12.2.2020 Vaccine Plan Press Conference

The County of Santa Clara
December 2, 2020
Live Stream - Press Conference on Vaccines, Travel Quarantine and Hospitals


Dr. Tong: Good morning. I'm Dr. Jennifer Tong, Associate Chief Medical Officer for Santa Clara Valley Medical Center. This morning i'm also joined by James Williams, County Council for the County of Santa Clara. I will be providing updates regarding the county's submission of its vaccine plan to the State of California, as well as the hospital capacity in the county. James will then be providing information regarding the county's mandatory quarantine after travel. The two biggest things that i have to share with you today are that we're making progress in the planning around vaccine distribution in our county, but we're still extremely concerned about having enough beds and staff for to care for those who are ill in our hospitals. Therefore everyone must continue to do their part to slow the spread of COVID-19 and help keep their loved ones and our entire community safe in the weeks ahead. I'm pleased to share with you that yesterday we did submit a vaccine plan for the County of Santa Clara to the State of California. This is a plan required of all counties by the state we will make that available to the public and to all of you on our website as soon as possible. The plan describes at a high level, how we will engage the community, and how we will join with health care partners to distribute vaccine allocated to us by the state. Our top priority is the safety and health of people who live and work here in Santa Clara County. A tool in helping us reach that top priority is a safe and effective vaccine that has been rigorously evaluated for safety and efficacy by the federal government and by the State of California. We are hopeful in this goal, based on what we have seen so far let me emphasize that we all must continue to do our part to stay safe while we wait many countries and states and counties want access to vaccines, and like everyone else, we will receive a limited supply at first. More will be coming over time. it might take many months though before everyone who is interested in getting a vaccine is able to get one, which means that we will all need to do our part to continue to reduce our risk of COVID-19 by engaging in the behaviors that protect ourselves and others, like wearing face masks, continuing to keep our distance, and not gathering with others outside of our households. The county's role and responsibility for any COVID vaccine is logistics planning and preparing for the distribution of one or more vaccines. We will be prepared to distribute doses of vaccine allocated to us from the state. this is part of our commitment to the health and safety of those who live and work here. this is part of the work that public health is built to do. the distribution of vaccine will be in accordance with the prioritization requirements set forth for us by the federal government along with additional recommendations from the state of california. at first the amount of vaccine will be limited the national system of prioritization will direct the first doses to people who are at the highest risk including those who work in healthcare and are on the front lines of exposure to COVID-19. we will work with the community to keep them informed and ensure that information about the vaccine reaches our hardest hit communities with an understanding that it is important for people to have trust in an effective vaccine so that it has the power that we need it to have to save lives. This positive news about vaccine planning comes amidst a time of record cases and hospitalizations for COVID-19 in our county .the number of patients hospitalized with COVID-19 in our hospitals continues to rise. we continue to be at risk of exceeding our hospital capacity with typical typically used beds in our hospitals, potentially exceeding capacity by mid-november. if the trend continues, as of December 1st, ICU occupancy among hospitals traditionally serving the south county and the east part of San Jose, their ICU occupancy was at 93 percent. The ICU occupancy for other hospitals in the county was at 84 percent. we are especially concerned because none of the hospitals serving south county and east San Jose had more than five ICU beds available. as of yesterday, those counties in particular serving south county and east San Jose include Regional, Kaiser santa clara and our three county hospitals, Santa Clara Valley Medical Center, O'Connor o'connor Hospital and St Louise Regional Medical Center. what this means is that the hospitals in our hardest hit communities have the fewest beds available for those in need. our hospitals throughout the county are working together engaging in phone calls at least daily to redistribute patients as needed to ensure that we are continuing to provide safe and high quality care to all of those who seek it but these numbers are gravely concerning. We want you and your loved ones to get the care that you need at our hospitals if you become seriously ill. We each must do our part to slow the spread of transmission and protect our hospital capacity, thereby protecting those who live and work here. Thank you. With that I'll turn it over to James.

