 Thank you everyone for joining us. It is January 13th, 2022. It's been a while since we checked in with you, but given the level of COVID transmission and activity in the county, we wanted to check in with the community. We have a new face with us today, so we're going to do some brief introductions at the beginning. We're just going to do a round robin real quick. I think Dr. Newell will start us off. Dr. Newell, why don't you introduce yourself and then we'll go around the room. Be helpful if I were unmuted. Dr. Gail Newell, Health Officer for the County of Santa Cruz, and I'm very pleased that I now have officially two Deputy Health Officers. We'll start with Dr. David Gillarducci. Good afternoon everybody. Dr. David Gillarducci, I am the Deputy Health Officer and EMS Medical Director for Santa Cruz County. And hi, this is Dr. Cal Gordon. Hi everyone. Good afternoon. So I'm Deputy Health Officer and I'm also a pediatrician and the Children's Medical Services Consultant. And good afternoon. My name is Jen Herrera. I am one of the Assistant Directors for the Health Services Agency with the County of Santa Cruz and I am overseeing the county's COVID-19 response. And we're going to use a similar format as last time. We're going to go around the room and talk about a few different things and then we'll open it up for a Q&A after that to ask a question. Just go ahead and raise your hand and we will call on you in order. And with that, we're going to have Dr. Gillarducci lead us off. Okay, well thank you, Jason. So let's start off with just a quick data update and our website has just been refreshed and you'll notice if you go to SantaCruiseHealth.org that we've added over 700 cases in the last couple of days. Just further evidence of the kind of rapid spread that we're seeing throughout the county. I'll be focusing right now on preserving our healthcare system through this surge. So the highly transmissible Omicron variant is really assumed to be the dominant strain throughout the county. We don't have whole genome sequencing on every case, but as predominant as Omicron is, it's safe to say this is what's really causing this surge. This is going to continue to be a hard month, perhaps the hardest yet, but it will ensue. The best, the best projections that we have at the moment is that the surge will probably peak around the first week of February, if not a little bit sooner. And then we should see a rapid drop off in cases pretty quickly thereafter. But unfortunately, it means that we're still going to have a lot of cases even on the backside of this wave or the surge, and we'll still see continued pressure on our healthcare system. So we ask that individuals with asymptomatic, you don't have symptoms or you have mild cases of coronavirus or other non-serious illness. We ask that you avoid going to the emergency department and making unnecessary trips there. Perhaps you're seeking a test, perhaps you're seeking reassurance. We understand that, but we ask that you contact your primary care physician first, unless of course you're having a true medical emergency. Mild cases might include things like minor coughs or throat, runny nose or body aches. But if you do have high fever, if you have any difficulty breathing or significant symptoms, you really should go to the hospital right away, and they are there, they're waiting for you and they're available to take care of you. But again, please don't go to the emergency department just to get tested. We'll have more on testing in just a few minutes. So although cases are at an all-time high, we are seeing that severe illness and deaths are not increasing at the same rate. That's mostly likely due to the large number of people in our county that have received a COVID-19 vaccine series, and very importantly, those that have received boosters seem to do really quite well with this particular variant. So it's clear, even though we're on the one-year anniversary of our peak last year, this is a very different pandemic than what we saw last year. Nevertheless, our healthcare system is still being impacted because they are having staffing shortages due to increased COVID cases. They're staff that are out ill, and we must all continue to do our part to stop this spread until we're beyond this. Our current projections show that we're still a few weeks away from peak in hospitalizations, perhaps a little bit sooner than that, but we're not there yet. So the worst really may still be to come, and we're asking everybody to do their part to minimize this as much as possible. I'll now hand this over to Dr. Nul, who will be talking about masking. Thanks, Dr. Gilarducci, and as you mentioned, as was mentioned earlier, this variant really is behaving quite differently than the others we have seen over the past two years of the COVID pandemic. Because Omicron is so infectious, we're making some different recommendations and specific recommendations than we have in the past. These are all based in science. They're all evidence-based, and I have to start out. Top of the list is vaccination. So if you haven't already, please get your COVID vaccination. If you haven't gotten your booster, getting boosted is especially important during Omicron. We are seeing people getting quite ill that are fully vaccinated but not yet boosted, and our boosting statistics are not where they need to be. So please make sure that you get your booster dose in addition to your initial series. We're also making different recommendations around masking. So in general, cloth masks are no longer preferred. We really want you to seek out medical or surgical masks if you can. And