Santa Barbara County Copes with the COVID Surge

Contact Tracers Phone Constantly to Stem the Coronavirus Tide

Santa Barbara County’s 68 contact tracers can phone as many as 120 people daily as they forestall the spread of COVID-19. | Credit: Jackie Ruiz/Santa Barbara County Public Health Department

A certain level of freakout takes place among employees when they hear a coworker tested positive for COVID-19. It’s a frustrating, even scary, situation for everyone. Patients must self-isolate, worrying if they’ll end up in the ICU. For Public Health, it’s a waiting game as state-run testing facilities are maxed out. For customers — well, wear a mask, everybody, and wash your hands.

Santa Barbara County’s halcyon 1 in 100 positive testing rate — just a month ago — rose to one infection in every 10 persons tested in recent weeks. That raises the question: Who is next in line to be infected? Finding out is the job for the county’s 68 contact tracers, who make hundreds of calls trying to locate anyone who was in contact with a positive patient. But is the system working?

So many people have flooded the state’s free testing system — some just out of curiosity — it’s taking 8-10 days for results to reach the county. A test through a private doctor can cost $130, and some places limit them to symptomatic patients. Insurance covers the test; for the uninsured, tests are paid by the federal Health Resources & Services Administration.

Getting Tested

“I just had an interesting experience,” Leo Raabe said. Raabe was an electrician before joining the Hope School District as a teaching assistant. He ended the school year recording video lessons for the classroom and then returned to his electrician job for the summer, working on a grocery store that’s about midway done.

Leo Raabe ended up in Solvang for his coronavirus test; the other speedy option was Oxnard. He’s recovered and back at work, and he shared his experience with the Independent.

“I started having very mild symptoms,” Raabe said, “and I’d been on that job for two weeks.”

Getting a test was an adventure in itself. But after his positive result arrived, Raabe waited a week to hear from a contact tracer. He finally phoned the county. Raabe reported that the person who answered his call said, “The contact tracing situation is a mess.” He did talk with a tracer the next day, as did the people he told the contact tracer about. “I guess the county’s still trying to catch up with the surge,” Raabe said.

At times, the county receives a massive dump of test results from the state, accounting for huge spikes in positive cases. When that happens, the county’s tracers dig in, succeeding in reaching patients within 2.4 days, said County Public Health spokesperson Jackie Ruiz. But the week-plus lag in learning their identity in order to start the contact process makes breaking the chain of infection nearly impossible; the genie is well out of the bottle by then. To overcome the delay, Public Health recently asked employers to report what they hear from their employees so that the tracing can get started sooner.

Nurse investigators do the first screening, Ruiz said, followed by a contact tracer, who can talk to as many as 120 people in the course of a day. Their findings show that about 5-10 people are contacted by a symptomatic person. State health officials tasked 15 more tracers to Santa Barbara County last week, and another 15 will begin work this week. All tracers are trained at an academy run by UC San Francisco.

A single sick employee must stay home and isolate until three days after symptoms go away completely. But if three employees report sick within two weeks, it’s considered an outbreak, said Ruiz.

Letters of Concern

A number of employees who work in local businesses have written to the Independent worried about their managers and co-workers who do not wear masks or sanitize the building regularly, and who allow so many customers into the store that social distancing becomes impossible. Even more concerning is when managers did not tell staff that one employee had become ill.

The Independent contacted all the stores at which employees had expressed concern and received full responses from their public relations spokespersons. Each confirmed they had employees who’d been ill and said they’d each done a deep cleaning and properly informed their employees.

The big box stores in Goleta — such as Home Depot — see thousands of customers and have dozens of employees. They have had positive employees; it would be extraordinary if they didn’t. Margaret Smith in Home Depot’s public relations department in Atlanta replied immediately. She reported that three weeks ago, one employee did have COVID but is now fully recovered and will be returning to work soon. The company gave paid time off to sick employees and also to those who care for ill family members, she said.

Businesses know full well that news of an active COVID case scares customers and that, legally, they can’t discuss the private matter of an employee’s health. When employees of a local grocery told the Independent that a colleague was sick, a manager who picked up the call was so flustered she hung up on the reporter.

A few days later, we received a call from that store’s corporate office confirming the employee’s status, who had remained home when symptoms developed. The spokesperson said it was the first case among their Santa Barbara stores.

Pandemic Protocol

Just about everything we thought we knew about COVID in March has changed. It still spreads through coughs and sneezes, and people are still dying — but we’ve learned that face coverings help shorten the spread and that younger people, not just the elderly and immune-compromised, can become very sick. “Under investigation” remains the largest group the county is tracing for the infection point, about half, but “close contact” is 20 percent and “general community spread” represents 15 percent.

The guidelines for employers, according to Public Health’s Jackie Ruiz, included the 15-minute rule — if employees were closer than six feet together for 15 minutes or more without face coverings in a badly ventilated room, they have been in close contact. The time period starts 48 hours before symptoms or a positive test, and 10 days afterward.

As for deep cleaning, it was recommended, but it was up to the business, said Ruiz. The Centers for Disease Control and Prevention outline that a deep clean involves either letting germs settle or be ventilated for 24 hours, and then common and individual spaces, especially high-touch places, were cleaned and disinfected.

It is a difficult decision to order a business to close. So little is known about COVID-19, and how it is transmitted, Ruiz said. “We have to rely on wearing face masks and social distancing to protect people.” At the county, cease-and-desist letters are being prepared. “We hope to see compliance,” said County Counsel Michael Ghizzoni, “and to see people back in business safely. But we’ll be in court if education and compliance fail.”

Employees concerned about workplace safety can file with Cal/OSHA, Ruiz explained. Additionally, the county accepts “compliance concerns” here.

Wearing a Mask

Back in May, former Indy intern Chris Salcedo wrote a poignant editorial describing his mother’s ordeal recovering from COVID-19. She’d fallen sick in March — on a generous leave from Costco due to her preexisting condition. She went from emergency room to intensive care to a ventilator in one short week. “[O]n Saturday April 4, my father’s birthday, her heart stopped. She had to be resuscitated and then spent the next three weeks in a medically induced coma. As I write this, she is still in the rehabilitation facility, literally learning how to walk again,” he wrote.

“We can stop these experiences through small, inconvenient actions. Wear your mask. Wash your hands. Social distance.”

Update: This story was updated on July 15 to indicate Santa Barbara County’s contact tracers phone patients within 2.4 days of learning their identity.

At the Santa Barbara Independent, our staff is working around the clock to cover every aspect of this crisis — sorting truth from rumor. Our reporters and editors are asking the tough questions of our public health officials and spreading the word about how we can all help one another. The community needs us — now more than ever — and we need you in order to keep doing the important work we do. Support the Independent by making a direct contribution or with a subscription to Indy+.