James Williams: Good morning. My name is James Williams and I'm with the County Counsel for the County of Santa Clara. I'm mostly here to answer questions but wanted to just make a couple points initially. First is that, you know, we are still in the midst of this really, really concerning surge in cases and hospitalizations, and that is why on Saturday, Dr. Cody took the steps to put in place some additional layers of protections to help try to slow that train down, to try to bring down that growth in cases. One of those very important measures was the new directive related to travel, and Dr. Cody and others had been communicating clearly, locally for many weeks to discourage travel and gathering during this holiday season. The state has been putting out the same message, the CDC has been putting out the same message, and the reason that there's been so much concern about that is, because we know that, that volume of mixing of households and the surging cases across the United States could really be an accelerant and leading to much additional growth in cases, and therefore serious illnesses and hospitalizations. The reason for putting in place a quarantine requirement for people returning from out of the area is to try to help avoid some of that growth in cases, to hopefully help contain spiraling chains of transmission that would occur from folks who did choose to travel nonetheless. And that's why we have this in place. We know we've received a number of questions about it. We have put up some a clarified version of the directive, which in greater detail breaks out the few categories of exceptions, along with updated frequently asked questions. I'm happy to answer some questions around that uh this morning, but it remains a very broad mandate and the reason for its breath is to really, at this critical moment, capture that travel that may have occurred or that may be occurring, and have folks really be in quarantine to avoid inadvertently spreading this disease. We know now that potentially a majority of cases are actually spread by people who do not have symptoms, and so you can't really know, and we also know that testing isn't perfect. We do encourage people to get tested. We do have tremendous amount of testing capacity available, accessible to the community. It's important that people utilize that. But because of how testing works, just because you may test negative at a on a given day, all that means is that you did not have detectable levels of virus at that moment in time, and it doesn't tell you what might happen after that specimen was collected, and so testing is not a perfect measure, it's just another layer of protection, it's just another way to try to help detect what's going on and break chains of transmission. The travel quarantine is yet another important protection in this multi-layered effort to try to control the surging cases and to try to ensure that we have adequate hospital capacity, as Dr. Tong mentioned. So with that, I think we will open up the questions.

Roger: yep we'll move across the house.

Media Question: Hi Dr. Tong, Can you provide an update, status update on collective surgeries within the Valley Medical Center Health System. If there are any plans to suspend those procedures in the coming weeks? and if not what those to be suspended?

Dr. Tong: Sure. the question was around elective surgeries and elected procedures in our hospitals whether or not those have been suspended and what it would take for those to be suspended? what i can say is that more than one hospital in our county and more than just a hospital operated by our county have made the decision to suspend some elective surgeries and procedures, particularly those that will require an inpatient bed, and particularly those that will require an icu bed. Part of the rationale for suspending those surgeries is is to balance the bed availability for those who need them most, and there are clinical decision makers at each hospital who help weigh the risks and benefits of delaying such elective procedures. At this point in time, each hospital continues to make those decisions, depending on the the state of their staffing and their bed availability, which changes from day to day and even from hour to hour.

Roger: Go to CBS next.

Media (CBS) Question: Is it fair to say that the travel quarantine relies on self-enforcement and the honor system? and what is the mechanism to penalize egregious offenders?

James WIlliams: Sure. So the question was does the travel quarantine rely on the honor system and what's the mechanism to penalize offenders? you know the health orders, including the the travel directive, but along with all of the other ones, the face covering requirements from the state and at the local level, the many other health orders, just like ... by the way, most laws in our society, rely on us to do the right thing and do our part on a daily basis, right? that's true of every law that we have out there, but there is also enforcement, and i think most people understand that those things uh go hand in hand, but that doesn't mean that every single everything is you know the subject of a enforcement action at all times. The directive is mandatory. it is part of the compliance efforts, like all the other health orders. People can submit complaints to sccCOVIDconcerns.org, and we will follow up on those. But just like our expectations around face coverings, just like our expectations around social distancing, we absolutely need to all do our collective part, and i think in this county in particular, folks have actually been really extraordinary about doing that. And I think people also understand that in the midst of this highest surge, yet, when cases are rising at the highest rate ever during this pandemic, that now is the most critical time to take action right now, and so if you have traveled, this is the concrete thing you can do to help avoid inadvertently setting off a chain of transmission that could affect countless others.

Roger: Ok. Next question.NBC.

Media Question: This is a question for Dr. Tong. Hi Dr. Tong. Can you tell me ... the vaccine will available children? and once it is, do you think that there will be a mandate that school-age kids must have it before returning to school?

