 Welcome to in the studio at Davis Media Access. I'm Autumn Lab Arano and my guest today is Dr. Amy Sisson. She is the help officer for Yolo County Public Health and we're very glad to have her here today. Dr. Sisson, we've worked with you a few times throughout the course of the pandemic. I think the last time I interviewed you was December 2020 and it was a really dark time. If you remember numbers were just spiraling upwards and everything was closed and we were all kind of wondering, okay, where do we go from here? And today it's a very different scenario while not everything has come to completion. We are in the sort of exit phase for the pandemic and it's a really important moment of transition and I want to welcome you and thank you for being here today. Yeah, thanks for having me. Sure. Let's take a moment just to acknowledge the staggering breadth and depth and width of this pandemic. From the earliest days when we were really concerned about washing our hands and cleaning surfaces and letting our males sit for a day or two to the realization that the virus was airborne and then the rapid deployment of vaccines. Not to mention the pandemic and the vaccines themselves as sort of political grenades. It has been one wild ride. So on behalf of many of us, I want to thank you for your work during this crisis. I can only imagine it has not been the easiest job. So I want to stop and leave been a challenge. I want to talk about the CDC and for if there's anyone on the planet who doesn't know what that means now the Center for Disease Control and Prevention. Their announcement on May 16th about new masking guidance. My interpretation was it kind of through everyone for a loop. I've seen a lot of confusion on social media especially because the state delayed its decision and the county follows a California Department of Public Health guidance. So let's talk about June 15th. What's going to happen on that magic day and what do we need to know and what kind of decision making is going on locally around this? Yeah, so the the state has announced that on June 15th we'll move away from the current blueprint for a safer economy framework with where we have colored tears and we move based on our case rates and testing positivity. So on June 15th that will go away and we will move to something called beyond the blueprint and the state has already announced that it's June 15th when we will adopt the CDC's recommendations for fully vaccinated people particularly when it comes to face coverings but also on June 15th we a lot of the sector guidances and the capacity limits that are currently in place for example restaurants only being allowed to be a 50 percent capacity that will go away. Physical distancing requirements in most settings will go away and really the very few sectors will still have mandated restrictions coming from the state level. Those that impact youth so particularly schools, daycares, those will still have limitations and masking and distancing but for the vast majority of the of the public we're going to see a lot of the restrictions that are currently in place going away on June 15th. Right so I every week I attend the public information officers call through Yolo County in which you give a report and that's been great it's been very helpful. I notice there are a lot of school administrators on that call and school nurses and things like that. So let's just take a minute to discuss what you what you just said it will be slightly different for schools. Does that mean that school kids will continue to maintain I think it's three feet of distance and that they will continue to mask? That's through the summer do we know if that's going to apply in the fall as well? Yeah so you're absolutely right Autumn the the current guidance that the California Department of Public Health has for K through 12 schools will remain in place for this school year and through the summer and CDPH has indicated that new guidance will be coming out for schools for for the fall. So the three to six foot but minimum of three foot of distancing will remain in place for the summer but what we expect come fall based on announcements from the Newsome Administration that the expectation is that students will be in the classroom five days a week so full-time in-person learning. We won't have distancing in the classroom there will still be masking requirements probably different for people who are fully vaccinated compared to those who remain unvaccinated so that will be the situation in schools come fall so there will still be protective measures in in place we'll have to you know we talk about safety in schools we think about layers and one of the models that I like to talk about is the Swiss cheese model where every you know protection is a slice of Swiss cheese and they all individually have imperfections and those are your holes in the in the Swiss cheese but if you put enough pieces of cheese together then you end up with a solid block of cheese that the virus can't penetrate and so things like like testing and masking screening for symptoms ventilation become you know more important layers of cheese when you take out that distancing layer of protection but then we also have this huge protective factor now for older students and for staff which is the vaccines against COVID. Yeah we're going to get to vaccines in a minute because I have several questions about that before we move on though I want to loop back to what you said about the the tears one of your comments on yesterday's public information call was that we did not Yolo County did not meet the metrics for a second weekend yellow which kind of we're back to square one there but the reality is June 15th that all goes away anyway right yeah that's correct so we we had an opportunity to to move to yellow this week we just missed out based on the testing positivity rate in our health equity quartile but the entire state is moving away from the blueprint on June 15th so it just you know delays the the relaxation of restrictions a little bit but it wouldn't have had a significant impact that June 15th date is for the state regardless of case rates right right let's take a minute to define that term you just throughout health equity quartile because you have talked about this a lot during the pandemic so for those who don't know would you uh would you clue us in there yeah I mean I think it's important to recognize that COVID-19 has not impacted populations in Yolo County or in California or in the United States uh equally and there are you know certain factors when we look at at neighborhoods uh you know where they have a lot of essential workers who haven't been able to to work from home who still had to remain in close contact with a lot of people as part of their jobs people who live in you know larger more crowded households also people who don't have sick paid sick leave at work um and other