03.31.20 Press Conference Live Stream Transcript

The County of Santa Clara
March 31, 2020
Live Stream - Press Conference
12pm PT

James Williams: Good afternoon. My name is James Williams and I’m the County Counsel for the County of Santa Clara. I want to first thank folks for attending and practicing social distancing here at the press conference. We are also using a pool camera for media, and did try to have people spread out here in the room. A few notes before we begin, starting tomorrow the county will begin Facebook Live briefings at 10am Monday through Friday that will cover different topics for the public each day to keep everyone updated with what’s happening with COVID-19 in our community. We will also continue updating our social media and web pages each day with any new FAQs and media advisories. For the attending media, we will give time to ask questions but due to social distancing guidelines we will not be able to accommodate one-on-one interviews after this concludes.

This afternoon, Dr. Cody is announcing an important update to the county’s shelter-in-place order. The new order being issued today replaces and extends the existing order, and makes important clarifications and tightens some of the categories in order to enhance the protections for our community. The bottom line remains this—the best thing we can do to combat COVID is to stay at home as much as possible and to maintain social distancing while out.

Our speakers this afternoon, Dr. Sara Cody, Health Officer; Supervisor Cindy Chavez, President of the Board of Supervisors; Sam Liccardo, Mayor of the city of San Jose; District attorney Jeff Rosen, we’re also joined by County Executive Dr. Jeff Smith, and I also want to acknowledge the other members of our Board of Supervisors, Mike Wasserman, David Cortese, Susan Ellenberg, and Joe Simitian, who are abiding by the shelter in place order and so are listening remotely.

I’m now going to turn it over to Dr. Sara Cody, county Health Officer.

Dr. Cody: Good afternoon, again my name is Dr. Cody, keeping distance as well. In unison with other fellow health officers around the Bay Area, today I’m announcing an update to my previous shelter in place order. As James will detail after this, my updated order both extends the shelter in place order through May 3rd as well as adds additional restrictions. I want to be very clear about the overall goal we are trying to achieve: the goal is to decrease to the greatest extent possible the average number of contacts each of us has with each other every day. So please remember—every unnecessary contact with another person increases the chance that the virus may spread from one person to another. Every revision in the order is guided by that overarching goal, and I want every person living in our county to understand that

We now know that people who do not show symptoms or show very mild symptoms can still spread the virus to others, so continuing to stay physically separate, to stay in small, stable groups, and to mix with each other only when necessary is vitally important. Since my previous order took in place on March 7th, just over two weeks ago, and I know in COVID time it feels like about a year ago, we’ve seen our county’s case count increase from 138 to 890. And deaths among people living in our county have risen from 3 to 30. Santa Clara County remains the epicenter of this outbreak in the Bay Area. We have some early indications, though, that the actions we have collectively taken are beginning to slow the spread. The sacrifices that everyone has made have given our hospitals valuable time to prepare for the expected influx of patients. However, more time and additional restrictions are needed to slow the spread and further reduce the impact on our local hospitals and healthcare providers.

Our hospitals are beginning to fill with COVID-19 patients—they need more time. We need to do even more to give our healthcare facilities and providers every advantage we can so that they can care for us when we need them, whether for COVID-19 or for any other acute healthcare need. This order like the last was crafted to balance the public health imperative to ensure social distancing with the need to preserve basic infrastructure and essential services to maintain our society. I recognize that this order and the previous one are creating social and economic disruption for everyone, and extreme hardship for many.

This pandemic has changed our lives. We are each doing the very best that we can, let every one of us keep doing the best—if we stay the course, we will save lives. People have shown extraordinary compassion and strength. We all must continue to do our part to slow the spread of disease to ensure that our essential services remain open, most essentially our hospitals and healthcare facilities. Thank you.

