Supervisor Peter Adam circa 2014. | Credit: Paul Wellman (file)

It was an hour into the Santa Barbara County supervisors’ meeting before anyone asked if the governor had replied to the request to separate the tri counties from the Southern California Region. The state’s new COVID regions count available intensive care beds, and the information that morning was bad: SoCal was at 1.7 percent availability, down from 10.1 a week ago; the tri counties were at 30 percent, down from 34.8. And, no, Newsom had not replied, said County Executive Officer Mona Miyasato, answering Supervisor Steve Lavagnino’s question.

Newsom was at that time holding a press conference and announcing the delivery of 33,150 Pfizer vaccines to four locations yesterday, and that all 327,600 doses from Pfizer would arrive in California by the end of the week. Pfizer had additionally committed another 393,900 doses for delivery the following week, and Moderna, once approved, would deliver 672,000 doses by the end of the year.

The vaccines due to arrive in Santa Barbara County, Public Health Director Van Do-Reynoso told the supervisors, would go to Cottage and Marian Medical — two boxes each, totaling 3,900 doses from Pfizer — and 6,600 doses from Moderna were expected next week if the Food and Drug Administration gave the company an Emergency Use Authorization. A third allocation from Pfizer would follow, Do-Reynoso said. Supervisor Gregg Hart noted that would cover about two-thirds of the 20,000 frontline medical workers in the county, and the second dose would come from future shipments.

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That could give some relief to those who care for COVID patients, whose numbers had increased, as expected, after Thanksgiving dinners and parties across the county. From November 30 to December 14, active coronavirus cases went from 410 to 940 — spurred in part by a record 360 new cases reported on Monday. Hospitalizations went from 33 to 75, and ICU cases went from seven to 21 cases during those two weeks. As well, Public Health was tracking cases at 10 nursing homes involving either staff or residents, and the Sheriff’s Office reported on Monday that five custody deputies at the county jail, a patrol deputy, and a staff member had tested positive.

In a video released by Cottage Health yesterday, infectious disease specialist Dr. Lynn Fitzgibbons explained why the ICU bed count has become a critical factor for the state. To start, nationally, the “big picture was quite grim this week,” she said. For the deaths they counted today, the patients were probably hospitalized one to three weeks ago, and their diagnosis counted a week or two before that. Daily reported cases have risen for the past six weeks, Fitzgibbons said, recalling that “in October Santa Barbara County was in the red tier and looking to drop to orange.” Instead, the county transitioned quickly to purple in November. She called the severity of the current surge in cases “staggering” and said the impact on ICU beds can be sudden.

This chart shows the county’s ICU bed-count was stable or slightly decreased in December, but for the Southern California area, it plummeted to 4.2 percent. | Credit: Cottage Health

“The ICU number trails the general hospital trend,” Dr. Fitzgibbons said, “and in the past few weeks, the general hospital trend has been dramatic.” She added that when a patient’s condition deteriorates and requires admission to an ICU, they stay there for weeks or longer. For a county like Santa Barbara with a relatively small number of ICU beds — about 90 — a small number added or released can change the percentage considerably.

The more sparsely populated Northern California region had a 29.8 percent ICU availability, the Bay Area was down to 15.8 percent, Greater Sacramento 14.9 percent, and the San Joaquin region was 1.6 percent after dipping to zero over the weekend. The state of hospital beds is such that although Cottage accepted two patients from Imperial County in November when it had only two other COVID patients, said spokesperson Maria Zate, that number has grown to 37, and the hospital can take no other transfers. At Cottage Rehab, which stopped new admissions last week after a 14-person COVID outbreak, new patients were allowed again on Monday.

The new state mandate has caused dustups in Solvang — whose City Council refused to tell its restaurants and tasting rooms to shut down — and Montecito, where Tre Lune held a rally against the closures on Saturday while serving pizza off of common trays. Most participants wore masks, as requested by the restaurant, which is fortunate — one COVID case was confirmed among the staff working that day. The individual did not contract the disease at the restaurant, and no one else has tested positive, but the Montesano Group encourages people who feel they were exposed to be tested, a spokesperson said.

The weight of the pandemic restrictions has rubbed Supervisor Peter Adam and his constituents the wrong way, and the supervisor, who will retire from the board after this meeting, asked for a resident whether false positive results could account for the drastic increase in the COVID positivity rate. Do-Reynoso explained a review of the literature found a range of 0.8 to 4 percent as the false positive rate for PCR tests. Outliers were zero and 16 percent, from single non-peer-reviewed articles.

One factor in the rate of false test results was the amount of disease in an area, which Adam questioned as relevant. Adam regularly challenged Public Health officials, asserting COVID was no worse than the flu and repeating popular theories that trouble the medical community, then waving off their answers with a casual rudeness. This time, Health Officer Dr. Henning Ansorg acknowledged Adam’s concern and gave something of a shaggy dog story as a reply — if he and the supervisor were to go get tested, since the county had a higher level of negative results, the possibility was greater for a false negative — and Adam broke into laughter, evoking a demand of “Why are you laughing, sir? What is so funny about that?” from Ansorg, who bristled at Adam’s disrespect.

“Excuse me, doctor,” said Adam. “I don’t know why you need to jump on me like that. Just relax.”

“I do not like to be ridiculed, sir,” Ansorg replied.

But whether the restrictions are ridiculous or necessary, they are causing real consequences, several public speakers said, especially among seniors who ran low on food. Because of vulnerability due to age and poverty, Lisa Brabo with the Family Services Agency, Joyce Ellen Lippman with the Area Agency on Aging, and Gary Linker with the Center for Successful Aging described how more than 2,000 seniors in the county needed programs that would falter with the end of the CARES Act funds at the end of December — and not just for food but also the companionship of having a delivery driver come to the door daily, assistance with buying scarce paper goods, mental-health services, and transportation help. Approximately $66 million has come to Santa Barbara County from the CARES Act and other federal pandemic sources, according to UCSB economist Peter Rupert.

Brabo said 76 percent of her group had not received services before. Linker added that many fell below the $1,040 monthly poverty level, some in wheelchairs who relied on neighbors and now service agencies.

Supervisor Joan Hartmann had her own brand of disrespect, but for Congress in holding up federal help. “Many don’t understand that a lot of county dollars are passed through from the state. We are in desperate need. The world, our country have a desperate need for federal relief. If Congress goes home for the holidays without enacting something, that is unconscionable.”

Correction: Family Services Agency is run by Lisa Brabo, whose name we misspelled “Bravo” previously.

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