03.16.20 Press Conference Live Stream Transcript

The County of Santa Clara
March 16, 2020
Live Stream - Press Conference

22:21 - James Williams: Good afternoon my name is James Williams, I am with the County of Santa Clara. We have an important announcement from seven of our local health officers representing among the largest jurisdictions in the Bay Area. We have with us this afternoon, Santa Clara County Health Officer, Dr. Sara Cody, Marin County Health Officer, Dr. Matt Willis, Alameda County Health Officer, Dr. Erica Pan, San Francisco Health Officer, Dr. Tomas Aragon, Contra Costa County Acting Health Officer, Dr. Ori Tzvieli, and City of Berkley Health Officer, Dr. Lisa Hernandez, and San Mateo County Health Officer, Dr. Scott Morrow. We turn first to Santa Clara County Health Officer, Dr. Sara Cody.

23:18 - Dr. Sara Cody: Good afternoon and thank you for being here. My name is Doctor Sara Cody and I am the Public Health Officer for the County of Santa Clara. I’m joined today by my fellow public health officers from seven Bay Area jurisdictions. Together, we cover Silicon Valley and much of the Bay Area region, including San Mateo, San Francisco, Marin, Santa Costa, Alameda, City of Berkley, and of course right here in Santa Clara County. As of last night, at 5 pm, there were a total of 273 cases of COVID-19 across our seven jurisdictions. We know that Santa Clara county is the epicenter of this outbreak in the Bay Area, and we know that COVID-19 is spreading rapidly. Today, we stand together to announce additional legal orders that will apply to all seven jurisdictions, covering Silicon Valley and the core of the Bay Area region.

These new orders direct all individuals to shelter at their place of residence and maintain social distancing of at least six feet from any other person when outside their residence. The order outlines circumstances under which people may leave their residences and defines essential activities, essential government functions, essential businesses, and essential infrastructure. A few highlights: people experiencing homelessness are exempt from this order, but are strongly urged to obtain shelter, and governmental and other entities are strongly urged to make such shelter available as soon as possible.

All businesses with a facility in the seven Bay Area jurisdictions except essential businesses are required to cease all activities beyond minimal basic operations. All essential businesses are strongly encouraged to remain open to the greatest extent possible. Essential businesses shall comply with social distancing requirements including when customers are standing in line. All public and private gatherings of any number of people occurring outside a household or living unit are prohibited with limited exceptions, and all travel except essential travel and essential activities will be prohibited. Mass transit will remain open. People may use public transit only for purposes of performing essential activities or to travel to and from work to operate essential businesses, maintain essential government functions, or essential infrastructure. People riding on public transit must comply with social distancing requirements to the greatest extent possible. This order will take effect at 12:01 am tomorrow, March 17th and will remain in place for at least three weeks.

This order was crafted with the seven of us and our respective county councils. It was crafted in order to balance the public health imperative to take swift action to ensure social distancing with the need to preserve basic infrastructure and essential services to maintain our society. I want to remind you and note that health services will remain open; grocery stores will remain open; pharmacies will remain open; food can be ordered from restaurants through delivery or carry out; gas stations, banks, and hardware stores will remain open; and essential government services and essential infrastructure will continue to operate. We know that the exceptions to these rules are complicated. They are written for health officers with the help of our legal counsel, and rather than attempt to answer specific questions, we will be posting detailed FAQs on each of our respective websites to help the public and everyone understand what we are attempting to do.

I recognize that this is unprecedented, and if I thought last Friday’s announcement was hard, this one is exponentially harder. But we must come together to do this, and we have come together as a collective of health officers. We know we need to do this, and we know we need a regional approach. We all must do our part to slow the spread of COVID-19, and ensure that our essential services remain intact and open, most especially our hospitals and health facilities. Now, I would like to introduce my colleague, Doctor Matt Willis, from Moren County.

28:52 - Dr. Matt Willis: Thank you, Dr. Cody. I am Matt Willis, Public Health Officer from Marin. It’s important to remember that social distancing and sheltering at home does not mean disconnection. You can remain connected to the things you need. The essential things we need will be available to us. Grocery stores will remain open. We are encouraging restaurants to remain open for deliveries. You can get your medicine from your pharmacy. You can still visit your doctor if you have an urgent medical need. You can even take your dog for a walk. We can all start to expect to feel some cabin fever and it is important to remember that we can get outdoors, as long as we are practicing those best practices of social distancing we have been talking about. We are not expecting empty streets, but rather that those who go out are out for those most essential trips to include getting your necessities. Social distancing does not mean disconnection with each other. Let’s be innovative and stay connected with our neighbors, our friends, and our vulnerable elders through calls, texts, and online communication. This is a necessary step for all of us to stay healthy together. I’d like to now introduce my colleague, Doctor Erica Pan, Health Officer for Alameda County.

