Models used to predict the progression of COVID-19 infection and the result of efforts to halt the spread of the disease show social distancing and the closure of all but essential businesses could extend until Nov. 1, according to a report delivered Tuesday to the Santa Barbara County Board of Supervisors.
As well, the novel coronavirus that causes the disease will be with us virtually forever, probably in a mutated form, County Public Health Department Director Van Do-Reynoso said in response to a question from a board member.
Fourth District Supervisor Peter Adam expressed concern over the economic impact the extended period of social distancing and business closures would cause, and said the board must have a policy discussion soon about how the county will balance protecting public health and preventing financial ruin.
“The economic impacts of this are getting overwhelmed by the health impacts of this,” Adam said. “If we go all the way out to Nov. 1, a lot of people are going to be hurt without getting sick.”
He added, “I just know there’s a tremendous amount of pain being loaded into this system at this time [but no one is hearing about it] because people are sequestered in their homes.”
He predicted there will be increasing public demand to identify those who are at the highest risk from the disease and protect them, and he believes people will not be willing to continue complying with the social distancing orders all the way to November.
“If we get to the point we have to start arresting people — that’s not America,” Adam said.
Board Chairman and 2nd District Supervisor Gregg Hart pointed out that because of a lack of data, there are a lot of caveats about the reliability of the coronavirus models predicting the course of the disease in the county.
“It’s probably premature to be talking about September, October and November,” Hart said. “We’re trying to concentrate on people today, what they’re doing now. And from the information you have now … it’s encouraging. It says we’re doing a good job, that it’s flattening the curve.”
First District Supervisor Das Williams agreed it’s too early to talk about November and what the models reveal.
“However, I do think Supervisor Adam is right,” Williams said. “It’s a policy question. My feeling is if businesses were properly equipped … people could go back to work. It is a policy question for the state as well.
“It is a fact that economic collapse and poverty kills people as well,” he said, questioning how long businesses can be kept closed. “I don’t mean hurting people as in making them lose a little income. I’m talking about hurting people as in ruining their lives.”
Third District Supervisor Joan Hartmann noted America has a different culture than other areas of the world, so we have to make wearing masks socially acceptable here.
“Maybe after our surge, our high point, we really need to think about our strategies to manage the disease and get as many people back to work as possible,” Hartmann said.
Predicting course of COVID-19
In her report to the board, Do-Reynoso said as of 12 p.m. Monday, the county had 192 cases of COVID-19, with 34 people in the hospital, 42 recovered and two dead.
But later Tuesday afternoon, the County Public Health Department reported 26 new cases had been confirmed, bringing the county's total to 218, including 37 health care workers.
Most of the new cases — 18 — came from the Lompoc, Mission Hills and Vandenberg Village area, with six from Santa Maria and one from the South County.
Twelve of the new cases are in the 30-to-49 age group, followed by eight in the 50-to-69 age group, three in the 18-to-29 age group, two 70 or older and one 17 or younger.
Of the total 218 cases, 83 are female, 134 are male and one is unknown; 120 are recovering at home, 42 are hospitalized, with 19 of those in an intensive care unit, and 51 have fully recovered, according to Public Health.
In her report, Do-Reynoso said hospitals are operating at 40% capacity, reserving 60% for coronavirus patients, with 376 medical and surgical beds at this time, 91 intensive care unit beds and 50 ventilators currently available. Total surge capacity is 699 beds.
Do-Reynoso outlined the two primary models used to project COVID-19 cases and the November social distancing projection — the Penn model recommended by the California Department of Public Health and the University of Washington model that’s used by the federal government.
Department staff have begun to remove basketball hoops from backboards, limit sports court lighting and prohibit the use of sports fields by groups of players, Director Dennis Smitherman said Tuesday.
“This is a very fluid situation,” Do-Reynoso said. “Long-term projections may not give us the precise data that we’re looking for because … there’s a lot of uncertainty around how COVID-19 infection rates happen, the transmission, and how do we gauge the social distancing measures. So those [predictions] are not engraved in stone.”
Do-Reynoso provided a graph of the disease’s progression using the Penn model showing different bell curves for 40%, 45% and 50% compliance with social distancing orders.
The Penn model shows that with 40% of the county’s population complying, the number of cases will peak June 25 with 1,198 patients hospitalized, with the number in intensive care units peaking the following day at 768 and the number on ventilators peaking the day after that at 566.
Those numbers greatly exceed the 569 hospital beds, 131 intensive care beds and 97 ventilators the model projects will be available in the county at that time.
A Righetti High School art student has put her last two weeks of sheltering at home to good use by helping in the battle against COVID-19. Madison “Madi” Curran started sewing safety masks for family March 21 and is now turning them out for Santa Barbara Cottage Hospital.
But if compliance rises to 50 percent, the number hospitalized won’t peak until Aug. 20 and with only 274 patients, or 924 less, with the number in intensive care units peaking the following day at just 176 and the number on ventilators peaking the day after at only 130 patients.
The number of hospitalized patients at 50% compliance is well below the number of beds projected to be available, and while the numbers in intensive care units and on ventilators exceed the units the model assumes will be available, they are far closer than at 40% compliance.
“If we relax social distancing, the curve doesn’t complete the bell shape but can actually go up,” Do-Reynoso said, estimating the county’s compliance rate ranges between 40% and 60%, depending upon the day.
“If we follow the [50% curve], we’re well within our system [capabilities],” she said. “It will be a challenge but [the system will be] not broken.”
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“If we get to the point we have to start arresting people — that’s not America.” - 4th District Supervisor Peter Adam
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