 You're tuned into the COVID-19 community report here on KDRT LP 95.7 FM in Davis, California. I'm Audemars Bay-Reno and today is Tuesday, December 1st, 2020, we're sharing local news and resources focusing on what's impacting Davis and nearby cities in Yolo County during the COVID-19 pandemic. My guest today is Dr. Amy Sisson, who began as Yolo County's public health officer in late October, and we'll get to that interview in just a few minutes. Given the surge in cases and test positivity rates we're seeing, I don't think there could be a more timely interview in this moment. Health officials and hospital leaders in California and across the U.S. are sounding about as much alarm as they possibly can about the autumn surge of coronavirus activity, which continues to intensify by the day in essentially every state but Hawaii, and which in many regions, including the greater Sacramento area, is posing a serious threat of overrunning hospitals, beds, staffing, and other healthcare resources. California has 1,212,968 confirmed cases to date. And listen to this, there were 14,034 newly recorded confirmed cases on Sunday alone. That's a one-day total. Also as of Sunday there had been just over 24 million tests conducted in California. And that number represents an increase of 217,670 over the prior 24-hour reporting period. And of course, as case numbers continue to rise in California, the total number of individuals who could have serious outcomes will also increase. There have been 19,141 COVID-19 deaths in California since the start of the pandemic. The state's projections now show California's hospitalized total could increase two to three fold during December if state-imposed business and activity restrictions don't do enough to reverse the latest infection trends. Governor Gavin Newsom said yesterday in a news conference he warned that renew stay-at-home orders effectively locking down purple-tier counties, which is pretty much every county in the state at this point may be necessary. Here in Yolo County, things have definitely taken a turn for the worse. As of yesterday, the county's online COVID-19 dashboard put the test positivity rate for the seven days between November 16th and November 22nd at 18.99%, meaning that nearly one in five people who were tested for the virus during that period were positive for COVID-19. The number of confirmed cases here in Yolo County is 4,893, and there have been 77 deaths county-wide. And when I last reported these statistics just a couple of weeks ago, the death number was 59, so we're seeing a definite uptick. In other news from the state, Governor Newsom announced yesterday that billions of dollars in immediate temporary tax relief will support businesses impacted by COVID-19, including an automatic three-month extension for taxpayers filing less than $1 million in sales tax and interest-free payment agreements to larger companies with up to $5 million in sales tax relief, as well as expanded interest-free payment options for larger businesses. These are those whose operations have been really significantly restricted based on COVID-19 transmissions. Additionally, in partnership with the legislature, California will provide $500 million in new COVID-19 relief grant funding for small businesses. And for those, I'll just direct you to the state's COVID resource page at cdph.ca.gov for more info, and that's the California Department of Public Health. And finally, the Advisory Committee on Immunization Practices, those are the outside medical experts advising the Centers for Disease Control, is expected to vote today on who should get the first doses of a forthcoming COVID-19 vaccine. Need to be first on that list are healthcare professionals treating COVID-19 patients, and there's speculation that nursing home residents could also be in that place. More on that later, we're going to go right to our interview. My guest today is Dr. Amy Sisson, Public Health Officer for Yolo County, who began her appointment with the county in late October. Dr. Sisson has multiple connections and personal ties to Yolo County, including being a graduate of the University of California, Davis, and previous experience running a small urban farm in West Sacramento, which is a great fit for our Yolo way here. She brings with her a breadth of public health experience, including more than 10 years at the California Department of Public Health, where she directed CDPH's preventive medicine residency program, and the California Epidemiologic Investigation Service Fellowship Program. I'm so pleased to welcome her at this pivotal moment in the pandemic. Thank you for joining us, Dr. Sisson. Thanks for having me. First, I want to acknowledge what a difficult job you have during this moment in time. And we're glad you landed in Yolo County here. And I'd like to thank you for your work and your service. You've kind of alluded to the don't shoot the messenger vibe. You have a tough job of conveying and carrying out what can be unpopular orders from the state. So I want to start by talking about public health orders. A few weeks ago, you issued a travel advisory for residents who had traveled outside the county. Let's tell us more and let's talk about the difference between an advisory and an order, for example. Yeah, absolutely. So my travel advisory was an attempt to clarify a travel advisory that was issued by the California Department of Public Health earlier that that week, which I think had created a lot of confusion among Yolo County residents. And there were some pieces that that didn't entirely make sense to me as I was trying to interpret it. So the idea is that people who are returning to Yolo County or coming into Yolo County as visitors from areas that are at higher risk than Yolo County when it comes to coronavirus should quarantine for 14 days when