factors in the community education level income um those all go together to uh you know create something called this healthy places index which measures how you know healthy the the conditions in the community in terms of whether they they promote health and so what the state has created this healthy places index and so the health equity quartile is looking at census tracts uh we have about 40 census tracts in Yolo County so the 10 census tracts that have the lowest healthy places index scores so they have the least healthy conditions how many people or what proportion of the people in those communities who are getting tested for COVID test positive um and that unfortunately is higher um in those communities than in the county overall so for this last week for example we had 2.7 percent of of people getting tested in these most disadvantaged communities the health equity quartile testing positive and 0.3 percent of county residents overall testing positive so a significant disparity that you know the health department has been working very hard to address uh but there's a lot of factors at play right thank you for that explanation so as we move forward Dr. Sisson so much of this hinges on getting people vaccinated and yet I know from all the discussion that well first I want to hear our numbers in Yolo County how are we doing this week and how are we doing since we introduced vaccine vaccinations for um 12 to 15 year olds that's important but so much of it we hear the stories of people not going back to get their second dose or people who are just kind of saying the vaccine's not for me for whatever their personal reasons are so that's a public health issue let's go first to how we're doing this week in Yolo County with our vaccination rates and then let's tackle that question yeah sure um so in terms of our vaccination rates we're now at and forgive me I don't have these memorized so I'll uh I'll take a look at my nose but we're at 53 percent of Yolo County residents overall who have received at least one dose of vaccination and now 41 percent of Yolo County residents who are fully vaccinated um so we are making progress so we're slowing down in that in that increase you may recall that that last week we were at about 52 percent so an increase of about one percent in the proportion of the population that have been vaccinated we've done even better in our most vulnerable residents so that's those who are 65 and older so we're now at um let's see 82 percent of residents who are 65 and older who've received at least one dose of vaccine and 67 percent of of residents 65 and older who are fully vaccinated but of course there's there's a gap in there um you know that 15 percent between 82 and 67 percent who are our older adults who are only partially vaccinated and the county is doing uh you know directed you know targeted phone calls to all of those individuals who are 65 and older who've only gotten a single dose of vaccine uh to help support them in getting that second dose because those who are 65 and older are the most likely to end up in the hospital with severe disease or even to die from COVID so we're putting extra effort into making sure that if they've started the process we help them finish that process right because otherwise they're not fully protected so there's a lot of articles out these days in New York Times just published one a couple days ago that the two biggest blocks of people who are are vaccine vaccination resistant are Republicans and then Black and Latino or Latinx communities and I wonder how we're doing overall relative to the rest of our region how our numbers are and I wonder if we're seeing that kind of resistance crop up within specific communities as well yeah Yolo County is actually performing better than nearly all of our neighbors when it comes to getting our population vaccinated so I don't have the direct comparison numbers in front of me but when I looked at this last week we were a couple percentage points higher than nearly every county that neighbors us with the exception of Napa County so I'm very proud of the work that our team has done and of course all of our partners on the the health care system in getting residents vaccinated and also really happy that our residents have have been so receptive to vaccination but we don't see vaccination happening evenly across our zip codes in Yolo County we certainly have you know pockets and neighborhoods where we see fewer people getting vaccinated and so we've been tracking this since we started vaccinating in in December there's a couple zip codes in particular 95605 in in west Sacramento as well as you know some areas in woodland and unincorporated areas where we're working you know hard putting extra doses extra effort boots on the ground in terms of community-based organizations trying to first of all make vaccines as convenient as possible for folks living in those neighborhoods who either aren't able or aren't willing to go out of their way to get vaccinated so you know being in the grocery store for example is is one way that you know words you know hey you're already here going about your your daily business so let's go ahead and get you vaccinated we can offer a single dose of the Johnson and Johnson vaccine so you don't even have to come back in in three to four weeks so you know the convenience approaches is one piece but for those who are hesitant to get a vaccine that's where it takes a different type of outreach and it really needs to be one-on-one conversations with with people and those are harder to do at a population level it really needs to be trusted messengers in that community people who look like them who who understand you know a lot of the barriers that that they face and some of their concerns about the vaccine who can sit down and you know very openly discuss answers to to their questions meet people where they're at and encourage them to to get vaccinated so we're working with community-based organizations across the county but particularly in some of those under vaccinated zip codes to encourage them to get vaccinated but it's it's slow going it's it's hard work so that's why you know you're not going to see the big jumps from week to week in the adult population like we were getting you know going from you know 40% to 48% vaccinated now it's going from 52 to 53% vaccinated but it it's still progress but every every dose takes more work and more convincing now I really appreciate your commitment in the counties to doing that level of work and also to partnering with community-based organizations I I recently interviewed jenna bella hi from yellow county children's alliance and so you know she helped make me aware of of the cultural differences that can prevent someone the language barriers transportation barriers there could be all sorts of things going on that as you said it's hard to know about without engaging one-on-one