 folks on the phone we're about to get started once again if you want to ask a question text me at 359-7190 and I'll put you in the queue when you do ask your question hit star 61 to unmute your phone and we will be live on Facebook as well. Dr. Newell why don't you take it away from here. All right thank you everyone Dr. Gail Newell County Health Officer and here with Jen Herrera Chief of Public Health and Director Mimi Hall of Health Services Administration Health Services Agency Administration. As usual I'm going to start with our most recent data from our data dashboard this can always be accessed at SamCruzHealth.org and you'll find that the website has been updated and is very interactive now you'll find a lot of really good interesting information there about how COVID is in our community. Today we have a total known case number of 2319 2319 cases of COVID-19 reported to date. Of that total number 306 are active known cases and just over 2,000 are recovered. If you've been following our website daily or regularly you'll notice that today we're reporting a new death so a total of nine deaths reported at this time. We wish to extend our condolences to this person's family and friends. She was a Latinx woman in her early 60s with underlying health conditions but COVID is her primary cause of death and we want to make sure the community is aware of deaths because the risk to our community from COVID remains significant. We've also this week had two additional deaths reported to us verbally. We're waiting for confirmation on death certificate before releasing further information on those. I'm going to adjust my mask so it doesn't keep slipping down. Sorry. All right so of our 2,300 cases 149 have required hospitalization and if you look at our epidemic curve it had been following a very nice viral trend of moving upwards and downwards so a kind of steep upward climb and then over the last two months really since our big outbreaks in July it's been steadily moving downward until the last 10 days or so. We initially thought perhaps we were stable at a certain case rate that it looks now like we're moving upward. This seems to have been driven by a number of factors still under investigation but it seems to be that there were some cases associated with Labor Day gatherings others having to do with fire evacuation including in at least one identified shelter situation and others in the usual method of or our most common method of person-to-person spread through household situations. And then we also now have a very significant and worrisome outbreak in a skilled nursing facility. Watsonville Post Acute Skilled Nursing Facility in Watsonville has now reported to us 27 positive cases in residents out of the 73 total and six staff I believe to date. Yes six staff to date. There have been significant staffing shortages and the California National Guard has come in to help cover staffing shortages at Watsonville Post Acute so we're very grateful to them. We have the potential of having many more COVID positive residents and staff at that facility although all precautions are being taken as they were previously and to clarify there were no relaxed visitation events or policies at Watsonville Post Acute from everything we've seen they were doing everything possible to prevent this kind of outbreak and following all of the guidelines. We will probably never know how the outbreak started both staff and residents tested positive initially so we don't have a case that we can call as patient zero so but as with all skilled nursing facility outbreaks it is most likely due to staff because the residents aren't coming and going it's the staff that are and are more likely to bring COVID into the facility. Not always the case however and I said we will never know exactly how this one started. So the potential for fatalities in that outbreak is significant and we will be working closely with them as we have been from the beginning of the outbreak and for months now already as we have with all of our skilled nursing facilities. As far as where we stand in the governor's tiered economic recovery system we are still in the red tier level 2 which shows widespread disease in our community still but does allow for some economic leniency. We will be there for at least another two weeks through Tuesday October 6th based on our data that we have at this point. Some private schools have opened for classroom education this week as they are allowed to do in the red tier. Transitional kindergarten through grade 12 is allowed to open for classroom restrictions with all precautions and regulations followed and we've been working closely with those private schools that have opened and with our public schools and County Office of Education to continue to allow them to plan for classroom openings in the future. We want to remind people that testing is much more available now. We have plenty of testing capacity in the County and we encourage anyone with any covid symptoms to contact their primary care providers office to arrange for testing and if you have a known exposure to a covid case that would also be an indication for testing and then some essential workers now need to be tested such as our teachers and educators and other essential workers and there is testing availability for those as well. There are state regulations in place that require health care providers to supply provide testing and to pay for the testing as well and so that is widely available and there's also testing available at sites like CVS pharmacies and other state and federally funded systems. The Optum Care OptumServe site at Ramsey Park is still open and available and will be at least through the month of November. There are testing slots available on short notice and turnaround times now are excellent at less than 48 hours in almost all cases. We also want to remind folks that it's important to get your flu shot this season more than ever. You've probably heard about the media and others calling this a twindemic of flu and covid 19 and we don't want that to happen in our own community. So please please get your flu vaccines. They're widely available now. We don't want our hospitals to become overwhelmed if we have a big flu season along with covid and a reminder that flu vaccines reduce your chances of illness, hospitalization and death. It's especially important for those with chronic conditions. Most health insurance plans cover the cost of the flu shot and the visit to get the flu shot. You can find out more at vaccinefinder.org. Vaccinefinder.org will tell you more about where you can get your flu shot, but we always recommend that it's best to connect with your primary care provider and receive your health care, including your flu shot in that way. For anyone who is uninsured or underinsured