04.24.20 COVID-19 Briefing Live Stream Transcript

The County of Santa Clara
April 22, 2020
Press Briefing with the County of Santa Clara
10am PT


Evelyn Ho: Good morning, I'm Evelyn Ho, Lead Public Information Officer for the County of Santa Clara Emergency Operations Center and with the Office of the Director in the Public Health Department here in the county.

I'm joined today by Dr. Elsa Villarino, an Assistant Public Health Officer with Santa Clara County as well. We wanted to let you know this morning that we were wearing our face coverings and have removed them so that you can hear us better and to also support our ASL interpreters to be able to hear us
better as well so but we have been wearing them and we are continuing to maintain social distance in all the work that we do in the Emergency Operations Center.  And we thank you for your support
and continue following of the strong recommendations to wear facial coverings when conducting any essential activity.

We know the weather out today is beautiful and the weekend looks like it will be really nice too and we
recognize that we have all been sheltering in place for a long time. We want to remind you that is critically important that we continue to stay home as much as possible. Find opportunities to enjoy the outdoors on walks with members of your household only and please remember that they're congregating in any numbers with any individuals outside your household continue to be strictly prohibited under the Health Officer order that is currently in place. I know that for me that, that is a
challenge I have young kids, we have neighbors that we want to be able to see, but we will continue to try to see them from afar, from windows and knowing that even congregating in our common areas while maintaining social distance is still not allowed under the orders. But we will try our best and we will continue to do our best to follow with all parts of the social distancing requirements for our County.

As you may have seen in our data that continues to be refreshed daily on our dashboards on our website. Our case numbers continue to grow but at a slow rate and that slow rate, that slow increase is thanks to everyone's efforts in following the shelter in place order, increasing social distance and reducing contacts. All that reduction of context helps to slow the transmission of the virus through our community.  So, thank you for that. Your choices are making a difference every day and it is imperative that we continue on.

So, join me this weekend and ensuring that we get to enjoy some of continue on the beautiful whether but also ensuring that we are not having additional contact with others in our community that are not part of our household.

So now I'd like to turn it over to our discussion with Dr. Villarino today. We wanted to focus our
discussion today on what the county is doing to support long term care facilities.  So long term care facilities include skilled nursing facilities, assisted living, independent living, and board and care facilities in our county.

This work is a particular area of emphasis for the public health department because we recognize the
specific vulnerabilities of residents of these types of facilities in its particular area of work. So, I'm happy to have Dr. Villarino with us today to discuss some of our efforts there. Can you tell us a little bit about what we are doing to protect this population?

Dr. Elsa Villarino: Yes Evelyn, thank you.  We are doing all that we can to help the managers and directors of nursing of the long-term care facilities and other types of congregate living facilities care for their residents. We want to diminish the number of new infections with COVID and we want to be able to keep the ones that are living there safe and healthy.

We are doing things like having a public health nurse assigned to each of the facilities to talk to them on a daily or weekly basis depending on what is the situation happening at their facility.  They share with them infection control guidelines, ways to control the dissemination of further infection if it's happening in the facility but more importantly to prevent infections in the facility because we know that this is a highly vulnerable population. What that means being very vulnerable it means that if you get ill with this disease you have a higher likelihood of getting severe disease or dying from it.

And we want to prevent, we want to keep everybody happy, healthy, and have all the tools available to them by the public health department in the infection control guidelines that the CDC puts out have everything be in place so that the prevention of COVID can be achieved.

EH: I know that there have been in some situations when we are alerted about potential cases in a
long-term care facility.  What are some of the things that we do in generally to respond when there are cases in long-term care facilities?

EV: When there are cases in long-term care facilities, we are in constant communication with the staff
that works at those facilities.  We create listings of the residents and where they're located within the facility. We provide support for in the case there is not sufficient personal protective equipment for the staff. We can supplement personal protective equipment to the staff. We even in many instances where there has been difficulties because of staff shortages that is when the number of staff available to take
care of patients gets too low to be a safe ratio of how many persons you need to have caring for the residents.

We have been able to provide employees, nurses, and others that can support that. This is because as County employees we're all disaster service employees and therefore we can we can mobilize persons where they're needed.

EH: Great to hear. I wanted to let everybody know that on our data dashboard site we do have a specific
dashboard focused on cases within long-term care facilities. There you can find the total number of cases, that of staff and residents, that have been associated with a long-term care facility over time.
You can also find the number of facilities that have had one or more cases within that facility and
associated with that facility.

One thing to note though, is that because of the widespread community transmission, it is not unexpected to have cases within a long-term care facility.  However, the Public Health Department
actively works then as those cases are quickly detected to support the facilities to control the spread of that infection within a facility but because we have contextual widespread transmission with the community that those cases within long-term care facilities are not unexpected but our goal is to actually minimize as much transmission within those facilities.

And to do that I know that we've provided guidance, our Public Health Department, has provided guidance to all skilled nursing facilities and long-term care facilities in our county. Can you tell us a little bit more about what that guidance includes?

EV: Yes, the guidance is infection control and infection prevention guidance.  You mentioned how we're working directly with the staff of the of the long-term care facilities but also with hospitals. Because people when they're ill, they sometimes have to go from the facility to a hospital and then get discharged back to the facility. So, infection prevention and infection control guidelines are important because we know that patients have to be sometimes mobilized between two places and we want to minimize the risk for transmission during those during those exchanges if somebody goes to the hospital or comes back.

We also want to minimize any risk to staff taking care of infected patients so we instituted something called contact tracing.  This is whenever a new case gets discovered, detailed investigation of who has been in contact with that person and could have potentially become infected needs to be assessed for signs and symptoms and also tested with a laboratory test to detect whether they have acquired a of infection themselves. We provide back to work recommendations for the cases of staff members that have been out ill and when is it safe for them to come back and take care of the of the residents.

We provide, like I said on occasions, staffing to supplement any shortages and we in general need to support the good work that the long-term care facilities try to do every day in taking care of their residents. We're very aware that it's almost impossible that cases would not have appeared in in the facilities but we also know that with good infection control practices, we can minimize the spread of further transmission in the impact into this communities.

EH: Thank you and we are really appreciative of our long-term care facility partners who are operating independently and are licensed by the state of California but that their participation in cooperation with
the County Public Health Department has been critical to our ability to ensure the health and safety of the residents of these facilities. So, we're very grateful for their cooperation with us in this effort.

We did want to let you know that the information about the guidance that Dr. Villarino shared is available on our website if you're interested in knowing more about what is included there.  We want you to know that the populations and the residents of long-term care facilities who are often
our family members, our neighbors are of particular importance to the Public Health Department.
While lab testing is still limited throughout the community, lab testing is prioritized for residents within long-term care facilities should the need arise for testing within those facilities so that testing is available and is prioritized for this group among some other groups.

So, thank you for joining us today please do enjoy this beautiful weekend remembering to wear your face coverings when out doing essential activities, remain within your household groups, and reduce all contacts with anybody that's not in your household groups.  Also try to reduce even your essential activities to reduce contact where possible.

We know that this is a difficult, difficult time and we appreciate everyone's best efforts to comply with the order every day.  We know that these are choices that we make daily. They're difficult for all of us and we thank you for your continued partnership with us.

Thanks, and have a good day.