when they arrive and to not make a distinction for the purpose of that travel so that whether your travel was for business or for pleasure, essential versus nonessential, the risk associated with that travel would would be the same. And so requiring the quarantine upon return, but it was issued as an advisory in similar fashion to the state's travel advisory, which was not a requirement and not a mandate, but rather a strong recommendation from the health officer. Right. By far, you mentioned confusion. People are definitely confused by far. One of the most frequently asked questions I've seen on on social media, for example, is around this. How does a citizen report what they perceive to be a violation of a public health order? So we were talking about advisories. Now we're talking about orders and that that would be a violation by an individual, say a neighbor's having a party or by a business who's not compliant and and then really what people want to know is what are the mechanisms for enforcement? And I suspect that has to be one of the hardest pieces of this. It definitely is challenging, especially when we're talking about things that are, you know, happening in individual homes. That is a very challenging area for enforcement. But the mechanism for enforcement really depends on the area of the county in which the person lives or the event or violation is occurring. In the unincorporated areas, the county takes the lead. And in the in the cities, the cities take take the lead, although with, you know, we work, the county and the cities work closely together. But, you know, depending on the type of the violation, it may go through law enforcement. It may go to code enforcement. But so there are multiple mechanisms for enforcement, depending on the nature of the violation. But really, while we have enforcement options, we we prefer and we always begin with education. Sure. I find that, you know, for the most part, people are trying to do the right thing, but we do have some instances where education is not enough and a citation or a client is necessary. Interesting. OK, so Governor Newsom hinted heavily yesterday that counties in the purple tier in California. And as I said earlier, that that's almost all of us at this point, not all, but almost, could potentially go into full lockdown mode again through the end of the year. What what do you know about that? What are your thoughts on that? And what would this mean for Yolo County? Yeah, I mean, I do think that the governor more than more than hinted at yesterday, I think what's not clear is the exact timing and the exact details of what that day at home order might might look like. And, you know, the health officers have not been been privy to any details more than than the public has at this point. But I think there's my dog wanted to participate in this interview as well. That's OK, we're dog friendly. And now he's forced me to lose my my my train of thought. But yeah, so the content of the day at home order is not known. But there's certainly a recognition by local health officers as well as the state health officer and the governor that, you know, cases are increasing very quickly. Testing positivity rates are increasing very quickly. And we're seeing hospitalizations begin to go up. And we know that those are typically lagged behind cases. So as the cases rise and the hospitalizations rise and it does cause concern. The whole reason why we did this day at home order that spring in the first place was to prevent our health care system from becoming overwhelmed and the projection that the state is looking at right now suggests that hospitals could very well become overwhelmed in December and January. So on that note, how is our hospital capacity here in Yolo County? Yeah, so we have two hospitals that are both on the smaller side. At this point, both of our hospitals have both regular beds as well as intensive care unit beds. So we are doing OK right now, but I would, you know, add the caveat that, again, hospitalizations lag behind cases. And the number of cases that we've seen in Yolo County in the last two weeks does if what the state predicts of 12 percent of those cases will require hospitalizations, we could end up at a point where there are not enough hospital beds and especially not enough ICU beds in our local hospitals for people with covid. Right. That's a real concern. I want to dig into. I wanted to ask you a little bit about some of the data and data reporting that we have here in Yolo County. So journalists covering the pandemic, we really look to the county's covid-19 dashboards with great regularity. So so thank you for all the work there and big shout out to Jenny Tan, who's been so so helpful to so many of us during the pandemic. There's a lot of data on the county's dashboard about where the infections are occurring, even which demographics with respect to ethnicity and age. Today, for example, those dashboards tell us out of our total four thousand eight hundred and ninety three cases, 41 percent of those are in Woodland, 30 percent are in West Sack, about 13 percent are in Davis, which has the higher population. And they're skewed really heavily to to young adults ages 18 to 25. So that's all interesting. But I guess I'd like to know how does public health use that data? Sorry, I'm having challenges with the mute button. You know, I think I think all that information is interesting. I don't think there's there's really that many surprises there. You know, we we see more more cases where there are more people. So, you know, I I think what's more interesting and but but still not particularly in lightning is trying to understand where people are getting infected in in the community. And, you know, I think that's also very difficult to tease out for a disease with a long incubation period