James Williams: I want to acknowledge the incredible cooperation and collaboration on the part of health officers from across the Bay Area’s largest jurisdictions, Alameda, Berkeley, Contra Costa, Marin, San Francisco and San Mateo, who by working together are keeping our broader community safe and are ensuring a consistent set of orders for our region. I’m going to take just a quick minute to talk about some of the key items that have changed in the new order that was issued today. First, the order has been extended through May 3rd, as Dr. Cody mentioned. Some of the other key points are that social distancing is now mandatory when performing essential activities or operating essential businesses. And to further enhance that, there is now a requirement that essential businesses must complete, post, and implement a social distancing protocol based on a form that is being provided on the website. This will help ensure that even those places that do need to remain open are adhering to careful guidelines and thoughtful guidelines specific to their own facility, to ensure maximized social distancing.

Essential businesses now must also scale down any non-essential components—there were some challenges previously where an essential business had other arms that were doing non-essential activities remaining open. Playgrounds and other related facilities are closed, many of them had already closed but this order clarifies that they are to be closed. And most construction is now prohibited with some narrow exceptions. The order also makes a number of clarifications that in part incorporate and reflect the guidance that has been provided over the last week on the FAQs on our website. All of these materials are available on the public health department’s website, including the order, downloadable social distancing protocol form for essential businesses, a detailed summary of changes, and a set of FAQs. Now I’m going to turn it over to Supervisor Cindy Chavez, president of the Board of Supervisors.

Cindy Chavez: Thank you. First, let me begin by saying a very significant thank you. We’ve been talking a lot about front line workers and in many respects we understand that to be just as doctors and nurses, I want to also talk about the respiratory therapists, the people who are cleaning the rooms, your grocery clerk, the truckers who are delivering your groceries, the folks who are making sure that water and sewer are still provided. I say that because every single one of those people, as they do their jobs, right now we know are risking their lives. I say that because we know that this is a highly contagious disease, and what we’re asking of all of you is to make sure that you stay at home, that you lessen the number of times you go to the grocery store. And that if you’re out, go for a walk, take your dog for a walk, go with your family out to walk but let’s be really mindful that every interaction that we have with another person could put them at risk, it could put your families at risk. Let me also mention this—I have been receiving a lot of emails about the hardships that people have been experiencing. I first want to extend my deepest condolence to every person who lost a loved one in our community and across the nation, and for every person who is in the hospital right now that can’t be comforted by someone else because it’s too infectious and too dangerous, these are really painful times. And we have families that are feeling this very deeply, and I do want to share my compassion with them and just to say to all of you that we don’t want any of your families to be experiencing this either, which is why we’re making the changes in the rules that we are.

Let me just close with this thought. This is taking a team effort, and I’ve been thinking a lot about teams lately as I’m thinking about the folks working in the hospital, the folks on the front lines working in our EOCs, but every family, every one of you who are sheltering in place are on the same team. And that team is to make sure that the community stays as healthy and as vibrant as it can stay. And the sooner we stay in our homes, the better we adhere to what Dr. Cody is asking us, is demanding us to do, the more lives we’re going to save and the sooner, I think, we’ll be back to our old lives again. I also just, in closing, Dr. Cody has been—I told her this earlier, I think God listens to some people more than others so I asked my mom to pray for Dr. Cody and for those of you who believe you have a connection let’s do the same for Dr. Cody and for all the frontline workers that are really fighting this virus. Thank you.

Sam Liccardo: I’d like to begin by sharing with President Chavez, my immense gratitude to all those who are working without much sleep, working long hours on the front lines, our healthcare workers, our first responders. Many folks who are involved with great nonprofits like Second Harvest Food Bank, who are helping food and essential, critical supports for our community during this time of extreme hardship, and this is a time of hardship, it’s a time of shared sacrifice. To be sure, and my city team will be working hard over the next several hours to understand how best to implement these new regulations as we are all doing our best to catch up to the fast-changing realities of this pandemic. We are committed to enforcing the regulations of our health authorities to ensure that this shared sacrifice happens now, because we cannot afford to simply hope we can impose these regulations weeks from now.

