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Dr. Frankovich: Slow Test Results, Why We Can’t Have the Same Info as Our Neighboring Counties, and More – Redheaded Blackbelt

Posted: July 8, 2020 at 8:50 pm

Humboldt Countys Public Health Officer Dr. Teresa Frankovich has been answering questions since the stay-at-home orders were instituted on a two question per media outlet roughly three times a week basis. The Emergency Operations Center takes the questions, and staff reads them on camera for her response. The resulting video, called a Media Availability, is then provided to news outlets at the end of the day.

Here are some of the main points covered in the July 6th Media Availability session with a summary of answers from Dr. Frankovich, followed by questions we would have liked to ask in response if appropriate.

Media Question: There have been some anecdotal reports of Redwood Acres testing site losing tests (and thereby not having results for those tested) as well as delays as long as nearly two weeks on getting test results. Is that something that you are aware of and how is it being addressed at the county level?

Answer by Dr. Frankovich:

So you know the Optum site that we have at Redwood Acres was initially an enormous gift for the county and and it still is a really good resource for us, but at the outset we were one of a small actually were the first county to begin using the Optum site and whats happened as testing has expanded across the state and vastly more people are being tested, these sites such as Optum and Verily that send their specimens to large commercial labs are finding that those labs are getting backed up and so its causing a delay in processing specimens and reporting specimens which is hugely problematic.

You know no one wants to find out six days after they have been tested that theyre positive; both the individual and for contact investigation purposes we need to have speedier test results. What Ive been hearing recently is that turnarounds have been as long as six to eight days in general and we need it much quicker than that so we are very actively at the county level investigating other opportunities for testing that we may be able to utilize and have some better turnaround times in the system.

2 mins in:

Media Question: Also, are there any other similar problems being seen at other local testing sites (ie Garberville and Willow Creek)?

Answer by Dr. Frankovich:

Well again, when were talking about Garberville, that was our Optum test site from Redwood Acres. Although it is not designed to be a mobile test site by Optum, we pleaded with them to be able to take the set up off site so that we could get to some areas that are underserved. And we are able to continue doing that, although were somewhat limited in how often we are able to. In Willow Creek that is a Verily, which is sort of a just another entity like Optum that was doing that through Trinity County, that site actually has been challenged by you know low turnout and so Trinity is no longer going to come on a regular basis to Willow Creek but said that they would be able to come and help us out if there was an increased need in that area. To the question- the previous question about losing tests- that is not, as we understand it, an issue of the local company losing the test; its an issue of the tests getting sort of lost at the lab; at the referral lab. Sometimes its not really a question of being lost, but specimens may just, you know, not be able to be tested for various reasons or have indeterminate results and not satisfactory and so they have to be redone to have an accurate result.

3 mins 25 sec in:

Media Question: At the Redwood Acres site, residents are seeing long wait times to get an appointment, long turnaround times for results, and even instances of being asked to get retested. How confident is Public Health that our case count (of both positive and negative cases) is accurate? Also, how can Public Health and the community understand how widely the virus is circulating if there are issues with testing?

Answer by Dr. Frankovich:

So, good questions; in terms of the case counts, you know the issue really is one of delay. So ultimately these tests that have long turnaround times we do get the results but it takes much longer, so on a day-to-day basis were not able to report as accurately about results for that reason.

In terms of the accuracy of those tests, I have confidence in the accuracy. The actual number of tests that are not able to be run or have problems are actually relatively small; the real issue is the delay. So once we have the results you know we feel confident in them in terms of how widely its circulating, frankly you know the lag time for this testing being about a week to sometimes slightly longer means that our numbers are delayed but ultimately from a surveillance standpoint you know were able to see trends over time. I think whats a more important issue is the one we discussed which is that the turnaround time being long makes it less useful for contact investigation being able to promptly isolate and quarantine people.

4 mins 50 sec in:

Media Question: Mendocino and Lake counties both are very rural like Humboldt, each has fewer total cases than we do as well as smaller populations, and yet they release current hospitalization data. Could you please provide that information or explain why you feel our situation is different than theirs?

