then the county’s numbers appear relatively rosy with only two deaths as yet attributed to the virus.
All this good news has generated a burst of bristling impatience from some in the business community who are ready to proclaim victory in the war against COVID-19. They insist that the peak is already behind us and that the proverbial curve has been flattened not just in Santa Barbara but statewide. The time to begin returning to normal, they say, is now.
Leading this charge are not just Joe Armendariz and Andy Caldwell — longtime conservative activists who’ve trumpeted pro-business agendas — but Noozhawk publisher Bill MacFadyen and columnist Brian Goebel, whose writing on the subject has blown up the online news site’s social media.
Making the case against any change of action in front of the county supervisors this Monday was Van Do-Reynoso, head of the county’s Public Health Department, who predicted the number of new cases would “drastically increase if we let go of social distancing.” Do-Reynoso told the supervisors that new epidemiological models indicate a 96 percent infection rate from COVID-19 if the state retreats from social distancing. By contrast, she stated, if the current practices remain in place, the infection rate would hover at 30 percent. If even tougher restrictions are adopted, she said, it would drop to 5.5 percent. Any relaxation of social-distancing mandates, she argued, would lead to an increase in cases and an “increase in demand for hospital services beyond our current capacity.”
Do-Reynoso told the supervisors she spent the better part of Saturday on a statewide conference call hosted by the California Department of Public Health with her peers from the state’s other 57 counties. Everyone was asking the same question. “At what point do we loosen the reins?” she asked. “This is a difficult period in our history. We have to acknowledge the societal impacts; we are aware of that.”
Two of the five boardmembers Do-Reynoso answers to—Peter Adam and Das Williams—have both expressed serious concerns about the economic pain inflicted by the declaration of emergency imposed by Governor Gavin Newsom on March 19. Typically, Williams and Adam espouse the most consistently divergent viewpoints of any boardmembers. Both have suggested that with COVID-19, the cure has proved almost as lethal as the disease. Adam took the opportunity to give a shout-out to Goebel’s writing on the matter. Goebel — a member of the Montecito Water Board and a former appointee to the Department of Homeland Security — has touted his own modelling efforts as superior to anything offered by the state or federal governments and has argued that the time to change course is now.
Do-Reynoso cautioned the supervisors they are not empowered to chart their own course on this. They can only adopt stricter measures than those enumerated by Governor Newsom but not less strict. To date, Newsom has indicated no intent on relaxing those requirements soon.
Adam asked Do-Reynoso whether she was familiar with the concept of herd immunity. She said that she was and explained that it referred to a point where enough members of any given population had been developed a natural immunity after having been infected, thus slowing down the rate of spread. Adam expressed relief that Do-Reynoso was familiar with the concept.
Lee Heller, a politically influential environmental and animal rights activist, testified later that herd immunity is achieved only after 85 percent of the population had developed resistance to a given disease. “We’re nowhere near that,” she exclaimed. Heller also dismissed Goebel’s research, objecting he was not an epidemiologist. “If you reduce prematurely,” she argued, “the economy will crash again, and people who are vulnerable now will be made vulnerable again.”
The $64 billion question confronting the supervisors and all elected officials in the state is at what point can they begin to let people go back to work. To that question, Do-Reynoso offered a first step, but hardly a blueprint for normalization. “We need to be able to do robust testing,” she stated, “but that has not been possible for various reasons.” That testing, she explained, was necessary to determine the scope and scale of the outbreak.
Supervisor Gregg Hart rushed to fill in some of those blanks, citing multiple shortages—from the cotton swabs needed to take mucous samples from the nose and throat to the chemical reagents needed to activate the RNA taken so that it can be matched with the coronavirus. Not all tests are the same, he cautioned. Public labs and private labs deploy different methodologies, and samples taken for one cannot be tested by another with any hope for reliability.
“It’s like trying to put a Ford steering wheel on a Chevy car,” he analogized. “It sounds simple to say, ‘We’re here, and we need to get there,’” Hart added. “But getting to there is a long, complicated change and not as simple as it seems.”
Do-Reynoso added that within two to three weeks, a new test is likely to be available that allows medical professionals to determine if a person has already been infected. The thinking is that previously infected people will be immune from further infection, thus allowing for a more surgically precise manner of quarantining. The problem, she added, is that the virus is still so new that no one knows for certain what level of immunity people who’ve already been infected enjoy. One report, she said, indicated it was a 60 percent immunity; another indicated it was closer to 10 percent.
“We’re so new into this,” she said. “There are so many unknowns about the virus.”
According to Suzanne Grimmesey, spokesperson for the county’s Department of Behavioral Wellness, the numbers seem to bear out such concerns. In March, she said, the county recorded 80 instances of declaring someone posed an imminent threat to their own health or someone else’s because of suicidal ideation. In February, that number was 62; in January, it was 38.
A list of regional mental-health resources can be found at countyofsb.org/admhs. If you or someone you know is thinking about hurting themselves, call 9-1-1 or the 24/7 National Suicide Prevention Lifeline at 1 (800) 273-8255. For more information on suicide prevention, including warning signs and risk factors, visit suicidepreventionlifeline.org.