where the plan does not provide a flu shot, you may come to either county clinic at Emmeline campus or Watsonville and get a flu shot at no or low cost. It may cost as much as $15. That's a small price to pay for a flu vaccine. Lastly for me right now is Halloween guidance. The state is developing guidance. The governor will be releasing guidance, hopefully in the next couple of days. So we're holding off on putting out any local guidance because the state guidance will supersede that. So there will be lots of really detailed information. What we do know about that, I've seen a draft version of it, is that there will not be any gatherings of any kind allowed. So a reminder that no haunted houses, no big parties, no small parties, we will be messaging on if you're going to trick or treat, how to do that more safely. And so look for guidance both on Halloween and on Dia de los Muertos with some messaging about how to do that more safely. It's a great chance for everyone to get creative and make their own fancy face covering COVID mask for Halloween or Dia de los Muertos. And I think that's all the presentation I have. Would anyone like to add anything or we'll go right into questions? I think we could go into questions. All right. Yes, sir. Yep. Dr. Newell, as far as the Skilled Nursing Facility in Watsonville, two-part are here, first win was the first identified as an outbreak or the first cases. And then what are the current rules right now when it comes to visitation for Skilled Nursing Facilities? So the nursing home had two positive results on their routine testing on Friday. One in a resident and one in staff. They notified the California Department of Public Health, their licensing agency on Saturday, and they notified us on Sunday. And then as far as the current rules for visitation and things like that for Skilled Nursing Facilities, has that changed at all? I did release new health officer orders last week for Skilled Nursing Facility visitation. Those don't go into effect in any Skilled Nursing Facility that's had a positive case in the past 14 days. And so this Skilled Nursing Facility had not relaxed visitation rules. We have a phone question from Todd Gal. Todd, can you hit star 61 and unmute your phone? Okay, yeah, thank you for taking my call. I really quick, I did a story this past week on four people from Watsonville High School. They're all working teachers at Watsonville High who died. There's some indication that they may have had COVID. Is there a way that we can confirm that? And I know there's different rules that I'm hoping that you can in some way confirm that. I have not been involved at all with those cases. As far as I know, our agency or public health division has not been involved. And if there was a concern, we would certainly have been notified by the coroner's office. So I don't have any indication that that's the case. Okay, thank you. And my other question is you mentioned that some kind of tools are opening. Can you do? Can you say which ones? Is there a list or something that are reopening? I received a list of 14 schools who were planning to open this week or next week from the county office of education. I don't have that with me. And I don't even know if that's a public list. I think that would be a good place to ask. We'll do that. Thank you. Do we have any other phone questions? I know there's a few people on the line. Hit star 61 if you want to ask a question. Do you want to answer? Hi, this is John from Ways City News. I have a quick question. You said that there were there was the ninth COVID death, but then there were two additional deaths. Are we still waiting to see if they're COVID related? Those were reported by telephone to us and we were told that they were COVID related, but we always need to wait for the death certificate and also to confirm that they are actually Santa Cruz County residents. Okay, thank you. Drew, do you have another question? Yeah, okay. As far as schools, Dr. Newell, what will it take now for public schools to be able to open in person to some capacity? And before the problem was mostly testing? The county office of education has successfully contracted with Stanford University labs to do their surveillance testing. So that is no longer an issue. And we have contact tracing capacity to follow the schools as well. Personally, I'm happy to see just a few schools opening at this point so we can kind of get our feet wet with them, how we're going to handle that from a public health perspective, making sure we have adequate staff for contact tracing and case investigation and see what kind of problems might arise in those schools. I know that some of the school districts, the public schools are committed to not opening through the remainder of the calendar year. Others are looking to open later in the fall. And several have been impacted by the fires and COVID is not reopening classrooms is not a priority for them at this point. Phil Gomez, you have a question? It's hit star 61 to unmute your phone. Mr. Gomez, are you there? All right, why don't we jump to Michelle Lockston from KZU. Michelle, if you can hit star 61 to unmute your phone. Thanks, Jason. I just wanted to get a count the numbers again from Dr. Newell for the what people persecute skilled nursing facility just to concern it's 27 positive cases out of 73 six staff today. Is that correct? That's correct. And out of the 73, is that is that residents at the facility or does it include staff? There are 73 residents at reported to us at the facility. 27 have tested positive. And it's for the what people persecute. Correct. Thank you very much. I'd like to make kind of an overall comment on what we're seeing and I think it's clear what's happening in the nation, what's happening in the state and we're experiencing in our own county. We cannot be complacent as public. And so we are going to be in this continued state of increased cases and then responding with actions. And I know that there's a lot of talk about a national vaccine being available soon. And I want to encourage people that while that will be a positive thing when it is available, it's not going to be the magic bullet. It takes a lot of action on behalf of every single person in our community to do what we've been asking all of these months is to take those precautions that ensure that we're reducing the risk of transmission and exposure. The usual. I'm surprised Dr. Null didn't say where your face covering stay six feet apart, be outdoors if you can. We hope to come out really, really soon with a little bit more information about how you can reduce your risk by it's not a choice of either either or but some safer ways to go about your lives as we try to find a place in the many months of this pandemic. I've had a lot of questions lately