that can be transmitted by by people who are asymptomatic. So, you know, one of one of the major challenges in controlling in controlling covid is trying to figure out where people are are getting infected. Contact where where those cases are. Yeah, the case investigation and the contact tracing. And while we we are very diligent with with that effort, it's a covid-19 is a particularly difficult disease to conduct case investigation and contact tracing for because of the nature of transmission. Yeah, and and if you can't really track it, then it makes it much harder to direct resources to those points of infection, I would imagine. So, yes, big challenges there. And the incubation period, I mean, for example, with the the seasonal flu, it's I understand it's like one to four days. And with covid, it can be up to two weeks, which is a really big factor, much longer period. Right. Yeah. So on the heels of Thanksgiving, where, you know, we saw all of the the messaging was around, you know, don't travel, don't gather. If you gather, only gather out to all of that messaging. There's a good article in today's Wall Street Journal about this topic, citing the dramatic even even the more dramatic pre Thanksgiving messaging that some states put out along the lines of this was when I saw and I can't remember which state it's from. It does no good to have grandma at the Thanksgiving table if you have to bury her at Christmas. I mean, that's that's really kind of hardcore messaging. That's that's really kind of in your face. I'm not suggesting that that everyone has embraced that. Yolo County has not embraced that. But I I guess I understand that there was some hope that the severity of those messages would get through to people. And instead, it seems like there's more of a backlash of people just kind of tuning it out. So how do we reach people about the importance of not gathering and not traveling as Christmas as people are tuning out? Yeah, I think that's a wonderful question. And I don't think that we have have a good answer. I think traditional public health approaches and messages are kind of failing at this point in the pandemic, where, you know, I think we have a lot of folks who who are listening and and are and are doing as we suggest and recommend. But there's also a large proportion of the population that has made a decision that that they will make their own decisions, that they will not follow public health advice. And so I think that is is very is very challenging. You know, on the on the gathering piece, we did have a shift in our messaging away from a, you know, a strict ban on gatherings, which I think you'd seen basically since the beginning of the pandemic and the first day at home order in March to what we're calling harm or risk reduction language focus more on look. We discourage gathering, but we recognize that many people are still going to gather, and so we're going to provide you with tools to help you make the decisions if you do choose to gather, how to do so more safely. So that's where you see the recommendations of do it outdoor, keep it short, keep it small. But I think it's it's a very tricky area to message because in the end, the safest thing is to not gather with people outside your immediate household. And so that's the message we really want to send. But at the same time, recognizing that some people are going to gather and to help provide them with information about how to do so more safely. And and I still think that we're we're trying to figure out the best way to get these messages out there. And and certainly, you know, open open to to feedback on how we can better convey the especially right now, just how high the risk is not just in Yolo County, but throughout California and throughout the United States and really send this message of right now being at home is the safest place to be. And yes, stores are open and many of them will continue to remain open. But if you don't have to go out, please don't. Yeah, yeah. Yeah, the the images online of all the Thanksgiving travelers, you know, thronging airports were disconcerting. They were disconcerting, you know, a whole lot of people traveled. And so now we're in this this waiting period of to see, you know, what that does to the what it does to the test positivity rate and all of that. I think I think we're in a difficult place in this pandemic. People talk about pandemic fatigue and, you know, it's real. People are tired. We've been, you know, living in a very abnormal state since since March. And I can understand this this need to get back to normal and have some semblance of normal, especially at the holiday time. But, you know, so things are really hard right now. And yet we have so much hope on the horizon with the great news about vaccines being, you know, at least two now three vaccines being 90 95 percent effective. And, you know, at least we're going to have the first doses for health care workers, we believe approved or authorized by the FDA in the middle of December. And while we won't have doses for the general public until likely the spring, you know, I think there's more hope on the horizon than there ever has been, which in some ways might make it even harder to buckle down. But I would hope, you know, the fact that we can now say, look, we won't we don't have to do this forever. You won't have to do this forever. It is just one holiday season and a few more months before we really can get back to normal with the vaccine. And, you know, sort of those messages of, you know, to quote the one that you said earlier, there's no point in having grandma at the Thanksgiving table. She's going to bury her, you know, before Christmas. A little bit crude, but, you know, the point is, you know, we are really close to an end in sight and, you know, you would hate to, you know, make a decision