Cottage Health Throws Down on COVID

For Cottage Health, it’s been the equivalent of a 21-gun salute. In the past two days, Cottage Health medical professionals and administrators have stepped up to the public microphone in an uncharacteristic and unprecedented manner to warn the community at large that the threat of COVID-19 is very real and getting worse.

On Thursday, it was infectious-disease specialist Dr. David Fisk — normally a paragon of clinical rectitude and understatement — who publicly stated that on scale of 1 to 5, the local threat posed by COVID-19 ranks as a 10. The same day, it was a team of Cottage administrators — including CEO Ron Werft; six infectious disease specialists; three chiefs of staff representing Cottage’s Santa Barbara, Goleta, and Santa Ynez hospitals; and Dr. Edmund Wroblewski, the chief medical officer for the health-care system.

Since then, it’s been followed up in a videotaped message today from infectious-disease expert Dr. Lynn Fitzgibbons, who has emerged as the hospital’s most prominent face forward in responding to the COVID challenge. In it, Fitzgibbons wishes viewers a happy Fourth of July but stressed the need for caution and vigilance and the critical importance of social distancing.

“[L]ocal case numbers are rising steeply,” the community missive from Cottage warned. “This virus spreads easily, and we are seeing growing numbers of people becoming very ill. The patients we are seeing have a variety of symptoms. We can’t let our guard down.”

Cottage currently conducts about 2,500 COVID-19 tests a day. According to Cottage’s community letter dated July 2, the past weeks’ positive test rates increased from 3.9 percent to over 6.2 percent to 8.7 percent as of July 1. The rising numbers of positive results generated serious alarm throughout Cottage’s executive team, which met a week ago to discuss epidemiological projections for how bad the crisis might become if present trends continued unabated. Driving the sense of urgency in that meeting was the steep increase in COVID cases since the Memorial Day weekend one month ago and an anticipated onslaught of out-of-town visitors expected for the Fourth of July weekend.

Dr. Stephen Hosea, who signed the community letter, acknowledged this is new ground for Cottage but said the hospital felt the need to get the community’s attention. “I don’t remember us doing this before,” he said, “not even during AIDS.” Cottage felt an urgency to combat the rising tide of quarantine fatigue, he explained, particularly with the arrival of a major holiday weekend upon us.

Part of Cottage’s response stemmed from concern that local beaches would remain open at a time when Los Angeles, Ventura — and now Orange — counties all had shut down their beaches. A mass exodus of beach-seeking visitors coming to Santa Barbara sent chills down the spines of Cottage administrators.

“Three weeks ago, maybe one percent of the people getting tested at Urgent Care clinics were testing positive,” Hosea said. “Then it jumped to 3 percent. Now it’s at 10 percent.” Many of these individuals will remain asymptomatic, he said. Many will not get sick or need hospital care. But they will help spread the infection to people who — in increasing numbers — will need hospital treatment. “And really, there’s not much we can do except give them oxygen,” he said.

According to the community letter, Cottage Hospital and its intensive care rooms set aside for COCVID patients are currently at 18 percent capacity. That does not concern doctors like Hosea as much as the sharp rise in hospitalizations. “Right now, we have anywhere from 22 to 25 people with COVID in our hospital. Three weeks ago, it was closer to five. Yes, we have a lot of room left at our ICU. But with these numbers, you never know when that’s going to change.”

Hosea said he was somewhat reassured that county health officials have partially shut down county beaches. “It’s not really a closure so much as restricted use,” he said. “It’s better than nothing.”

When asked where he would be spending the Fourth, Hosea replied, “Probably in the hospital,” adding, “I can tell you where I won’t be spending it. At the beach.”

Cottage as an institution is exceptionally careful and calibrated in how its employees — doctors and staff — interact with the news media; subjects of conversation are carefully vetted in advance, interviews are often presided over by Cottage media personnel, and pains are taken to make sure nothing too surprising is uttered in Cottage’s name. This recent outreach effort had been conspicuously different in this regard, reflecting the high degree of alarm the hospital is experiencing. “Two weeks from now, we’re going to be seeing a whole lot of people who will be getting infected this weekend. We already saw the rise in cases from Memorial Day. We don’t want that to happen again,” Hosea said.

Hosea expressed sympathy for the fatigue and exhaustion people are feeling, having dealt with COVID now for four months. “It’s a balancing act, we get that, between the economy and public health. A lot of people have been economically hammered because they can’t work. That’s real.” But Hosea added that when he’s out shopping, he frequently sees people wearing face coverings under their chins or that don’t cover their nostrils.

“We need to remind people that this is really serious. And if we don’t take it seriously, more and more will wind up infected.”