 Hello, I'm Becca King Reed for CTV. Santa Cruz County now has 54 confirmed cases of the coronavirus. Most of the ill are between the ages of 18 and 64. The cases are nearly evenly divided between women and men. Nine are hospitalized and sadly one has died from our county. Earlier this week, our health officer, Dr. Gail Newell extended her shelter and place order to May 3rd. Dr. Newell joins us next to tell us what we can expect in the coming weeks, and when she thinks we'll see the beginning of the end of this pandemic. Stay with us. Welcome, Dr. Newell. Thanks for taking the time to talk to us today. Thank you for the opportunity to be with you. Oh, you're so welcome. You're so welcome. I think people will be very relieved to hear from you. According to the COVID-19 models that have been created by the researchers at the University of Washington, they feel the virus will peak in California around April 28th, which is amazing to me. They can be that specific. Is there a model for Santa Cruz County? Do you have a model you could look at and predict something like that? Yes, we're looking at four different models and because we don't have a lot of local data, we're also looking at our region and trying to see what's happening there. And we think that probably our most accurate data is going to follow from watching Santa Clara. So pretty much from the beginning, we've been mirroring Santa Clara two to three weeks behind what's happening there. So probably that's our best hope for getting an idea of what's going to happen in Santa Cruz County. We are using some models. The favorite one that we've settled on is called the Penn Chime. It's out of the University of Pennsylvania. And that seems to fit best with the data that we can plug in to the models. And that's telling us we're probably going to start seeing an upward movement and perhaps a hospital surge where we get close to capacity about two to three weeks after that. Okay, so six weeks from now, it will be when you say close to capacity, is that the capacity that hospitals can handle? Correct. Okay. That doesn't mean that we won't continue going upward. Okay. But that's what we're anticipating that will be at our peak capacity. So, okay, so this model also indicated that California would not have a shortage of beds, but might have a shortage of ventilators. So at that capacity point, what do you think? How are our hospitals prepared for that surge? Both of our hospitals that have emergency departments, so Watsonville Community Hospital and Dominican Hospital, both have made tremendous strides in expanding their capacity. So, for example, we think we'll pretty much be able to double our bed capacity in the county for this surge as well as our ventilator capacity. Is that enough? Probably not. We probably, like most of the rest of the state and the nation, will reach a point where we're saturated with our hospital capacity. And we're preparing, we have two different alternate care sites set up. One, we've made the location public and that's at the Simkins Pool site in the buildings there. And the second, we're in final negotiations around this site itself. Okay. So you're already thinking about alternative care sites. And so how will you manage those? Will that be people who are not suffering from the virus? Will that flow kind of, if you will, people with broken legs and that sort of thing? Or will those be coronavirus patients? They'll be coronavirus patients, probably patients who don't need critical care anymore or a ventilator anymore and are close to being able to go to their residents or back home, but yet, and need a day or two in what we call step down care, which is where we could still watch them, but not in a critical care capacity. Okay. So you've got space. What about healthcare workers? Are there enough, do we have enough of those to last through the next six weeks during that surge period? That's a great question. And that's our biggest concern. We know that our hospitals can double their bed capacity and their ventilator capacity, where that's how the projections are looking. But who's going to stop those? So the state has set up a medical reserve port and some of those positions are even paid. And they are to attract physicians and nurses and respiratory therapists and others who at the time are not fully employed or busy in their usual capacity. And we know that other positions and nurses, for example, the hospitals are very low capacity right now because we're not doing elective surgeries in this county. We're not doing routine care, annual care, preventive type cares. So the hospital capacity and healthcare capacity is low at this time. And there are physicians and nurses who can be used to care for COVID patients. Okay. So do you feel secure in that area? We're working on it. Let me just leave it at that. We have many, many people working hospital leadership. We have a clinical task force set up. We're looking to hire a medical director for our ultimate care side, actively searching for that person who will be overseeing those sites. Okay. So recently we saw a request for donations for PPE or personal protection equipment. Will we be able to get enough healthcare professionals the protection that they need? And is there anything that we all in the community can do? This continues to be a big concern of ours and of our healthcare partners. PPE continues to be scarce for a variety of different reasons. We are accepting donations. All of the hospitals have donation sites where PPE can be brought. This is medical grade PPE. The county also is accepting donations. We did get a fairly large shipment from the state yesterday. That's our first big shipment from the state. So we got some more N95 masks that we will be distributing to our healthcare partners. We have depleted our own supply completely, the county's supply. There was guidance issues from the California Department of Public Health yesterday about face coverings for the public. And we should talk about that in this regard too. So our big concern is when the public begins to use medical grade masks or other PPE, personal protective equipment for their own use. If that happens, that will lead to further scarcity of resources for our healthcare workers. So it's very important that the public not use medical grade masks or other PPE. And instead, if they have those supplies, those should be donated to one of the healthcare providers in the community. So what this is going to be? I was going to ask