these include N95s, KN95s, another one called KF94s. You can see more information on our website or the California Department of Public Health website. Or use a surgical mask widely available now with cloth on top or a surgical mask that you've altered with a hack. You can find those on YouTube. Or a cloth mask with three or more layers that include a filter. So very specific masking. It's as much about the materials as the fit, however, so make sure there's a snug fit across your nose right here. Cloth masks in particular are only effective if they've got a fit across the nose there. And then on the sides as well, you want to make sure you're not leaking air out this side. So a very important aspect of masking. And then in addition, remember that in general, outdoor activities are safer than indoors. So we want you to continue to gather with family and friends, but we want you to do it as safely as possible. So that means outdoor activities, outdoor celebrations. We fortunately live in a beautiful place that allows us to gather outdoors, including outdoor dining. Many kinds of celebrations and gatherings can happen outdoors. If you do need to gather indoors for any reason, please do your best to optimize ventilation and filtration. So open all the windows and doors, have people wear their jackets and wrap up so that you can have lots of airflow through the room. Think about filters that you can buy to clean the air in your room. And then testing is the last and important part and I'm going to let Dr. Gordon cover that in a moment. But I do want to touch on some updates on vaccination. Again, it's the number one tool to prevent serious illness, hospitalization and death with COVID-19. And everyone needs to keep their vaccinations up to date. If you've been vaccinated more than six months ago with your primary series, you need to get a booster, as I mentioned. Children ages 12 to 15 are now eligible to be boosted as well if it's been five months since completing their initial series. And a third dose is also now available for certain immunocompromised children ages 5 to 11 immediately following their initial series. Those who received a Johnson & Johnson vaccine should be boosted two months after their dose and preferably with either Pfizer or Moderna, although you can still get a Johnson & Johnson booster. Those who received Pfizer or Moderna for their primary series can be boosted as soon as five months with either vaccine. And it's never too late to get vaccinated. Visit SantaCrisHealth.org, coronavirus vaccine to find out where you can get vaccinated or boosted, or my turn on California doctors. And with that, I'm going to turn it over to Dr. Gordon to talk about the ever popular topic of testing. Thank you, Dr. Newell. So with the Omicron surge, we've seen a dramatic increase of testing demand and our county has been working on expanding testing in anticipation for the Omicron. We offer close to twice as much testing as we did a month ago and we're currently seeing about between three and four thousand tests performed each day in our county. Our Opticron, I'm sorry, our OptumServe site at Ramsey Park in Watsonville has added an additional lane, so we've doubled our capacity to about 500 tests per day. And the County of Office of Education has moved their South County testing through Inspire laboratories to the Watsonville fairgrounds. So they've actually increased the capacity there in addition to their cabriol testing site and then the Office of Education headquarters on Ensenal and Santa Cruz. We know that antigen tests are extremely hard to get at the moment. And so if you are experiencing symptoms and are not able to get a test, we strongly recommend that you stay home and assume that you have COVID-19 and that you go ahead and spend the full 10 days for isolation or quarantine during that time. In addition, the Santa Cruz County Public Health has received reports of unverified pop-up test sites that have produced delayed test results. So that we would advise caution that if you see a new pop-up test site in the county that's not listed on our SafeLive Santa Cruz County website that you exercise caution. We do have some previously verified test sites that are not included because they have closed. We understand also that some employers are requiring testing for employees to return, even though the employees have recovered and have followed and followed through with their isolation and quarantine guidelines. So we want to assure employers that it's safe to allow the employees to back to work without a test if they have completed the isolation and quarantine guidelines. And then finally, we have also heard that some employers are asking employees to continue working even if they have mild symptoms. We ask employers not to do this. This will impact our healthcare system. It'll promote potential additional spreading and we want to be able to keep our community safe and safe lives. So with that, I'd like to hand this over to Jen Herrera for some final comments. Thank you, Dr. Gordon. So given the movement of people in the faster spread of COVID-19, it's best to assume that you are interacting with people who are infectious. Or you yourself may be infectious and just may not know it. It's really difficult to contain this surge. And at this point, we're really just riding the wave. People who are doing everything right may become positive. So this is a time to also practice compassion with ourselves and with our community. And although it may seem inevitable that most people are going to become positive, individual behaviors do make a difference with flowing the