WILLITS, 7/15/20 — New milestones were crossed today in Mendocino County, which though spared the worst of the pandemic, is rapidly seeing conditions worsen. Nine new cases were announced today, and 10 yesterday, but more importantly today’s “dashboard” data from Mendocino Public Health shows six new hospitalizations of Mendocino County residents from COVID-19, the highest number yet. Additionally, the death of the Mendocino Co. resident who perished two weeks ago was confirmed to be COVID-caused and so was added to the data dashboard as a confirmed death. The racial disparities in the rate of infection of the disease also continue to become more stark in Mendocino with Latinos making up nearly 60% of all cases even though they account for only a quarter of the population. Young adults have also pulled ahead as the most affected group according to test result data, with people from 19 to 34 years of age now accounting for 35% of all cases.
In a press conferences a few weeks ago Mendocino Public Health Officer Dr. Noemi Doohan stated that modeling showed that by August there could be as many as 50 people in Mendocino hospitals with COVID at any given moment, but until today the hospitalization numbers had stayed flat. As such, this new spike is a worrying sign that the impacts of this new surge are about to become more acute.
In this pandemic hospitalization tends to be a lagging indicator. Test results are the first metric, but as it takes people some days to become sickened enough to require hospitalization, hospitalization rate lags test results. And since people may spend several weeks in the hospital, on a ventilator, before dying or being released, deaths lag even more. And given that we are still only 11 days from Independence Day, when it appears at a number of private parties furthered spread the disease, we’re still within the possible incubation period for the disease meaning the cases count will likely continue to grow briskly.
Also worrisome is that the amount of time it takes for the case count to double has contracted. At least week’s press conference Dr. Doohan noted that the cases count was doubling over a period of about 19 days, and that this number was stable. After today’s new numbers it appears that it’s only been two weeks since we were at half these numbers indicating that the growth rate could be accelerating significantly — though this faster spike might also be attributable to the spreading over Fourth of July weekend.
Certainly the situation across the state is worsening, and on Monday Governor Newsom shut down a variety of activities across the state including bars and indoor dining.
(Read more about that in this article)
In addition to the statewide closures Newsom ordered greater restrictions in counties that have been placed on the state’s COVID watchlist. As of Monday Mendocino was not on said watchlist, but CEO Carmel Angelo cautioned that the county was at risk of being placed on the list if infections continued to grow as they have. There is currently no word on when such a decision would be made, but there is a significant possibility another set of restrictions could be coming to Mendo in the next several days.
WILLITS, 7/12/20 — “It is not slowing down and we don’t have the end in sight,” those were the words of Mendocino County Public Health Officer Dr. Noemi Doohan Friday morning at the weekly COVID press conference and with today’s announcement of 19 new cases including three in a nursing home in Fort Bragg bringing the case total to 132, with one person hospitalized, 40 in isolation, and an unknown number of close contacts in quarantine.
Today’s 19 cases, which were counted over the past two days, are a record number of COVID confirmations in Mendocino County, and the fact that COVID has reached a nursing home is a cause for substantial concern as the elderly are particularly susceptible to the disease, and in other states nursing home outbreaks have accounted for a disproportionate number of deaths.
The three new cases are the nursing home, Sherwood Oaks Skilling Nursing, are among residents, and follow a positive test among one of the staff members on July 7, implying, though not confirming, that this staff member may have been the vector in this small outbreak. Sherwood Oaks has moved to to an “outbreak response,” requiring full “personal protective equipment” (PPE) for staff, and isolating the residents in their rooms.
Last week saw a slew of new developments in the pandemic, including the passage of a new masking ordinance by the Mendocino County Board of Supervisors, moves to more strictly enforce and fine people who refuse to mask (without legitimate medical exemption), Doohan confirming that she believes that Mendocino has seen its first COVID death, Lake County experiencing its first COVID death, and Sonoma County being placed on a state watchlist — a first step towards closing that county back down.
