Spread of COVID-19 feared easier than previously thought, masks recommended

On Friday, San Luis Obispo County completed the last of planned daily updates from the Public Health Department, and covered three important issues related to the COVID-19 pandemic as it related to the residents of SLO County. Emergency Services Officer Wade Horton, SLO County Sheriff and Coroner Ian Parkinson, and County Health Officer Penny Borenstein.

A Thursday-night protest by local healthcare workers alleged a lack of personal protective equipment (PPE) for those on the frontlines caring for the sick. As the County transforms Cal Poly’s Recreation Center into an alternate care site with several hundred beds in anticipation the county will see a spike in cases of COVID-19 needing hospitalization, concern that healthcare workers on the frontline are not adequately supplied also spikes. As of Friday, 15 healthcare workers were among those who tested positive in the county.

A flashback to January recalls medical workers and those transporting COVID-19 patients were head-to-toe in protective hazmat suits. Now the world has seen more than 1,000,000 confirmed cases of COVID-19 and deaths in nearly every country on Earth, and SLO County healthcare professionals are asked to tend to a growing number of cases locally.

Supply and Demand of PPE

Horton began the conference with an address to the complaint by healthcare workers that there was not an adequate supply of PPE made available to those tending to those sick with COVID-19.

The number of confirmed cases in SLO County hit 93 on Friday, with 57 of those being fully recovered. Of the 36 active cases, 30 were recovering at home and six were hospitalized. Horton assured the public that the County is placing a high priority on local healthcare workers, even as the protest suggested otherwise.

“Our nurses, techs, EMTs, and healthcare workers are all stepping forward to serve our community in this crisis. They are our heroes,” Horton said. “They are also our neighbors and family members. They are putting themselves on the frontlines to protect us. We have a responsibility as a community to do everything we can to protect them.”

Less than 24 hours since candles and dozens of nurses stood at recommended social-distancing lengths and families gathered in support, Horton pressed his message that local hospitals have been given supplies upon request.

“I regularly speak with the CEOs of all four hospitals in San Luis Obispo County to determine if they have the PPE they need to protect their workforce,” Horton said. “Since this pandemic began, several have told me they need more PPE and we have been able to fulfill those orders. I spoke with them this morning and they confirmed they currently have the PPE they need. We have a logistics team working around the clock to purchase PPE and get it out to those hospitals.”

Along with placing orders with national and international suppliers, local healthcare providers are supplied by local donors who have masks in stock to give.

“We are also accepting PPE donations,” Horton said. “The community is stepping up. People like Brad Goodrow of Mid-State Solid Waste and Recycle donated approximate 10,095 masks. If you have PPE to donate, please let us know at readyslo.org.”

Despite the protest on Thursday, the County Public Health Department contended they had an adequate supply of PPE and hospitals were able to receive orders as needed.

“We’ve been in direct communication with hospital presidents,” Borenstein said. “They are not using anything but medical grade PPE. Yes, in some cases they are reusing PPE, but it is all in accordance to Center for Disease Control guidance as to what can be used, how and when.”

However, Borenstein admitted that local healthcare workers and patients may be forced to reuse PPE at times — she also assured that the reuse is within suggested guidelines from the Center for Disease Control.

“In some cases N95s are maybe used for more than one patient,” Borenstein said. “They are being kept because it is the person who is wearing it that is being protected, and as long as it is not soiled and in good condition — the elastic and fitting is good, then it is a way that we have not only been allowed to, but recommended to stretch the PPE availability.”

Borenstein reported that the County does have a stock of N95 surgical masks and other PPE, and while meeting local demand is working to preserve some of the stock for future demand.

“If it is not requested on a day-in-day-out basis,” Borenstein said, “we are definitely ensuring that our alternate care site will be ready to receive patients, but we have also been able to fulfill requests as they are coming in. We also have additional orders in place and have seen those orders being fulfilled — perhaps not as quickly as we would like, but we are getting supplies of PPE.”

Crime and Enforcement

Parkinson took the podium to address the enforcement questions and issues facing the community, and explained the process businesses might face if they violated the County shelter-at-home order to close nonessential businesses.

“There is a couple things that need to be cleared up,” Parkinson said. “First, law enforcement is not making traffic stops asking people where they are going. Our purpose is to identify issues out in the community, either through businesses or social gatherings, where we make contact. We are not making traffic stops nor issuing citations for overnight parking — things that might be normal day-to-day operations, we are not doing that right now.”

Concerns about crime and the deployment of the National Guard grow as the pandemic begins to push “normal” out of sight and heavy-handed enforcement becomes the new normal as businesses and residents adapt to orders and guidelines, and changing health conditions.

“There is no deployment plan,” Parkinson said of the National Guard presence in the county. “There is no order for them from the state for them to deploy in any other way but for humanitarian purposes. Our goal in enforcement is really simple — it’s voluntary enforcement. We want people to follow the rules. At the end of the day, if we come out of this with zero arrests, zero citations, and zero actions against a business, that is what we want. So far, we have been successful in that attempt.”