30:05 - Dr. Erica Pan: Thank you, Doctor Lewis. This joint action that we are demonstrating today in unity to show the importance of how important it is that we need to come together as a community and region to protect our most vulnerable. We are here to protect the elderly and those with underlying medical conditions. Together, we can slow the spread of disease, protect our parents, our grandparents, and those who need us most to protect them for serious illness and hospitalization. I would like to now introduce Dr. Eregon from San Francisco.

30:40 - Dr. Tomas Aragon: Good afternoon. My name is Doctor Tomas Aragon, and I’m the Health Officer of the city and county of San Francisco. First, I just want to thank everybody, the health officers, but also all of the support we have been receiving in the prior weeks for everything that we do. We have felt very supported for every action that we’ve taken, and we’re grateful for the continuing support of everyone. In San Francisco, we’ve had three core goals from the very beginning: one is to protect the public, but especially the most vulnerable populations; to protect our healthcare system and protect our workers, we need to keep healthy so they can take care of us. And the way we are going to do this is by reducing the community spread of this virus.

Sheltering in place is a core strategy. By staying home, you reduce your risk of becoming exposed, which means that we reduce the risk of transmission, we reduce the risk of illness and severe disease, we reduce the demands on our healthcare system and thereby we improve the health and social impacts in the long term. Thank you again for all the support, and as Mayor Breed has reminded us, we are going to get through this together. We’ve been through tough times before, and we’re gonna do it again. Thank you. I want to now introduce the Acting Health Officer Contra Costa County, Doctor Zaelli.

32:37 - Dr. Ori Tzvieli: Hello, my name is Ori Tzvieli and I am the Acting Health Officer for Contra Costa County. I want to thank our federal partners, our state partners, our firefighters, our elected officials, our municipal partners, our nonprofit partners. This is a time where we as a community all need to come together and all of us have to work together to get through it. We know this is not the normal way of doing business. It’s gonna take some sacrifice on all of our parts, but we’re doing this for the right reasons. We're doing this to help prevent unnecessary death, we’re doing it so we can all stay healthy and together we can remain a stronger community at the end of all of this. I would like to now introduce Doctor Lisa Hernandez from the city of Berkeley.

33:35 - Dr. Lisa Hernandez: Good afternoon, I am Doctor Lisa Hernandez. Collective action is powerful, and with no vaccine or medicine for COVID-19, our unified actions have the power to slow the virus and to continue to maintain a healthy community. I want to thank my colleagues here and in the city of Berkeley for supporting this effort and continuing to protect the community that we serve. I want to now introduce Doctor Scott Morrow, Health Officer for the county of San Mateo.

34:17 - Dr. Scott Morrow: Hello I am Doctor Scott Morrow, San Mateo County Health Officer. I do not usually address the press in this format, but I have a very important thing to say. My message is: I stand in solidarity and alignment with my fellow health officers in the Bay Area. I ask the community to follow our recommendations, to follow our advice, to follow our orders, heed our warnings. We are in a rough place, and we are going to have difficult times ahead of us. The measures that we are putting in place are temporary, but they will last longer than any of us want. This is the time to unite as a community, come to each other’s aid and dig really deep – find your best inner self and pull out all of the compassion and gratitude and kindness you can.

35:05 - Announcer: Now, I’m going to have comment from the President of the Board of Supervisors and from the Mayor of the city of San Jose. President Chavez.

36:05 - President Cindy Chavez: Thank you. Thank you all very much for being here today. I know these are a dire direction we’re taking and it feels overwhelming. I just want to re-emphasize how important it is that our public health officers are unified in believing that this is the next step we need to take to really slow down the Coronavirus.

The second thing I wanted to say is a very big and a very sincere thank you to all the frontline workers, our emergency responders, people who are going to have to stay at work like our grocery clerks because we are going to want everything to stay open that we can. So today is really about taking the next step, to take cautious steps about what we need to do to make sure our community’s safe.

The last thing I want to say, because I know people want to get to questions, is this: we as a community can completely handle this. Our goal right now is to make sure we have as few people as possible straining our medical resources so we are only using those for people who are most in need. What does this mean? This means being helpful to our neighbors, it means being good to our families, it means finding fun things to do in the house. I already had friends tell me that this has been challenging. We are going to give you some ideas about what to do about that with your kids, but what it really means is pulling together as a community as we already are and I know that we will continue to do. Thank you. I am going to ask Mayor Liccardo to give us some words.