spread. Things like masking, distancing, isolating if you test positive, and vaccinations being up to date with your vaccinations, which includes boosters. These things make a difference because it helps to flatten the curve. So flowing the spread preserves our healthcare system and that's going to help prevent death. Thank you. We're now going to go ahead and take some questions. If any of the press on the line have questions, go ahead and raise your hand and they're coming up already. I'm going to start with Tony, doing you as Tony. Go ahead and ask your question. Hi, everyone. Can you hear me? Yep. Awesome. Thank you for holding this press conference. Appreciate that. Dr. Newell, you said that the statistics for booster shots is not where they need to be. Do you have data on exactly where they are right now in terms of the people who have been vaccinated going back for their booster shot, and maybe they're coming to that. And if so, can you share that? And then also where do those need to be the percentage of that for us to see the sort of change around here in terms of our, the hospitalizations going down. I understand that they are not rising in the same numbers that are case counts, but for them to stabilize it a bit. Well, we don't have the exact answers to where we need to be. We're still shooting for the rough goal of 80% of us in the entire population being fully vaccinated. According to CDC's definition is still just the primary series, but we're beginning to talk about the term up to date for vaccination and that would include your booster in addition to your primary series and any additional doses if you're Indian compromised. Our population, as is the states is far below that. So our overall we're getting close to that 80% in our primary fully vaccinated or having received at least a first dose. But in the county overall, we're only we're less than half of us have gotten boosted. Now it's better in the older populations, but much lower in folks under 50. So we need to see some big improvement there if we're going to have an impact and studies have shown that Omicron variant in particular, we need that third dose we need that booster in order for the vaccines to be effective. You can find this data, which is updated regularly both on our website and the CDPH website. Tony, I have a specific number for you there's been about 90,000 boosters, plus or minus administered in the county. And as Dr. Noll said that's just under about half of the fully vaccinated population, 12 and older. And only a third of our total population. Yeah. Next question we go to Melissa Hartman Melissa go ahead and ask your question. Thank you and thank you all for hosting this day. I wanted to start by asking whether we have any idea what percentage of her testing operations now our home tests, because we've talked about how the dashboard really affects the populations and deaths are the metrics that are being focused on right now because of this difficult effect of the at home antigen tests and so I was wondering if you guys had heard anything about, you know, approximately, how much of testing is happening at home these days. Dr. Gordon or killer do you want to add to that? I think, first of all, the case rates that are reported on our website are those only for PCR tests. So with the antigen test, we actually underestimate the total amount of infection in our county that's been probably the case for the prior surges, but this is accentuated with the antigen test Melissa as you as you suggest. I, we don't know in part because most of the home tests people are not reporting those people. A lot of the home tests will allow for people to report through an app or other options. But we know that the school system handed out 40,000 antigen tests just these past two weeks. We know that other people are getting the test either online or in the different pharmacies. So at this point, we don't have any solid information and there's been a lot of discussion among the health officers that the case rates aren't going to be accurate from here on out because of the home tests and yet we think this is the appropriate way for the future that home tests are going to be our future and that people will have the ability to test when they are symptomatic or exposed, which is what we want. And they will probably be reaching out to their personal physician, but the county may not be able to have as good tabs on on what the actual incidence of infection is. Yeah, and I'll just briefly add that, although we may not know the amplitude or the height of the case curve. We have a pretty good sense of the trajectory so when we hit the peak, at least based on PCR test results that we get that'll probably be representative of what is happening with the home testing as well. I'd also like to briefly talk about hospital data. The census data is important to us in many ways, especially as we look to preserve our healthcare system capacity, but one half to two thirds of the COVID patients in our hospitals are incidental COVID. They're there for a different reason. So, for example, I know as an obstetrician and my wife is an obstetrician that there are many labor patients who come in and of course they must be admitted and treated. And they have COVID so they're counted among their the COVID patients, but they're not there. They may not even know they have COVID at the time they present. They may be completely asymptomatic, but they do require more care, more PPE, more special staffing, more resources in the hospital overall. So it's worthwhile to track those numbers, but it's also not necessarily indicative of the effects