This is the moment when it counts the most to save lives, weeks from now we will only have regretted that we did not move sooner. And so it’s important for all of us to recognize that there will be more hardship as a result of tighter regulations. There will of course be all the hardship that so many have encountered already, we know that we’ve got thousands of families already that are struggling without a paycheck and so this is a moment where we have a moment as a community to come together. To recognize this moment of shared sacrifice, where we can give of our time, of our energy, in any way we can. I encourage everyone to get online, siliconvalleystrong.org, to please give, and give generously if you are able to. We have many families, as we all know, who are struggling without a paycheck right now, and through a constellation of nonprofits led by Destination Hope and Sacred Heart Community Services, we are ensuring as many families as possible can get these dollars directly to help them pay for food, rent, basic necessities. And we also have, if you have a passion for small businesses or nonprofits, we have ways to give to those organizations as well. We also have opportunities for folks who want to donate their time in partnership with the nonprofits who are out there, serving their community, obviously abiding by the county’s mandate for physical separation.

Physical separation does not mean social isolation, this is a time for our community to embrace shared sacrifice, to embrace this moment because it is in this moment that we will find our character as a community, how we can move together to address the pain that so many of us share, and to be able to walk proudly through this very difficult moment. To be able to say we did it together. Thank you all for your collaboration.

James Williams: And we will now hear from District Attorney Jeff Rosen.

Jeff Rosen: I would like to talk directly to the business owners of Santa Clara County who have closed. Thank you. You have made a great sacrifice. You are saving lives. We may never know how many, or who. It is very hard to measure the result of a good deed—your good deed, your sacrifice, your civic duty will be measured in lives. Someone’s grandfather, someone’s mother, someone’s child will survive this pandemic because you’ve done the right thing. Those are the stakes, and for the vast majority of you you’ve shown over the last few weeks the importance of this great challenge. To those very, very small number of non-essential businesses who have remained open during the pandemic—please close your doors. Please close your doors. Every person who enters your business carries the potential of spreading the virus and endangering more lives. Please join the rest of our community, the vast, vast majority of our businesses, as we stand together through these difficult days. My office, like the police department in this county, like all of our justice partners, are working hard every single day to keep our community safe. Crime may be down in certain cases, but it has not stopped. We have made extraordinary efforts to safely bring the jail population to a point where we are protecting both the inmates and the public
For the first time, we’re holding many court hearings remotely by video, and we’re working to protect vulnerable people in our community from crime. We’ve put out warnings about price gouging, and virus-related scams. Just yesterday we released a video public service announcement discouraging hate crimes that have been sparked because of this pandemic. While there are many issues to work out, we know this is not over by a long shot. The good news is that Santa Clara County is washing their hands, social distancing, staying home as much as possible, and following the law. Your actions are saving lives. Thank you.

James Williams: We will also now hear from the County Executive, Dr. Jeff Smith.

Dr. Jeff Smith: Thank you. So, as Dr. Cody pointed out the main issue here is to try to flatten the curve, so to speak. Make sure that the capacity and ability for our health system to deal with the very critically ill COVID patients and our other patients is preserved. We know that 80% of individuals who contract the virus will have minimal or mild effects, but we know that the 20% who have severe effects have very severe effects so I wanted to let you know a little bit about what’s going on right now to surge our health system in this county. We have 11 hospitals, all of which have surge plans in place, all of which are focused on making sure they have as many ventilators as possible, trying to reorganize their physical structure so that they can expand their ICU beds, looking at how they can increase the number of staff, doctors, ancillary staff, lab staff,  and they’re making significant progress. In addition to that, we have been able to obtain a federal medical station which is now up in the Santa Clara conference center and should be starting to see patients on Monday. This medical center station will be available for only COVID patients who don’t need acute care hospitalization but for whatever reason still need some services. The idea being here that we will move them out of the hospitals, all 11 hospitals in the county, and therefore make more space. That being said, we’re still requesting and ordering supplies from both the state and the feds and the private sector.