Answer by Dr. Frankovich:

Well, I think you know, weve talked about this before. Public Health historically has had great sensitivity to concerns about revealing peoples identities- basically, publicly stating their confidential health information. I think most of us appreciate the fact that thats a good idea. You know, that we dont want our personal health information discernible to our neighbors. And so in small communities, if your neighbor gets hospitalized and then you hear theres a new hospitalized COVID patient, sometimes thats enough to make you go Hmm, I think thats whats going on here, that type of thing. And so for that reason historically again, Public Health has not put out small numbers at a time.

However, COVID seems to be a different environment and information that normally would not have been given out in this fashion is, and its actually now becoming available at the state level. And what wed like to do actually, is there is a state site that reports on the daily hospitalizations, so well make that site available to the public; provide that link so that you can see that information if youre interested. It may not be exactly accurate on a day to day basis but it will give people a general idea about hospitalizations.

Media Followup questions were unable to ask because of the format:

Apart from any surge capacity, please tell us exactly, using a numerical identifier, how many ICU beds are available in the county- not occupied, but rather open and available?

6 mins 30 sec in:

Media Question: When doing local contact tracing, does/can the health dept ask people whether or not they have gone to a recent protest?

Answer by Dr. Frankovich:

We can ask about everything and we typically do. What were looking at is where have you been and what have you done in, you know, the 48 to 72 hours before you develop symptoms, or before you had your test date that was positive. And so, anything that youve been doing in terms of gatherings and contacts with other individuals is relevant and important. and so, yes that is information that we do ask in the context of our larger investigation.

7 mins 10 sec in:

Media Question: Before 4th of July, the governor said, Any public or private events this weekend that include people who do not live together in the same household should not happen. This includes family get-togethers. What message do you have for the people who ignored that suggestion over the holiday weekend locally?

Answer by Dr. Frankovich:

Well its probably no secret that Ive been frustrated by this, and I think you know I completely understand the desire to socialize and have a bit of normal life as we had known it. The problem is, is that I can tell you absolutely, that as were dealing with new cases coming in, and calls even that were over the weekend here, that there are people who are becoming ill or exposed in settings like birthday parties, visiting family. Either our residents going elsewhere to visit family and coming back exposed, or exposed family members coming here and exposing the household. And so there is no doubt in my mind that a lot of what is driving our increases going forward is gatherings. And as much as I hate to say it we really, really need people to be able to limit those gatherings outside their household unit and it wont be forever, but its important now.

Again the real issue is not trying to make our cases zero. We need to control our number of cases so that again, people have access to the health care they need when they need it. And you know as weve pointed out before in pandemics or epidemics of this sort, people die not only because of the direct effect of the virus on their body but sometimes they die because they cant get care that they need at the level they need for the infection or they die of heart attacks, car accident injuries, strokes, because they cant get the care they need when the hospital is full of COVID patients, or the ICUs are full of COVID patients. So its really an investment in each other to just really be cautious at this point, knowing that when we can do it more safely well open up more.

9 mins 35 sec in:

Media Question: With more and more places reopening and people out and about more, how do you feel residents have been doing overall when it comes to masking, social distancing, etc? Do you think residents acted responsibly this 4th of July weekend?

Answer by Dr. Frankovich:

Well, I hope that a lot of people did and when I go out and about and see people masked in the grocery stores and different places around the community I find that encouraging. And you know, I feel proud of the community, because you know its something, again, that isnt really meant to protect you; its meant to protect everybody around you.

So you know I think that compassion for our neighbors and friends is really important.

You know, I think that a lot of people restricted what they would normally be doing on these holiday weekends and I appreciate that. Although I can also certainly say that, you know were probably all aware of people who were gathering with extended family and having parties.

I do want to remind people that well you know large gatherings, you know, 100, 200 or more people increase your risk increase the risk of the community dramatically and when I hear of weddings and things like that being planned that involve hundreds of people, all I can say is nobody has the capacity here to do contact tracing investigations and that for hundreds of people at one time. You know it is just not a feasible thing to do and so I want to tell people that while large gatherings are particularly problematic and worrisome to the community, what were seeing right now are a lot of smaller gatherings. Its 10 to 20 people, at birthday parties, barbecues, things like that each of those generating additional cases and quarantine people who are exposed so again we just really need to limit these activities right now; it should be your household unit and you, outdoors and doing all the things we love, just not with other families right now.

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Dr. Frankovich: Slow Test Results, Why We Can't Have the Same Info as Our Neighboring Counties, and More - Redheaded Blackbelt

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