you so, you know, I know that you are new to Santa Cruz County. So you might not have experienced the fires that we have here. So everybody's probably got half a box of some kind of mask for fires, and you know, they're the kind that come from CVS. So I don't know if they're medical grade, but I do know the boxes are open. So if you had like a box and you pulled a couple masks out for the fire, would you want to give the rest of that box? Or is that not, has it been contaminated? And is it not stringent enough? Yeah, they're only, the hospitals and the county are only accepting unopened boxes, but I'm sure that people know healthcare workers who would be more than happy to accept their donations. Okay, so you could pass them on to someone you know who knows someone kind of thing. Yes, even if you have an open box, even if you only have a few. Yes, I know the artist community in Santa Cruz, many of them have N95 or other masks that they use in their work and they've done a good job of sending out the rallying cry and getting those donated. There's many people also who are sewing masks, fabric masks and fabric gowns, and the masks, the cloth masks cannot be used in a healthcare setting for healthcare workers, but they can be used for patients. And so we encourage people to continue to sew their cloth masks, and then we can give those to patients instead of giving patients the hospital grade masks so that will preserve the hospital or medical grade masks for healthcare workers. And so the patients wearing the mask then they have less of a chance to transmit the virus to others. Right. So the whole idea of mask wearing in this case by the public is so that the public doesn't spread to other people in the public or to healthcare workers in the healthcare setting. So it's protecting though, it's protecting the public from the wearer. Yeah. Yeah, so I protect you from me and you protect me from you. So what this state guidance the state issued yesterday, they specifically call it face coverings and not a mask, because again, we don't want the general public to use masks. But they're saying that even though there's not a lot of good strong scientific evidence to the benefit of wearing a mask, or a face covering that the public should feel comfortable to do so if they would like. And there's some indication and experiences from other countries that it may help Latin America and further than what we're doing. Well, I work near downtown so sometimes I walk down there and I expected to see no one, but I saw lots of people at Trader Joe's and they were lined up six feet apart, so to speak, I mean as close, but there were a lot of people, and they weren't wearing masks, they were just there. What do you think about that? Is that safe to be in a group of people six feet apart? Well, that's what we're recommending buying groceries is one of the essential activities that are outlined as a necessary part of life. If possible, older folks and medically fragile people should stay home and have someone else shop for them shop for us. I'm in the elder category. But once shopping it's something we need to do we need to be able to get our food so social that what we used to call a lot of that social distancing we're trying to move to calling it physical distancing because we still want to stay socially connected and we need to. And because of all this wonderful technology we have, we have the ability to stay socially connected but we want to be physically distancing six feet apart, whenever possible six feet or more. Okay, so, okay, I'll follow up question to that if you're standing six feet away from someone who has this virus and they're breathing, or maybe coughing, and they move forward, and then you move into their space, are you likely or is it possible you could breathe in. The virus will hang around in the air. It's possible but it's very unlikely. We know that this virus is almost exclusively transmitted through large droplets. So they're pretty heavy and fall down toward the ground quickly. So it's unlikely you would hatch it from a cloud of spray that the last person left in their wake. Okay. In a physician's office, for example, a healthcare office where we're treating patients with COVID or suspected COVID. And there's no circulation in the room, for example, in a typical doctor's office. It is recommended that the room air out for an hour between patients. So in that case, it's a small room with no air circulation within an hour with disinfecting of surfaces. Because then it should be fine. So theoretically walking through a grocery store, you could breathe in someone else's droplets, but a small risk compared to standing one and talking. Okay. And so and then if you take the extra step of wearing a mask, you could decrease that risk somewhat. Or some kind of face covering. There's not great studies about this, not a lot of evidence, especially in cloth masks. But there's some hope that those large droplets are clothed by that mask and that the transmission of those large droplets is decreased. Okay. All right. All right. Well, let me move on to a different topic here. One of the things that has been very nicely provided by the Mercury News is a map of the virus in California. And on it, you can see our county and the counties that surround us, San Mateo and Santa Clara. And in those two counties, there are many, many more cases than there are in Santa Cruz County. And that looks pretty rosy on its face. We hope that perhaps we might be less impacted than the more populous counties, especially now that we have shelter in place orders in effect in all of our surrounding counties, including our own. So with fewer people commuting back and forth in and out of these counties, fewer travelers coming to and from our county that perhaps there will be fewer travel acquired and contact acquired places. And that might result in lower community transmission than our neighboring counties. So across the nation, experts are saying that they think social distancing is making a difference. And you ordered the whole shelter in place thing early on, even earlier than the governor. What do you think the impact has been? I think that hope I'm seeing hopeful signs that we have been the curve flatten the curve to the point where we may have less of an impact. I think regionally the Bay Area counties that did that first. And there's some growing evidence that that has had an impact. Certainly, we've had far less disease and disease impact than, for