37:38 - Mayor Sam Liccardo: Thank you, President Chavez. I support the actions of the health officers throughout the Bay Area to enact a shelter and place mandate. We must move aggressively and immediately. The time for half measures is over, and history will not forgive us for waiting an hour more. I appreciate that our residents have endured much already, but this is our generation’s great test, our moment to stand together as a community.

We need to work together to conquer this virus, and amid our collective fears, we will find uncommon courage. It will take time for us to get systems in place, and you will hear me, President Chavez, and Jeff Smith and Dave Sykes, who is behind me, and many others who are talking about the systems in the days ahead. We will be joined by our General Manager of the Valley Transportation Authority. So we appreciate everyone’s patience as we are putting in place food delivery systems, childcare for many of our healthcare works and first responders and the like. We’ll need everyone’s patience because we’ll need to work together.

Specifically on the issue of food distribution, I know that is increasingly a concern, particularly with the recommendation from the governor that seniors stay in place and those with health challenges also stay in their homes. In collaboration with the County of Santa Clara the City of San Jose will be taking a lead on food distribution county wide. Our focus is on securing food security for our most vulnerable residents. The principles are very simple: we are going to move fast, we are going to act comprehensively county-wide, and we are going to act as one team. There are multiple networks that are operating together and the overwhelming number of county residents will continue to be able to get their food as they do today, going to the grocery store.

If you’re interested in heading to a restaurant, we hope that restaurant will remain open and provide that food to go, or drive-thru, or for pickup. Schools are standing up their own food distribution systems, particularly for low-income families whose children depend on that lunch or breakfast they get at school. For example, the Campbell Union High School district in San Jose, and other unified school districts are offering breakfast and lunch to any children under 18.

We will focus our delivery efforts primarily on seniors and those with medical vulnerabilities. We will be standing up a massive volunteer effort and you’ll hear more about that tomorrow. We wanted to ensure there was at least enough bandwidth in the media to be able to discuss in greater detail and I think there’s probably enough to announce for today. We are grateful that there are some experienced, excellent nonprofits like Second Harvest that will be stepping up in a big way.

We’re going to use some nontraditional approaches as well. We’ll certainly rely on private sector players—we've reached out to Door Dash and others and we are going to do this the Silicon Valley way. We are going to do this in a way that integrates everyone working together to ensure that none of our residents is left behind. So, we will be coordinating externally with other city officials and officials around the county and we will be using all the data at our disposal. Fortunately, or unfortunately, we’ve been through some emergencies in the last couple of years that have enabled us to better identify who’s vulnerable—use what we call “Medical Baseline Patient” to help identify where some of those folks are that we definitely need to hustle to be able to serve.

So, I support the actions, again, that have been announced today. I look forward to continue to work with our county, and I want to re-emphasize one message that you’ve heard already: social distancing does not mean social disconnection. We can continue to be a community, and we can continue to find ways to help each other. We’re going to need to care for each other to get through this together. And I look forward to continuing to explore the many creative ways in which we will be able to do that.

42:13 - County Executive Jeff Smith: So, with that we will take a few questions. Please, in an orderly manner.

42:29 - Reporter: So, can you explain how this food distribution is going to work? Talk about Door Dash – how is that going to work?

42:34 - Mayor Sam Liccardo: So, I think it’s fair to say that we are moving at the speed of the information we are getting and I think for cities and for nonprofits throughout the valley, we’re all going to be setting up these systems in the next hours and days. And there are a lot of folks who are working triple overtime, and they are working on setting up those systems now, so we will certainly have more to announce in the days ahead.

43:05 - Reporter: So it’s basically going to be Door Dash? Companies like that?

43:10 - Mayor Sam Liccardo: We are going to need to rely on a lot of volunteers, we are going to need to rely on existing companies, and we’re going to need to rely on existing nonprofits that have been serving the community and doing such an excellent job.

43:26 - Reporter: So Mayor, as I’m sure you know, there have been food and supply shortages—customers cleaning out dry goods aisle, toilet paper aisle, the cleaning aisle—is there any discussion of a system you would create to smooth that out?