of COVID itself on our hospital systems. And our ICU numbers remain very low, I believe. Yes, this variant thank goodness is sparing many from the ventilator and ICU beds. Wallace Bain why don't you go ahead and ask your question. Yes, thank you, Jason. You may have just answered this question but I'm curious if there have been any reports of any non COVID related procedures or surgeries or anything medically oriented that have been delayed or rescheduled because of Omicron to this date. I think I can take that one. Yeah, Wallace. Yeah, we're hearing that on occasion, the hospitals are finding it necessary to delay elective surgeries. And just briefly what are elective surgeries these are usually ones that don't have to happen right away. But it's important to note that they're also, you know, important surgeries that people need. For example, orthopedic procedures a knee replacement or something like that. You know person is in pain. That's the reason they've been prescribed a, you know, a knee procedure. And, and for them to have to delay is really disruptive for them. You know, they plan on the surgery they maybe have family that's set up to help them with it and then suddenly gets delayed can be really disruptive but my understanding is that the hospitals are taking it on a case by case basis. They prioritize they look at their staffing. One big difference from this year than last year where last year we had to ask hospitals in fact require hospitals to hold all elective cases until the surge was over. Now that was mostly because these cases drew from staff that were urgently needed in the ICU as well as equipment that was urgently needed for ICU patients. We're not seeing that same pressure on the ICU this time so there's a little more flexibility we haven't felt that a prohibition on elective procedures was necessary. So to answer your question briefly it's largely based on a case by case basis and has to do with their staffing levels that day. They also opt to delay elective care and elective procedures because of the COVID surge. But we don't want anyone to delay important critical care for chronic diseases, cancer care, other kinds of treatment because they're afraid of COVID in the hospitals or health care systems so please talk with your own personal health care providers before you make those decisions. Okay, next we're going to go to Edgar Alvarez, Edgar go ahead. Do you hear me? Hello? There you go. I can't hear you. Thank you. Okay, well, more than a question I would like to have comments from the officials about the staffing you know we're hearing all of the state you know people like nurses protesting and everything going on because of the staffing National Guard now helping testing sites. What's going on like the, what do you think is going to happen during the next weeks in the staffing situation do you think hospitals and health systems are going to need like emergency staffing from somewhere or you think you're they're going to make it. Perhaps I'll start and my colleagues I'm sure we'll have something to add but you know as we've said before, our health care system has been under strain for two years now you know the health care systems, typically in every county are sort of right sized for kind of normal operations there's not a lot of excess or fat, if you will, and, and this has been a tremendous strain on health care providers we're hearing reports that, you know, we've lost nurses and doctors to early retirement they've gone on to other professions because it's just too much for them. You got to remember to this Omicron is coming just on the tail end of Delta surge that was pretty tough on people as well. And so, on top of that of course, people that work in the hospitals and health care sector themselves are coming down with with illness and then therefore have to stay away from work so lots of pressure there. As you say the National Guard has come in to help with some of the testing, we're seeing some more support from the state, and in terms of staffing support we're looking at, you know, possibly posting paramedics and EMTs and the emergency department bringing some other non medical volunteers to kind of stretch this out. But I think the important thing going forward is that we have to recognize that we're going to need to rebuild our health care system we're going to need to rejuvenate the brave women and men that work in the health care system to keep it going forward in the future to come. If I could just comment briefly about the National Guard and the testing sites. So we have three state testing sites one is up in Felton. One is at the Depot freight building on Center Street and Santa Cruz. The third one is in Watsonville on Main Street at Bramsey Park Community Center. And we actually have now National Guard at all three sites, and they have actually integrated in a very effective fashion, we went and expanded our capacity at the number of the sites. And we were having tremendous problems actually finding staff to be able to perform the tests and so we are having a lot of fatigue and difficulty with with our staff and turnover. And so, having the National Guard has been a really important boost. And from every indication our community members have are very receptive. It's been very seamless and so we appreciate the additional manpower that and women power that has been brought brought to those sites. Thank you we're going to Tony Melissa we're going to go right back to you but first I want to go to Adriana she's had her hand. Adriana, go ahead and ask your question. Good afternoon, can you hear me okay. Yes. Thank you for having