example, New York City, and now Florida, who were both slower and in Florida's case, much lower to issue a shelter in place order. So, but we should not take that for granted, I'm guessing we should keep up the good work. It's going to be tempting as the weather gets nicer and people are on officially spring break and spring fever hits and then it's summertime to really remember that we need to shelter in place whenever we can. When we do leave our home, maintain our social distancing or physical distancing, continue washing our hands regularly for 20 seconds or using hand sanitizer, copper sneeze into your sleep or tissue, and to stay home when you feel sick. Very important. Now, I have to bring up the subject of testing. So, I know that you have said that testing isn't on the on the top of your list at this moment you're working on other things and I'm wondering if you can tell people why why testing isn't really going to make the key difference here. From an individual point of view, I understand how folks might want to know if they themselves are infected or members of their household or the people they work with. But we're really trying to address this at a population level, so that we can experience less impact on our health care systems, fewer deaths, fewer overall impact to everything including the economy, if we can get past this. And so we're looking at it from the 30,000 foot views, so to speak, from a population level, we're able to model and predict how we're going to be moving based on hospitalization numbers and death numbers. And so we really don't need the data to predict and plan. And where we do need those test results is on our sickest patients who are hospitalized so that we better know how to treat them. And also in our health care workers because we don't want our health care workers to infect the patients they're treating and to infect each other because we're going to need them all on the frontline for the next coming weeks. So true, so true. So we salute them for all the work that they're doing. And our health care officers as well. I'm wondering if you, as you lead the fight here in Santa Cruz County, are you able to collaborate with others like yourself in public health on strategies and the latest best practices to just kind of get get the energy and get get new information ideas. So I have a huge benefit in working with an organization called the Association of Bay Area Health Officers, AB, AHO, or APAPO, we call it. And that's the 13 Bay Area counties, Santa Cruz is one, plus the city of Berkeley. And with them, we've together as a region developed most of our orders and guidelines so that we can be consistent from county to county with our guidance and our decision making. It's been a huge benefit to me. In addition, we have calls almost every day, sometimes multiple calls a day with the state of California, the California Department of Public Health, as well as federal agencies working with us on this battle as well. Thank you for that. It's very interesting to know to pull back the curtain a little and see how we read all of your orders but we wonder how you get there. I'm sure it's difficult and it's nice to know that you have support and others to bounce things off on. The last set of orders, I want to give kudos to our county council, the attorneys who worked with me, and my health services agency director Mimi Hall. We sat together for 10 hours on Tuesday and went line by line through the big six, the Bay Area health officer orders, and made significant changes to the Santa Cruz County Health Officer orders compared to the rest of the Bay Area. And there are changes that I hope our community address that directly address some of the concerns that our community members have had. So going forward, what do you think is the most important for the community to do? What can we do to make this outcome the best it can be? I don't want to be redundant, but the most important things are the things I've been saying already for weeks and that is stay at home whenever possible. So follow the shelter in place orders that include the social distancing requirement and that is state 60 to part whenever possible. Wash your hands frequently. The number 10 times a day is being used now with 20 seconds or hand sanitizer if soap and water is not available. Pops into your sleeve, puff and sneeze into your sleeve whenever possible or a tissue which you toss away immediately and stay home when you're sick. Those are the most important still. Okay. Is there anything that I didn't ask you about the state of the virus here in Santa Cruz County that you would like to share? Well, I would like to say that some of the differences between my health officer orders this shelter in place this month for the shelter in place order are less restrictive than the Bay areas in general. So for example, we've had very good voluntary compliance for the most part around the use of our parks and our beaches. So I did not close those down. And I hope that the public will recognize that and voluntarily comply so I don't need to do that by order. Well, that sounds very nice. I hope that happens to I like to go there myself. Well, thank you to exercise and the mental health that the outdoor activity can bring. So I asked for the public's compliance and continuing to stay safe while they're outside. That really leads me to one final question. So, so I, you know, covering health things over the years I find that when people are in emergency mode they just right out the window, all their dietary things that they do and exercise just an emergency we just have to eat chips. That's all there is. What can you what do you have to say about that how important will it be to stay healthy to eat to continue to eat right and exercise. Of course, so we still want everyone to be healthy and their food choices and hopefully with the stores and restaurants staying open we can do that. And of course we want activity, physical activity, so we're encouraging outdoor activity if you can do that safely. And in Santa Cruz County that's pretty easy to do unlike some of our surrounding counties like San Francisco and Alameda, for example. So we're very fortunate to have those kind of local natural resources. All right, well on that note, I will let you go and enjoy those natural resources. I hope you can get a walk in today yourself. Thank you. Thank you so much. Thank you very much. Dr. Newell, health officer for public health in Santa Cruz County. Thank you.