based on the short term that would have very negative long term implications. So just really encouraging people to push through with remote gatherings and ways of connecting with each other because as human beings, we are absolutely social animals and we do need connection, but to do, to make choices, safe choices when you do connect with people and just push through for a few more months until we will have widespread vaccine and herd immunity. Definitely. And I do like inserting what there is to be, you know, hopeful about this time because, as you said, that the fatigue on all of this is very real. We are all feeling it. I wanted to take a couple of minutes to get to know a little bit more about you. This is perhaps an unfair question because you have stepped into your job in here in Yolo County. You stepped out of a job in Placer County where they weren't taking the pandemic seriously into a county that is taking it very seriously and this is what you're working on. But moving forward when we can move out of this time of pandemic, what are some other things that are kind of near and dear to your heart that you foresee working on? Yeah, absolutely. And, you know, my focus since starting in Yolo County, I guess five weeks ago really has been on COVID and I think it will be until we are able to give that last dose of vaccine. But looking forward beyond the pandemic, I think my areas of interest are health equity and health and all policies, thinking of, you know, getting non-traditional partners at the table to think about how we design and plan our communities and the policies that we have in place to make the healthy choice the easy choice. And then also, you know, I have particular interest in the healthy food area, having run a small farm in West Sacramento. And so I think that's a large piece of, you know, preventing chronic disease. And so I hope to continue doing work in that area. Great. I have someone text to me a question. So I'm gonna jump back to a place we were earlier and redo this because I like when this happens. Does the county have the resources to deal with increasing case, I think it's case numbers, especially with respect to contact tracing? How exactly is that process working? Yeah, that's a very astute question and one thing. So the county's capacity has basically been maxed out with this current increase in cases. And while we have expanded our team of case investigators and contact tracers, the cases continue to rise faster than we can add staff. And so we are starting to get a backlog of cases and the US Centers for Disease Control and Prevention last week released guidelines for prioritization of case investigation and contact tracing in hybrid and jurisdictions. And that applies to Yolo County at this point in time. And what they found in their modeling based studies is that there's very little public health benefit in following up with a case that's more than six days old. They've probably already transmitted disease. And so the opportunity for intervention and really making a difference falls in those first six days. So what we are beginning to roll out with our case investigation and contact tracing team is a focus on cases that come to us within six days of the person testing positive and making sure that those are given priority attention and cases that come in that are already more than six days old when public health gets the report. It is not, those cases will not receive a phone call from the health department. They will instead receive a written communication, either a letter in the mail and email or a text message indicating that they do need to isolate providing them with a copy of the Yolo County Health Officer isolation order from earlier this summer, isolation instructions and guidance on how to contact, to notify their close contacts of their need to quarantine, but they will not receive a full investigation from the health department because the benefits are marginal in those cases. And we wanna concentrate our limited resources on the cases where we can have the biggest thing for a buck, so to speak. That makes a lot of sense and it's really good information. I'm glad we can help put that out there. I wanna thank you for coming on. You've answered a lot of questions. You've helped clarify a number of things for me and I hope it's been useful for listeners as well. And I know how busy you must be during this time so we really appreciate you taking time to come on the air with us today. I'm happy to be here and happy to be in Yolo County. Great, we're glad to have you here too. All right, I look forward to the day I can meet you in person sometime. Likewise, thank you very much. All right, thank you. Take good care. All right, I have a couple of other things. We have just a couple of minutes. I believe the Senior Center in Davis is still offering testing, but I wanted to talk about, Winters has some testing today, which is Tuesday, December 1st, 2020 at the Winters Community Center, which is at 201 Railroad Avenue in Winters and from four to 7 p.m. Let's see what they say. Registration is recommended but not required. Registration does not guarantee a test and does not allow you to select a time slot or receive a confirmation of receipt. This is not a drive through location and so you may, you are required to mask, you are required to observe all the safety protocols that you can and you can register here. I'm gonna read it and then I'm gonna spell it. Avalinocoronatest.com slash patient. Avalino is A, V is in Victor E, double L, I, N, O, coronatest.com slash patient. And again, this is just one of many testing sites the county's been working on and you can find more at YoloCounty.org and I can see them out of time. So I'm gonna say this is Autumn Lab A. Renaud signing off from the KDRT studio and I'll see you next week.