this session is very important for our community my question is, have there been any reports of an outbreak at Santa Cruz County Court, knowing that other counties have reported similar outbreaks at county courts, thank you. Do you know anything. We have many outbreaks throughout the county. And we're working hard with employers and entities, but we're focusing on high risk congregate living settings for the most part so our skilled nursing facilities are shelters, the jails juvenile hall, and the schools of course. I have not heard about an outbreak and our court system but honestly I would not be surprised we have a lengthy list of outbreaks with them we're working. So if I could add, I attend. We have a communicable disease unit that meets on a daily basis to go over the cases and I attended a number of those sessions. I have not heard of any outbreaks at the at the court, not that it couldn't happen but but start on my radar either. Thank you. Thank you and then let me just hit the chat and some texts that I'm getting the Stephen Baxter would has asked if we could say a little bit more about why and 95 and surgical masks are preferred now. I think the more prone variant behaves differently than the previous variants of this COVID virus. It seems to be more airborne than the previous variants and so there's when you sneeze or cough or cough loudly or laugh, or even just breathe. There are still respiratory droplets that's how COVID is spread, and they're in different sizes, and this variant tends to live more in the droplets that float in the air for longer and less likely to fall down onto surfaces so we're less focused with this variant on surfaces, although it's still a good idea to wash your feet right down surfaces, especially during flu season. But this variant seems to stay floating in the air longer, even between people in rooms and in that aren't in the same room at the same time but it seems to be able to float for some period of time in the air. So it requires a different kind of fit and filtration in our masking and maybe one of the deputies wants to add something to that. You said it but I think it's what's really interesting is the biology of this variant and how it does seem to kind of favor the upper airway the nose throat the upper parts of your respiratory tract. So this variant seemed to be preferable for kind of deeper down, like into your lungs that is probably one of the explanations why the severity of illness seems to be a little bit less with Omicron. But it also explains why it is sort of, I guess the best way to say it's sort of stickier if you will. You know, where, if there were one or two kind of Delta particles floating out there they may not cause an infection but with Omicron it's more likely so the better the mask the better the protection. I think a recent study that's been on the news that is if you have two people in a room together with with cloth mask. It takes about 37 minutes to potentially infect another individual. The surgical mask if it could be up to an hour. But if you're worried in 95. It can be up to 25 hours to infect the other individuals so there is a significant difference. These, there's a better filtration process that keeps the virus out. And there are some sort of anti viral kind of components to some of these masks so they just are much, much more effective. And then before we go back to Tony I have another question on text and that is do we have any data on the number of people hospitalized who are vaccinated versus unvaccinated and I think this might get to a point we're making earlier about people who are admitted to the hospital with COVID versus people who are admitted for COVID. Somebody want to grab that. The most helpful data in this regard, locally, the numbers are too small to make any meaningful comparison, but the state on the California Department of Public Health website does a comparison that they update daily or almost daily of vaccinated versus unvaccinated rates of infection hospitalization and death. And it's been consistently around 15 times more likely to be hospitalized if you're unvaccinated, and up to 25 times as likely to die if you're unvaccinated. And Dr. Gillard did she just posted a link in the chat if anyone is interested now let's go back to Tony unions Tony go ahead. Thank you. I'm looking at the hospitalization data at the state website for Santa Cruz County and it looks like there has been a rise in hospitalizations over the last week or so I'm sure, if not further back to 34 people being in local hospitals with COVID, but there's only three people that I see use. I'm wondering, when you look at those two data points, how you interpret that and if that changes the way that you look at the infections here in Santa Cruz County, and then also just to throw this on here. Do you expect any other business or gathering restrictions in the same way that we saw in 2020 or 2021 to return anytime soon. Thank you. I'm going to answer the second question first because it's really easy and the answer is no. The business restrictions. You can take number one. Okay, I'll take number one. Wish my word quite as easy but yeah yeah you're right you're seeing hospitalizations go up and you got to remember of course that's a lagging indicator from cases so it takes you know a little time for people to end up in the hospital. We know a mix of those are incidental COVID. But still, we're seeing this decoupling between cases and hospitalizations. The decoupling is probably the most evident when it comes to ICU, whereas last year we were talking about crisis standards of care which is, you've heard some