about the vaccine. And so when there is a vaccine available, it's there will be production and it won't happen all at once. So we will still be in this continued state of a lot of effort and resources on behalf of all local health jurisdictions on rolling out that vaccination plan, identifying the most at risk populations that the federal government will likely identify for us to distribute those. And so I just ask everyone, we're in such a concerning place right now. Our epidemic curve is going up dramatically. And when you compare our reproductive rate, meaning whether we have exponential spread or how exponential our spread is, we're one of the worst performing counties in California right now, right behind Lake and Lassen counties. And that's a concerning trend. So I just ask everybody to be vigilant and be mindful and we can't test or trace our way out of a pandemic. Prevention really is the best medicine. Let's try one more. Phil Gomez from KSBW. Phil hit star 61 to unmute your phone. Can you hear me okay? Yes, go ahead. Okay, very good. I want to get back to the skilled nursing facility. The big concern, I mean, what what is being done? Are there still people who are patients or living there? And what's being done for them? Are they all been moved? So it's best not to move people around the same reason we don't move homeless encampments during this COVID pandemic. The more mixing, the more movement we have within the community, the greater at risk our community is. And so the same is true with skilled nursing facilities is if we can keep those residents in place, that it's safer for everyone, including those residents. You can imagine these are some of the most fragile medically fragile individuals in our community. And it would be very physically hard on them to move, especially if they are COVID infected. And so we've established a red, yellow, green zone system, which we have practiced with the skilled nursing facilities now for many months. Our nurses have been in the facilities working with the staff and administrators there and have determined the best way to create these these different colored zones that are for positive patients who are isolated are in the red quarantined patients who have been exposed are yellow. And the non exposed patients, non ill patients are in the green zones. And then the staff are assigned similarly. So if they are now known to be infected, but are still able to work if they're asymptomatic or not severely ill, then they work with the impacted infected patients. So it's a proven method that's been utilized around the world and has proven to be the safest way of working with these skilled nursing facility outbreaks. Do you know if these patients or the people who live there or stay there, are they from out of town? My understanding is these people who are being staying here are not just from Santa Cruz County, but also from Monterey County and other surrounding counties. I don't know that detail of information, but these are generally people from our own communities with families in our own communities nearby, which is why they're in our our skilled nursing facilities here. Not to end up again. I just wanted how many people currently staffers and residents are being treated for COVID there's that number that we gave you already the 27 residents and six staff are those that have been reported to us. Okay, very good. Is there a concern that other facilities in our county are being watched carefully as well? Yes, so anytime there's an outbreak in one skilled nursing facility in the county, all of the seven skilled nursing facilities in our county are notified and some of them share staff and so that way they're able to make sure that those staff aren't rotating through their facilities. So that is the case and both Watsonville Post-Acute Center and their sister facility, which is next door, the Watsonville skilled nursing facility, Watsonville Nursing Home, I believe it's called. Both of those are closed to new admissions and will not be discharging patients either. So we're making sure that movement in those facilities is minimized. Would you speak to us? Yes, just to make sure that everyone knows the nursing facilities have been on a surveillance testing program for many months already. So every week 25 percent of their staff are tested in a surveillance plan and all of the local nursing facilities have been very compliant with this testing and we help oversee that. Our nurses from our communicable disease unit are very involved and our emergency preparedness team as well. And so we've been preparing for this kind of event and doing everything we can to prevent this type of event as well. If there's a positive in any of that surveillance testing then widespread testing throughout the facility and the staff is done. When you talk about the concerning trend that we're on, is that mostly due to fire evacuation than as Dr. Newell mentioned labor day? Or is there something else and then kind of on top of that? We've probably seen all the cases that we're going to when it comes to due to evacuations and things like that or would we still have more coming? So it's many of our cases that we've had in the last 10 days are still under investigation but as Dr. Newell mentioned we have seen some cases from labor day. We only recently began seeing cases associated with the fire for the first three and a half weeks or so we hadn't seen any and we thought well with the time frame that has passed we're probably passed that but as you know there are still some people that are evacuated or will not have a home to return to. So I think it's a combination of factors that are really really difficult to tell and as time goes by I think what we're going to see is more of more proportionate spread of different kinds of transmission but the most important thing is to identify cases early because wherever that source of transmission is it's the household close contact person to person transmission that is still making up the vast proportion of what we're seeing and then secondly we're seeing that continued trend of the largest proportion of new infections that we're seeing are in young people and young people are our essential workers they haven't been staying at home as those of us who are older have been able to in the kinds of jobs that we have and so all of these things kind of impact what we're seeing in our transmission trends and very very concerned going into the fall having more indoors activities all of the holidays happening so this is probably we're all concerned we feel like this is the beginning of us really needing to get ready for an increase in cases and a lot more response in the coming weeks all right well thank you all for attending today we'll try to do these as needed going forward talk to you soon