43:36 - Mayor Sam Liccardo: So, there are already stores that are beginning to ration in terms of sales and we’ve had some of those conversations as a county and I expect that you’ll hear more on that in the next day or two. We recognize that there has been a lot of fear that has driven consumer behavior that is not helpful. We want to assure everyone that all the food delivery systems that we rely on every day and have relied on for decades are going to continue to be in place. So no one should fear that they need to go buy everything in the aisle. There’s going to be food. And we are going to push to make sure—also dealing with, for example, or understanding companies like Safeway, for example, may have difficulty delivering because of curfews on delivery—we're going to get those curfews out of the way. That’s what it takes to ensure more food gets delivered.

44:23 - Reporter: I’ve heard that our police have no idea what this means. What does this mean for our police chief?

44:33 – City Manager Dave Sykes: Dave Sykes, City Manager—as the Mayor mentioned, many of us are responding to these orders I think in a responsive way. Police departments ultimately would be responsible for enforcing some of these orders. I think it’s going to be important that we don’t rush to that enforcement, that we set up the system and processes in place so that the community understands what’s expected of them before we rush to enforcement but ultimately, I think all jurisdictions will have that responsibility.

45:12 - Reporter: Along those lines, you mentioned essential functions. Without going into granular detail, can you explain what is essential? You’re speaking at a press conference with a bunch of news journalists who are going to be out there.

45: 27 - Mayor Sam Liccardo: Maybe I’ll take a first crack at it. I know some of my colleagues maybe want to as well. Most of the Mayors in the Bay Area are probably hearing about this for the first time in this news conference. So, the implementation of these directives, is up to each city and local jurisdiction and we’re going to do everything we can as the largest city in the region to flesh out as much as we can in a very public way for other cities to adapt, if they find that helpful. But it’s fair to say we're simply these directives in real time and we now have to translate them into very specific orders. And obviously, our police department is not going to be out there enforcing at midnight tonight, it’s going to take some time for us to get the systems in place to get the rules in place, to make sure everybody understands what the rules are and then to enforce if it’s really appropriate. We expect most folks will be following the rules without the need for law enforcement.

46:35 - City Manager Dave Sykes: Sorry, I just wanted to add a little bit of context to what the Mayor said. We’ve many cities have been planning for this, and understand that we are going to be at a point where we will be providing essential services. The orders that have been issued give each city a fair amount of discretion to determine what that is for each city, I know in our city, the city of San Jose, we’ve done quite a bit of work and a lot more detail will be coming out. But I can assure you it’s more than police and fire there are many essential services that are needed to keep a city running in a safe and orderly and health way so more detail will be forthcoming but I wanted to assure you that it is more than police and fire, it is much more than that.

47:23 - Reporter: We've seen the slow ramp up of measures going into place over the last couple of weeks, you’ve said this is a more difficult decision to make than the announcement that you made on Friday. Can you tell us was there anything in particular, a tipping point that has taken place between here and there that made this necessary?

47:39 - Dr. Sara Cody: Thank you so much for that question. As I said in my remarks on Friday, we were seeing a tipping point here in Santa Clara County with exponential growth of our cases, we’ve also looked at the acuity—a number of our cases are hospitalized and some requiring intensive care. Over the weekend, I had a discussion with fellow health officers in the Bay Area and we were looking at trends and realized very quickly that we are one region and that’s what’s is happening in Santa Clara County today where we are the epicenter, will soon be happening in the adjacent jurisdictions. We decided collectively that we needed to take swift action as soon as possible to prevent the further spread and to protect our critical healthcare infrastructure.

These orders were crafted with great thought and with great care. They were also crafted very, very quickly. We thought of everything that we could—our intent is to preserve essential infrastructure, to enable people to get food, get medicines, to enable people to telecommute, to enable the businesses that support all kinds of core infrastructure to remain operating. At the same time we are also trying to maximize social distancing to the greatest degree possible because we know that this is moving so fast and we needed to take very, very swift action.

49:26 - Reporter: Is testing being ramped up, is there an update on testing? And also for the jails is there any update on the cases in the jails and their function?

49:37 - Dr. Sara Cody: I can tell you that testing has begun to accelerate. There, I believe as of today, a site has been stood up, one in Santa Clara and one in San Mateo County. A number of commercial laboratories are coming online in addition to the academic laboratories. So yes, that’s beginning to ramp up and as I’ve mentioned in previous remarks, once we expand testing we will be able to identify and report more cases so our numbers will increase rather dramatically.

50:09 - Reporter: Can you elaborate on what ramping up means, like on what scale is the County ramping up?

50:14 - Dr. Sara Cody: I can’t give you particular numbers because I don’t have them about the quantity of testing available. But what I just want to emphasize is that testing is now becoming decentralized. Prior it was done just in the public health laboratory system and now it is across the commercial and academic sectors.