And we have at this point, anticipated well over 500 new ventilators coming to the county as a whole, for all hospitals not just county hospitals. But to give you a little bit of insight into where we stand right now, and the numbers I’m going to give you come from yesterday, and you’re going to all wonder why we don’t have all these numbers constantly, it has to do with the difficulty in collecting numbers from many institutions who are all private institutions but we’re working on having some of this on our regular dashboard. But in the hospitals, all 11 hospitals right now, there are 152 confirmed COVID patients, another 90 who are suspected of having COVID, we have a capacity in terms of beds of 1475. We have available in all the hospitals 611 ventilators, only 209 are used at this point so we have 400 available to be used. We have 300 ICU beds total, and available right now 119 total. In the ICU, 56 COVID patients, again all 11 hospitals. So at this point, we’re not near capacity, but we’re getting prepared for capacity. I just wanted to talk a little bit about capacity and health systems. Capacity in a health system is quasi-elastic, where it’s not like filling up a glass of water where you fill it to the top and it overflows, it’s more like filling up a water balloon where there’s more flexibility because the type of beds available in hospitals change, the types of care given changes, the availability of resources changes, as we get more experience in the health system with this particular disease you’ll see the type of interventions change.

Things like ECMO, or extra-corporeal oxygenation will start to be used more often, which is a way of bypassing lung problems and putting oxygen directly into the blood. So, it’s not like you’re going to reach a capacity and then you’re done. But, at some point, the water balloon does break. So our job right now is to get as many resources and as many ventilators, and as much space in the hospital system as possible to be ready for the inevitable problems that will come our way. With this health order, or public health order, we started two weeks ago. We know that the incubation time period for COVID is about two weeks. So we really expect to have more data, more understanding, more flexibility in another two weeks because we’ll have the people who got exposed and contracted the virus two weeks ago will be getting ill and we’ll be able to see how that effects the health system. Also, we’ll be able to see more clearly how social distancing works. But we know from experience around the world, particularly in China and Singapore and South Korea and others, that social distancing is the only thing that works to prevent contracting the disease. As Dr. Cody mentioned, the fewer contacts that we all have with other the better we are because we reduce the ability to transmit the disease. So everybody should practice social distancing, follow the public health orders, make sure that you understand that Dr. Cody and her entire team and the other public health directors and their entire teams are experts, they know epidemiology, they know public health transmissions, they spent their entire career working with infectious diseases, they know how to deal with pandemics, they’re giving us the best, most up to date, most important information possible, so follow it. Thank you.

James Williams: Before we take questions, we want to note a couple of things. We have, in this county, a very diverse population. Forty percent of our residents are foreign-born, so we are making sure that information is given in different languages. There are summary pages of the order that have been translated into Spanish, Vietnamese, Chinese, and Tagalog. Those documents will be going up on our website very shortly, and we will have full translations of the order in the very near future. The second point on that is we have speakers in Spanish, Vietnamese, and Chinese available to do interviews following the press conference to make sure that our monolingual communities get the information they need. Lastly, starting tomorrow at 10 AM there will be a daily briefing, Monday through Friday, that will be done by the county of Santa Clara. And with that, if we could begin with questions for Dr. Cody?

Reporter: [unintelligible]

Dr. Cody: Thank you for the question. We have challenges left, right, and center in maintaining our situational awareness with so much going on, and I won’t get into the details of the data, but what I can say is one, if you look at the dashboard—we now have a dashboard on our page so everyone can track along with us—it shows the number of new cases that are reported every day, as well as the cumulative. You’ll notice that the number of new cases is kind of bouncing around a lot, that has partly to do what’s happening and partly to do with how the cases come in. What I can tell you though, is that once we account for those variations maybe in the last day or so we think we’re seeing a slowing. I mean I say that very, very, very cautiously, it’s really early, and like Dr. Smith mentioned it’s going to take us more time to see the impact of the social distancing. We are collaborating with everyone we can think of in our county, the academic sector, the tech sector, everyone we can bring in. They’re helping us, they’re eager to help us really understand what our trends look like so I want to say that the incredible sacrifice that everyone has made, I believe it is starting to bend the curve but it’s not enough, and it hasn’t been in place for long enough, and so we need to keep at it. We just need to keep at it. I believe it’s beginning to make a difference, it’s giving our hospitals more time.