states have to do this with Delta recently. But this is where physicians have to get together and decide okay this person's going to get a ventilator, and this person's not. And so fortunately what's very different so far with Omicron is we haven't been forced to make those kinds of decisions or even contemplate it. And so the ICU capacity still seems to be pretty good. We hope that it will continue to be so. And, but there's still a lot of pressure on hospitalizations itself. Even though fewer people get hospitalized from Omicron, the sheer numbers of Omicron cases, again underrepresented because of home testing as we talked about before, the sheer number is going to continue to put a lot of pressure on hospital capacity. Thank you. I'd like to go back to question to and make one caveat and a reminder again that outdoor activities are more dangerous than indoor activities and gatherings, or safer sorry the outdoors are safer than the indoors sorry. I do want to specifically state that throughout the state we're seeing rising numbers of cases among indoor sports athletes and spectators and indoor basketball in particular is a place that we're seeing many, many cases arise. My face covering order, my masking order here locally in Santa Cruz does indicate that everyone spectators, referees, everyone involved in indoor sports must be masked unless the referee or coach would determine that that would be dangerous for a player. Everyone else must remain masked so just a good reminder about that one specific activity. Thank you. Melissa Hartman why don't you go ahead and ask your question. Thank you. So we had talked about staffing in our healthcare system but I was wondering about schools and whether or not any of you had heard about having you know any staffing situations where I know that districts and other places are begging even parents to become subs. And not the people that aren't usually instructing to become subs and so I was wondering if it had gotten that dire here to the point where we could see a translation to or transition I'm sorry to remote learning as has happened in some other places. I can feel that both Dr. Newell and I participate on a school hub that works with the county office of education and in the schools. I was actually on a call with the power of valley. It's a unified school district superintendent and our county office of education superintendent and in general, we're doing well. We're very fortunate that we have a robust testing capability so that the staff can be tested and they have been able to do actually do antigen testing so that they can be tested quickly to see whether they need to isolate or quarantine. And, and they're potentially return more quickly to so there is. We have that luxury and at this point. It's not to say that this is couldn't happen, but we've been fortunate to date, we've only come back from, you know, into school, two weeks or for power valley unified school district just one week so we were just sort of early in this and things can change. Definitely there are teachers that are calling in because they're symptomatic or have symptoms or have tested positive. So we're watching this very carefully and we're doing our very best to be able to keep that people and school and I think that is the intent for our schools in our county. And I can offer more of a personal perspective, because my wife teaches middle school in the county and she's pointed out that there have been shortage of substitute teachers for quite a while but it's really gotten worse with with this pandemic, you know, the other students are, they tend to be retired people who, you know, are are resistant or maybe reluctant to come into work because you know they're at higher risk they're older folks. And so there's a real shortage of subs and so in her particular school, I think they can tolerate a total of five teachers calling in sick, and then they're going to be having trouble keeping a classroom open. That's the number three mark a couple of times and they're sort of writing on the edge right now. Thank you. Our next question comes from Wallace Bay and Wallace go ahead. Thank you. In terms of the masking guidelines. I'm wondering, does the county have any guidelines to help people find these in 95 masks whether it's online or local retailers. I recommend the KF 94 which is cropping up in a lot of places as a suitable substitute for the in 95. Are there any programs maybe to help low income people get their hands on these masks and do you have any reports on shortages or or delays in in getting them. Somebody want to grab that one. Yeah, I'll, I'll try yeah I, there are n 95s, can 95s and KF 94s. And those of course become more in demand these are basically higher quality masks that the key component is not only the filtering material but really they kind of seal around the face that you know prevents some of the gaps. They might have a great layer or layers of material over your mouth but if you have leaks around the edges the air is just going to follow the path of least resistance and not do you any good. So any of these masks do provide more protection because they, they fit more tightly around your mouth and nose. To reply. It's not as critical as it was early on in the early parts of 2000 when we were just completely out and preserve them for the health care system. I was, I'm able to buy some 1095s on on Amazon, although I have noted the price is almost doubled in the past couple of months. Right now our stockpile here in the county is reserved for the health care system. We don't have a lot of extra, but you know I think we'll probably have