50:39 - Reporter: How has the spread impacted healthcare workers who may have been exposed so far and is there a plan to make sure we don’t have a shortage of healthcare workers after dealing with this virus?

50:49 - Dr. Sara Cody: That’s an excellent point. One of the reasons that we need to slow the spread of this infection as quickly as we can is to protect healthcare workers. Healthcare workers are also residents in our community who are also at risk of being exposed to the virus just as we all are in addition to in their workplace. We have had a number of healthcare workers infected, I don’t have the exact numbers. That is happening here in our county and in many other communities and is one of the many reasons that it is imperative to slow the spread and preserve the workforce.

51:35 - Reporter: What about the jails?

51:37 – Santa Clara County Sheriff Laurie Smith: Yes, very briefly—we had two exposed in the jail, they were immediately isolated. We had two additional exposures, we have no confirmed cases in the jail at all.

52:10 - Reporter: Dr. Cody, you talked about the number of patients requiring hospitalization acute care. Can you get into any more specifics and how close we are perhaps to the system being overwhelmed? And can we get some kind of daily data or graph to show If these measures are beginning to suppress the spread?

52:30 - Dr. Sara Cody: We very much want to provide as much data as we can to the public, for many reasons. In part, we want you to understand why we are taking the actions that we are. It's more difficult than it would seem to classify the cases by whether they are in the hospital or at home or in the ICU and the very simple reason for that is because the case status changes. People are moving between home and the hospital or between the hospital and the ICU. And so we're trying to figure out how we can make those data accurate and useful.

But big picture, right now, the acuity of our cases is rather high. That is because we are finding, we are doing more testing in the hospital at this moment than we are at the outpatient setting. So, as we progress and testing expands, I think those proportions will change. The proportion of patients in the hospital will shrink and those who are isolating at home will grow.

53:49 - Reporter: And limits on Travel? I don’t know if we’ve addressed that. Can people get their car and drive where they want to go? Can they hop on a plane if they already had a reservation? We haven’t really talked about travel restrictions.

54:00 - Dr. Sara Cody: I will try to give you a high-level overview. Briefly, the order restricts non-essential travel so you may travel by public transportation, private automobile or an airplane to perform essential functions for essential services or essential businesses. The ideal though is to limit it as much as possible. The whole idea behind this is to have people remain in small stable groups and to limit mixing to the greatest degree possible.

54:56 - Reporter: Is there priority testing for public safety or do they get in line for anybody else?

55:05 - Dr. Sara Cody: As testing ramps up and as testing is still limited, we have had to include some priority groups. The broad outlines are—and this both for testing and as well as information that we’re going to get with tests as it expands—it's very important to us to know if someone is positive and they are performing an essential role because that is of public health importance. That is just the general outlines because remember our goal here is to limit social distancing at the same time as we preserve essential functions and essential services.

55:51 - Reporter: We’ve had a lot of people that contact the station saying they’re sick and they have symptoms, whether a high fever or a cough, etc. It‘s unknown whether they actually have CV maybe they haven’t travelled abroad or maybe they’ve haven’t had direct contact with somebody who has tested positive. They're telling us that they can’t get tested for it, or they feel like they weren’t able to get tested for it. What is the position from the health professionals on this? If you exhibit systems should you be able to go in and get tested?

56:25 - Dr. Sara Cody: So I have a very, very important message. If you have symptoms of fever, cough, shortness of breath or any of those symptoms of getting a viral infection and they’re much the same, right at the beginning, you must stay home. Even if you are—especially if you are an essential worker—you must stay home and self-isolate and not spread. As testing ramps up, it’s not possible now for everyone with symptoms to obtain a test, but with every day the testing capacity expands so people will be able to get tested and know whether they have this infection or another one.

But for now, as for example the time between getting a test and receiving a test It's not right away it may be several days. It’s incredibly important that people self-isolate to not spread their infection. That is key, absolutely key.

57:30 - Reporter: But there is a plan at some point to test people who exhibit symptoms but don’t they know if it’s CV or not – it could be something else. But there is a plan to have people tested for CV and if that is true, when would that kick in?

57:42 - Dr. Sara Cody: So, as I have mentioned before, we are trying to scale testing through commercial laboratories and academic laboratories. As testing scales, more and more people with symptoms will be able to get tested and confirm their infection.  But in the absence of being able to confirm an infection, anyone who is ill needs to stay home and to the extent possible, away from other members in the household where they live.

This concludes our press conference for today, thank you.