Reporter: [unintelligible]

Dr. Cody: So, James Williams can provide more detail on this, but one of the—again, my overarching goal with this order is to ensure that everyone stays home to the greatest extent possible and that when you go out to perform an essential activity that there are guiderails in place to be more protective and one is that businesses need to have a social distancing plan and we’ve provided a template for that, so that there’s some way to understand and organize social distancing within a place such as a grocery store.

Reporter: [unintelligible]

Dr. Cody: Thank you for the question, so as you know I had progressive orders during the month of March with the biggest order by far the March 16th order issuing the order to shelter in place. The updated order that I’m issuing today does a couple things—one is that it extends it, acknowledging that we need to do this for longer, and it makes it more clear so that it’s easier for people to comply and it will be more apparent for our enforcement partners what they need to do to ensure enforcement. I think that our order is about as strict as you can get and still enable basic services, essential services to continue, you know people need to eat, people need to access care, and essential services do need to continue.

Reporter: [unintelligible]

Dr. Cody: Yes, we have codified much of what stores and essential businesses need to do when they’re open and serving the public in order to be most protective. I just wanted to highlight something that’s very important—I want to ensure that people understand, the six feet, it’s not as though you’re within six feet and everything’s fine, that’s a minimum. More is better, okay? More distance is better, smaller groups is better. The less time you’re in contact with other the better. There’s a lot of dials that we use to improve the protectiveness of the order.

Reporter: What is the enforcement mechanism for this?

Dr. Cody: I’m going to turn it over to some of my colleagues for that question.

James Williams: So I can speak a bit to the enforcement piece and a bit more about the protocols. One of the big changes in the order is to require essential businesses to complete, post, and implement social distancing protocols, there’s a form that’s attached to the order that helps them do that, it includes things like sanitation measures, social distancing measures, and they need to tailor those to their specific facility rather than coming out with some sort of number that may or may not make sense for a specific facility, we are requiring those businesses to create a tailored social distancing protocol and plan for the specific facility that they will have that is open. By doing that and requiring that that protocol be posted, provided to employees, posted so that it’s available to the public, it is also available for folks who are carrying out enforcement so that they can then validate that there is adherence to those protocols that are facility specific. So the intention is to craft a model that accounts for the fact that different stores have different physical configurations, that they operate in different ways and there are different kinds of services being provided in different facilities, but emphasize and reinforce the need for these social distancing practices to be implemented on the ground there. The order is enforceable by law enforcement, we did hear from the district attorney’s office and they’ve been doing a phenomenal job with intake on various complaints and follow-up, working in partnership with local law enforcement, and that is an effort that is continuing and the vast majority of folks really are getting the message and they are adhering to the order. I want to piggyback off of one thing Dr. Cody did mention, just because something is open as an essential business doesn’t mean that people should be out and about as much as possible. The reason it’s open isn’t because it’s necessarily a good idea to do those things, it’s because we need access to those services. So people should be thoughtful about how often they’re, for example, going to the grocery store because every interaction does count and there’s a lot of things we can do in our daily lives to minimize those, even when we do need to access essential services.

Reporter: Are you going to be having police stopping people who are out, or groups of people who are congregated?

James Williams: The enforcement really has been focused on the business as Mr. Rosen mentioned, and I might turn it over to him to talk a bit more about what his office is doing in partnership with local law enforcement to make sure that people understand the order and are adhering to its requirements.