At the press conference and on previous occasions Doohan has described Mendocino as a ‘firewall” guarding the infrastructurally more fragile counties to the north from the worsening pandemic in the Bay Area. At said press conference Doohan remarked that the case count was doubling every 19 days, a pattern roughly held to even with today’s big jump. Though that growth is quick, it doesn’t represent true exponential growth. In the case of true exponential growth the time it takes to double would become shorter, rather than staying roughly steady as it has in Mendo. Speaking about this Doohan called it “a very good indicator that we are flattening the curve and slowing the spread due to what every single person in this county is doing.” Still, it is unclear how long this pattern will persist, and a spike from private Independence Day parties is still expected and pending.
Even with the new cases at the nursing home, the biggest jump in cases continues to be among people of prime working years from 19 to 49. Community spread has been confirmed in the Ukiah Valley, and potential in other areas of the county, but the actual percentage of cases resulting from community spread, as opposed to such sources as close contact (generally with family members) is very unclear. As the case load has increased the county government’s capacity to do full contact tracing and case investigation appears to be faltering, with an ever larger percentage of cases being designated as “under investigation.” Currenlty 47% of cases are listed as under investigation, up from only 24% under investigation on June 23, when the case count was roughly half of what it is today.
Here is the press release from Mendocino County:
Health Officer Confirms 19 New COVID-19 Cases and First Outbreak at a Skilled Nursing Facility
Post Date: 07/12/2020 4:30 PM
Today, Mendocino County Health Officer Dr. Noemi Doohan confirmed 19 new cases of COVID-19 reported to the County over the last 2 days. County staff has been working all weekend conducting case investigation and contact tracing. The number of Mendocino County COVID-19 cases is now 132 (91 Recovered; 1 hospitalized; 40 on home isolation).
Mendocino County is experiencing a rise in COVID-19 cases and it’s important every resident help slow the spread of COVID-19 and keep our community safe by wearing a facial covering that covering the nose and mouth; practicing social distancing; avoiding gatherings, confined spaces and close contact with others. COVID-19 incubation period is up to 14 days and Public Health is concerned we may experience an additional spike in cases resulting from increased activity county-wide over the 4th of July holiday weekend.
Of the 19 new cases, 3 are residents at Sherwood Oaks Skilled Nursing Facility in Fort Bragg. On July 7 an employee of the facility tested positive for COVID-19 and was promptly placed into isolation. Following the positive case an immediate plan was made in collaboration with Public Health to test all the employees and residents. The results of these tests included 3 positive test for COVID-19, all of whom were residents of the facility. These results were reported to Public Health on July 11. Once the COVID-19 status of the employee was reported to the Skilled Nursing Facility (SNF) on July 7, the facility went immediately into outbreak response with full Personal Protective Equipment (PPE) for all staff and isolation of residents in their rooms. In addition, the facility was following the Health Officer’s Medical Masking Order which provides additional protections to SNFs.
The 3 new cases in the SNF were identified through testing conducted by the SNF on July 8 and processed at the Public Health Viral and Rickettsial Disease Lab (VRDL) in Richmond. The VRDL is available to the County for COVID-19 outbreak testing. All 3 individuals are currently asymptomatic. Case investigation and contract tracing was immediately initiated. The recent death at the facility tested negative for COVID-19 and the cause of death at this time is presumed to be unrelated to COVID-19. Public Health is doing further investigation and awaiting the death certificate. In addition, Public Health has reported this outbreak to the State as required and will be working with the State in support and review of the actions to contain the outbreak. Thus far Mendocino County is not on the State watch list. Additional testing will be conducted Monday, July 13, in effort to monitor and continue timely response to this outbreak.
Public Health and the SNFs throughout the County have been meeting weekly for months, led by our Medical Health Operational Area Coordinator (MHOAC), to allow a coordinated response to potential outbreaks and to ensure SNFs have sufficient PPE and prevention protection protocols in place. The County and SNFs follow all the State guidelines including; using Optum Serve to do surveillance testing for 100% of SNF staff monthly and offering SNF surveillance testing to residents through Public Health. The preparation, planning, frequently testing and adherence to State guidelines were a key factor in the quick and coordinated response to this outbreak.Mendocino Public Health
UPDATE 7/7/20 — The Mendocino County COVID-19 count is now at 98, having gone up by another six since yesterday. Four of the cases are in the Ukiah region, one is in the North Coast region, and the last one is in North County. (See note on regions below.) Of the six people tested positive today, three are Latino, which continues a trend where Latino people make up slightly more than 50% of all cases in the county.