all right um moving on a little bit from our vaccination rates uh something I've heard a little bit of conflicting opinions about is the the need or the desirability for fully vaccinated individuals to continue with asymptomatic testing of course here in davis we have the amazing healthy davis together partnership which has been so important during the pandemic what is your opinion on that or your recommendation for us fully vaccinated folks should we be getting tested on a regular basis yeah so both the the cdc and the california department of public health and and myself uh no longer recommend uh routine screening testing so for people who are asymptomatic who are fully vaccinated we no longer recommend that they be tested on a regular basis and that's for for several reasons but you know if we if we think about the performance of these tests as we see case rates in the community declining and we know these vaccines are very good you know two doses about 90 effectiveness so yes there are some breakthrough cases of people who do get infected after vaccination but by and large that these vaccines work very well and so as case rates decline in the community anyone who tests positive on these very sensitive PCR tests that healthy davis together and of course other labs are are doing those positives become more likely to be a false positive and the risk there is that you're excluding people from from work and from school when they're not actually infected with with the virus and so that's what we want to avoid and it becomes more likely in people who are vaccinated who have no symptoms as case rates are low in the community and that's really what we have right now so that's why the recommendation is that people who are fully vaccinated who have no symptoms go ahead and stop that regular testing now of course those who haven't been vaccinated yet we still encourage them to do regular testing and if somebody is fully vaccinated and develop symptoms of covid then that is absolutely a time where we want to see that person get get a test right as you said there will be breakthrough cases this is still new information unfolding as we go all right as we work towards our our conclusion here this is a big question but what has changed in the public health landscape as a result of this pandemic i'm i'm looking to get a sense of big lessons learned and also where do we go from here what are your thoughts at this moment in time yeah i mean i think there's there's a few things that that we've seen in terms of lessons learned um and i think unfortunately there's some lessons that we may we may not have have learned as a society just yet but i think we've really seen that the value of of partnership you know i've i've seen that here in in yolo county working with community-based organizations with healthcare providers in our in our hospitals emergencies services you know first five and trying to get child care workers vaccinated um you know what i've always said and this is a quote from one of my public health professors at u.c. davis that the public health is a team sport and we've really seen that with the pandemic it it really takes a a village to fight a pandemic and we've been very fortunate here in yolo county to to have such support coming from the community coming from our board of supervisors towards these you know very difficult actions that we as public health have asked the public to to take you know staying home for extended periods of time you know so many so much sacrifice that our residents have have done and so i'm just really grateful um to have had the cooperation from from the public support from the board of supervisors for the actions that that have been taken and you know i can speak from personal experience that that is not the case on the ground in in every county in california so we really are lucky here i'm lucky to to be the health officer in in yolo county um i think you know when i talked about maybe there's some lessons that that we haven't learned as a as a society it's thinking about sort of this boom or bust funding cycle that we see for for public health and you know the important role i think everyone is now much more aware of the role of public health typically you know we're behind the scenes we're now you know in the forefront and people know who the health officer is they understand what public health does um but there's this tendency historically you know public health gets a lot of funding for for covid that will last for the next year or two and then we're going to go back to our state of of chronic underfunding where we don't have enough staff on a regular basis to to address communicable diseases tuberculosis sexually transmitted diseases that are that are on the rise and have risen um it during covid because we've had to pull our limited staff away from controlling those diseases to address covid so i think what's really important in the lesson that that needs to be learned is the importance of public health and how we need to invest in public health infrastructure and my concern here is that at the state level and nationally we are leaders who make budgetary decisions still haven't learned that lesson uh case in point is the you know the governor's may revise budget uh where there you know there was a budget ask for 200 million dollars of ongoing funding to support infrastructure in public health departments so that we can maintain a steady level of of staffing and be ready and have trained staff on board win the next pandemic hits as well as to address chronic and other infectious diseases that 200 million dollar budget ask despite the tremendous budget surplus that we have at the state level this this year with money sort of being flung in all directions no additional money was going towards public health departments so that's where we really need to learn this lesson of the dangers of chronically underfunding our our health departments and direct more dollars on a regular basis get out of this boomer bus cycle and just have steady funding over time for our our important work being done by health departments i think that's an important note on which to conclude that and it's a great takeaway too i thank you for bringing it forward i also i suspect that you could have never uh estimated how how politicized public health could be or what a rock star you would become to those of us here in yolo county so we're i'm personally very glad you landed here and i want to thank you for your work and i want to thank you for joining us here today in the studio well thanks thanks for the opportunity i appreciate it you bet you have been watching in the studio here at davis media access this is one show among many i invite you to visit davis media dot org for show highlights and so much more about the work we do running nonprofit non-commercial community media here in davis and yolo county thanks for tuning in