Jeff Rosen: There is a hotline and a website that we’ve set up at the district attorney’s office in conjunction with county council and the county, where residents can email and say they see a business or a group of individuals who are violating the public health order. In the past week, we’ve received close to 2,000 complaints. We have a team of prosecutors, investigators, that respond to all of those complaints, we triage them. As I want to emphasize, the vast majority of businesses in our county are voluntarily complying with this. For the small number of businesses who aren’t, a phone call from a District Attorney investigator or a prosecutor from the DA’s office often does the trick. If a phone call is not sufficient, then we’ll send out one of our investigators from the DA’s office or we’ll alert the local law enforcement in the city where the business is operating and the police will go out and talk to the business owner. That takes care of many, many situations like that. For the small, very, very small number of individual businesses that still refuse to comply, there are two options that are a lot tougher. One is to pull the business owner’s license and proceed administratively. That can be done very quickly and very efficiently. The second is to charge that business owner with a misdemeanor for violating the public health order, it’s a misdemeanor that will obviously be heard in a couple months after this crisis has been averted but it carries a significant deterrent effect. For businesses that are flagrantly violating, there’s also unfair business practices which lead to civil penalties and punitive damages. I want to emphasize that prosecution and pulling business licenses and punitive damages are last resorts, our emphasis is on voluntary compliance and we are getting voluntary compliance from the vast majority of business owners. I’m not surprised, this is a wonderful community. But for the small number that do not get the message the second, third, or fourth time, there will be consequences.

Reporter: [unintelligible]

James Williams: The prior order did limit construction activities significantly, the new order tightens that restriction down and really tries to focus on what construction is essential at this time. So there are eight categories that are still allowed, that includes projects that are immediately necessary for the maintenance, operations, and repair of essential infrastructure; projects associated to healthcare operations related to the COVID-19 response, as obviously we might need to set up and FMS facility; affordable housing that is or will be income restricted with at least 10% income restricted units; public works projects but only if specifically exempted by the governmental entity, so it’s not just a blanket—each government needs to look at the specific list of public works to validate that it’s something that needs to move forward at this moment; shelters and temporary housing; projects immediately necessary to provide services to for example the homeless or elderly or others who need access to other assistance at this time; construction that’s needed to wind down a site and leave it in a safe condition; and construction to repair residences or buildings containing essential businesses to keep them safe and habitable. So specific categories, much narrower, I know it’s something we’ve gotten a lot of questions about in the last few weeks, but really the focus for this and all the other provisions in the order was really the health officer’s collective judgement that the things that are exempted are the things that need to happen now, and the things that can be deferred or the things that might not come online for a long period of time are not the things that need to happen right now in this moment when we need everybody to the greatest extent possible to stay at home.

Reporter: [unintelligible]

James Williams: The language with respect to restaurants is unchanged, meaning that takeout and delivery is still permissible, but dining in is prohibited so that language remains the same. Those businesses will still be required, just like grocery stores and others, any essential business will have to fill out that social distancing protocol specific to their facility to document and implement steps in its facility to ensure social distancing and cleanliness and so forth. So that applies to all businesses.
Reporter: What will your team need to see, in terms of results, before rolling back the severity of the order?

Dr. Cody: I think what we need to see is that our demand curve, which is how many are ill requiring hospitalization and ICU care, comes to place where it’s comfortably nestled under our supply curve, that’s the supply of beds, ICUs, necessary staff, and necessary equipment to care for them in the way that they need to be cared for. It’s a complex balance, I want to say that bringing in the data to understand all the needs in our healthcare system be they supplies or beds or staff or personal protective equipment, is fairly complex, as is understanding the trajectory of the epidemic in our county and so we’re trying to bring all of that together to best understand and do everything we can to ensure that everyone who needs care for COVID or for something else gets that care.

Reporter: Does the county plan to start releasing daily hospitalization numbers?

Dr. Cody: Our overall goal is to provide as much data as we can, as granular as we can, as quickly as we can, so that’s our top-level goal. On the back end, it turns out it’s pretty complicated, and the hospitalization data is particularly complicated but we’re going to do everything we can to make sure that the public—I think it’s also important for the public to see and understand what the data looks like so that the actions that we’re taking and the sacrifices they’re making make sense, and that’s our goal.