The federal government has enacted three stimulus programs so far this year to assist with the economic damage crushing the state and country. In order to defend the nation against a health crisis, the nation and the world have engaged in a voluntary economic crisis. Most states have ordered mandatory closures of nonessential businesses, and all the other businesses have seen a sudden downturn due to the shelter-at-home orders and coronavirus concerns.

Mandatory closures of nonessential businesses have been well-received by the majority, but confusion or willing noncompliance led Horton to insist last week that enforcement would be an option if compliance was not voluntary.

Parkinson explained the steps the sheriff’s office would take to address noncompliance with the shelter-at-home order.

  • First the sheriff deputies will notify the business that they are out of compliance
  • The next step would be a court order, and suspension of business license
  • Under “dire circumstances” continued noncompliance could lead to an arrest or citation

“Ninety-nine percent of the time, they immediately take action and follow,” Parkinson said, adding that he does not expect his office to issue any citations or make any arrests related to noncompliance.

To date, the sheriff’s office has fielded 357 complaints, and Parkinson said 113 were deemed valid.

“If there is any doubt, we follow up on it immediately,” Parkinson said. “We go out and watch the activity of the business and if they are not following the guidelines, we make contact and ask that they cease or follow the guidelines.”

Crime in general is down since the shelter-at-home has been in effect. Parkinson also reported a drop in calls for service to the sheriff’s department.

“In the month of March, there was a 1,400 fewer calls,” Parkinson said. “We see people staying at home, less activity, less crime, less calls and reports. That’s a good thing.”

While crime is down significantly and most private businesses are facing layoffs or furloughs, Parkinson reported that his department has added deputies and patrols.

“The Sheriff’s office has stepped up patrol,” Parkinson said. “We’ve added more deputies on the street than we’ve ever had. That is for a couple reasons — the public’s concerned. The public is worried, and we want them to feel safe when they see a black and white patrol car out there. The second reason is there is a lot of businesses that are left unoccupied because of the closure. We have a right … a responsibility to protect businesses from crime. So, deploying more deputies is essential during this time.”

Parkinson stressed social distancing and personal hygiene as the main concern for citizens, remarking that violations are happening with young people more than others.

“What we have noticed a lot is children mingling together on the street, at parks, on beaches, and other things,” Parkinson said. “I want to personally implore parents to not allow this.”

Physical distancing guidelines apply to those who do not live in the same household. Anyone who is not sharing the same daily environment is encouraged to stay at lease six feet apart to avoid unknowingly spreading the coronavirus disease COVID-19.

“This is how this is potentially transmitted back to your home,” Parkinson said. “As hard as it is for people to be cooped up in the house with their kids all day long, look for other activities to occupy your daughter or son outside the home. Isolate your family from others the best you can.”

Parkinson reported a general satisfaction by his office about the response by citizens of SLO County, but it was followed up with caution.

“The only concern is moving forward as this thing stretches out is that people could get impatient,” Parkinson said. “People could start deciding they need that social interaction. I would encourage them to please consider the more we are in this together, the more we are going to get through this and restore us back to some sort of normal life.”

Health and Safety

Borenstein’s report included some encouraging news regarding the statistics seen in SLO County. Some experts reported that California as a whole is doing better than expected in facing the coronavirus outbreak, and SLO County has resisted exponential increases week-over-week. Reducing the spread of COVID-19 means an increase in recoveries, and resources available to those most sick. Four of the six hospitalized are in the ICU, and concentrated resources could be the difference between their life and death.

“As far as hospitalization goes, the stays are short-lived,” Borenstein said. “They are staying three or four days and not getting to intensive care. That is important, because we are beginning to understand that those who end up having severe cases and needing ventilators, are having the poorest outcomes.”

Meanwhile, with 30 recovering from home, there are 57 deemed fully recovered.

“What is important about that is the percentage,” Borenstein said. “Of all the people who have gotten the disease, a majority of them have recovered. That is consistent with what we know about this disease. People are concerned that if they should get it, it could be very bad, but the majority — more than 80 percent of individuals — recover without any issues and most of them have mild symptoms.”

Keeping the overall numbers low is paramount to the success in recovering as a worldwide community. Recent discoveries in transmission changed recommendations at the national level. Guidelines from the CDC on Friday raised the bar for personal protection, adding that masks or other facial coverings are part of the recommended protections when venturing into public places, like grocery stores.

“We are following the state’s guidance that says using some manner of face cover,” Borenstein said, “anything that puts a barrier between you and another person is looked at more and more as potentially a means of reducing transmission.”

But Borenstein reiterated that masks are not a substitute for physical distancing or personal hygiene.

“The masks should not be used in place of all the measures that have been tried and true,” Borenstein said, “hand hygiene, hand washing, hand sanitizer if you don’t have that soap and water, staying way from people who are sick, staying away from people by six feet, and staying home when you are sick.”

Week over week, confirmed cases saw a slight decrease from 39 positive tests during the week of March 21 to 34 during the week of March 28. Unlike much of the world seeing an exponential increase, local numbers are dropping but the reality of COVID-19 in the community remains far from over.

SLO County health officials will update next week on Monday, Wednesday, and Friday.

For more information and articles related to COVID-19 in our county, and North SLO County, go to our dedicated COVID-19 page.