some conversations back amongst ourselves about how we any ways that we can support the community. If I could add the status applying to school systems in 95s, both for staff as well as students. The schools have received their shipments unfortunately, they're all adult size, so they fit the staff and they fit the people in high school and so we're there, we're working on or the school systems are working on getting smaller size in 95s for for the younger students at this time. I think I'll just add as well, you know that this is a need that has been bubbling up to us of where to find these higher grade math as Dr. Gordon mentioned, the state is starting to supply mass to certain industries to help fight those inequities. So locally, we are keeping eye out for resources, we're working really closely with our emergency operations center to find resources and support the community. So again, echoing what Dr. Gilles Ducci mentioned from a public health standpoint we are reserving our stock for the health care system at this time. Thank you, Melissa Hartman go ahead and ask your question. Thank you. And this one's for Dr. Gillard Ducci because you and I had talked about how the county was applying for a grant to try to support resumed wastewater testing. I know that's something that epidemiologists are starting to focus on since the dashboards are kind of skewed at this point. And I wanted to know if you or anyone from the county team had heard anything on this effort in trying to secure the grant, whether we could make this happen again. Yeah, thanks Melissa I know that's an area I've been interested in for a while and I think Jen can give us an update on that as well. But I will point out that we are making progress. And I'll point out some really interesting data coming out of Santa Clara County that I just saw in the news, showing that they're saying showing a rapid drop off in their, in their wastewater viral load. So, you know how we talked about hospitalizations being kind of a lagging indicator. The wastewater surveillance is kind of a leading indicator of what's going on they sort of happened before the cases, the case counts themselves. So, especially as we go to home testing it's going to become probably a more important modality, but I'll let Jen finish. Thanks, Dr go DG. But we did get a machine to be able to conduct wastewater surveillance testing through our water quality lab. As part of our environmental health division. So we just received notice about this machine and we look forward to working closely with environmental health to, you know, see what a surveillance system could look like for a county. Thank you. Are there any more questions. From our, our media guests. I see Melissa go ahead. Thank you. I was going to ask we it was kind of touched upon about this message about how everyone is subject to catch COVID at some point and I know that I think it was Dr Fauci that had said something yesterday or the day before about you know just statistically it's likely that we could get it but that is such a difficult message for these communities that have been in the pandemic for two years now. And I wanted to see, or here I guess your guys is take on this message like do we just accept that this virus is all around us it's going to enter our homes is there something other than I guess keeping up good practices would help but you know what do we do with this thing so prevalent. That's such an important point and now we don't want chicken pox parties. We don't want it may be inevitable that we will all get this sometime but we don't all have to get it right now. If we all got it right now the health care systems would be so overwhelmed that many lives would be lost and many lives would be saved and so we do need to keep up with those individual behaviors that will flatten the curve slow the spread the same messages we've been talking about for two years or now more important than ever. So if we can spread out when we get this disease and, and hopefully until we have more therapeutics these wonderful antivirals that have been approved. We want them to be much more abundant before people get this and think of it as inevitable. If I could add my feelings are that at some point we're going to move from pandemic to endemic where this will be just part of the cycle probably more of winter type of disease. As Dr. Newell said, we don't have those a robust supply of some of these antivirals. Some of these like Pax Lovett allow us to have 88% protection for getting hospitalized that type of thing. So I think with the vaccination the booster in that sets up a certain level of protection in with these antivirals in the in the wing. We will be moving at some point from a pandemic to an endemic situation where COVID will be there but it's not going to have the same level of threat to to people as it has currently. I'd like to make one more important point and that is that there have been rumors that Watsonville Community Hospital has closed or is closing and those are not true. So when we refer to the hospitals and the emergency rooms we're referring both to Dominican and Watsonville. Watsonville Community Hospital has their doors open. They are ready to provide excellent quality care. They're fully staffed in their emergency department and their ICU and labor and delivery and they are ready and waiting for the community's business. So, please remember, don't go to the hospital at all if you don't need to, but if you do need hospital attention, we have two excellent acute care hospitals. Thank you very much and thank you everyone for joining us today. Stay safe out there.