Dr. Tong: The question was about vaccine availability for children and whether or not there would be a mandate for children to have that vaccine before returning to school. At this point in time, I can only say it's just too early for us to tell. The um the results of the clinical trials are still underway still being evaluated and at this point in time, children would not be most likely in the phase 1a highest priority population, which includes health care workers and those who are living in congregates long-term care facilities, while there might be a few children in that population, the vast, vast majority are not going to be children. So our current focus right now is around that first priority population.

Roger: We'll go with the Mercury News next.

Media Question: can you talk about what the uh the allocation amount the county will receive a vaccine from the state, and what percentage of healthcare workers and long-term care facility residents that will be covered.

Dr. Tong: The question was about the allocation amount the county will receive a vaccine from the state, and what percentage of healthcare workers and long-term care facility residents that will cover. The answer I have for you today is that that that number is evolving, particularly, because there is more than one vaccine that is scheduled to be reviewed by the FDA over the next couple of weeks. The numbers that we receive over the next few days might change, as an additional vaccine is reviewed and most likely will be approved, so what we know is that we are prepared to distribute the allotment that we receive from the state. We do anticipate that there will be some additional refinements of prioritization that we will likely receive from the State of California to help guide how the initial doses are distributed, in a prioritized way, among health care workers, particularly, those who are caring for patients um with COVID-19.

Roger: We'll go with KCBS.

Media Question: (voice to low).

Dr. Tong: Sure. So plans have included identifying the vaccine administrators across our county, the different providers and systems that are able to administer the vaccine, working with them to estimate the initial numbers that they can handle in terms of storage, ensuring that they have preparations in place and supplies in place for storage, including the ultra cold freezer storage that is required for at least one of the vaccines, and then working with them, in terms of the data transmission, ensuring that those who are vaccinated are recorded in an electronic system, in a way that we can track how many people are being vaccinated, from what zip codes, what age groups, and that that information is transmitted to the state in a way that the state requires.

Media Question: A question from the county counsel. Was consideration given to announcing the travel quarantine prior to Thanksgiving that might have discouraged some people from traveling? and would that have made any difference?

James Williams: so the question was, was consideration given to announcing it prior to Thanksgiving? What i can say is it was this policy was developed afterwards, and so there was a strong discouragement travel that was issued beforehand, and then throughout the course of that week i think all of you saw along with us the growth in cases the growth and hospitalizations that really pushed the need to take some more significant actions, and so the this was one of the actions taken, as soon as uh as that decision was made, and it was ready um and um you know the hope is, having put it in place pretty quickly, and being one of the first jurisdictions to do so that it will make a really meaningful difference, but the basic recommendations had actually been out there for quite some time, including not just a discouragement to travel but that people should quarantine if they do travel. That had been emphatically out there from many sources including the County preceding the Thanksgiving holiday.

Roger: We go to san jose Spotlight.

Media Question: hi i have a question for Dr. Tong. how are you?

Dr. Tong:  good thank you

Media: good. um when a vaccine is approved, how many doses does the county expect to have? and how many freezers does it have to store the vaccine.

Dr. Tong: so the question was. when the vaccines approved how many doses does this county expect to have? and how many freezers are there to store the vaccine? so the answer, as i was just answering previously, is that the number of doses that we will receive will evolve quickly over time since there is more than one vaccine that is scheduled to be reviewed by the FDA over the next two weeks. So we do not yet have firm numbers on the exact numbers that we will receive, but we are prepared to store and then distribute the full volume of what we do receive. In terms of the number of freezers, i do not have an exact number right now, because that number actually evolves on a daily basis. I literally, before coming to the press conference, was on the phone with a group that was telling me that freezers had arrived on a truck. As of yesterday, multiple freezers have been installed in parts of the county buildings that we own and operate, and there are additional freezers that are being purchased and installed by other private healthcare providers as well.

Roger: Another media question.

Media Question: Dr. Tong. hi. for healthcare workers and even members of the general public who may have concerns about the safety of this vaccine, can you address that? and also which will the vaccine will be coming, which pharmaceutical company?

Dr. Tong: so the question was if i could address concerns that those in the highest priority population, particularly healthcare providers might have about receiving the vaccine, and if we know from which manufacturer we will be receiving vaccine. I'll answer the the second question first. My expectation is that we will receive vaccine from multiple manufacturers to distribute throughout the county. We are prepared for that. Once someone receives a first dose from a manufacturer, it's important they receive the second dose from a vaccine from that same manufacturer and we have worked that complexity into our planning. In terms of the the concerns around safety and efficacy of the vaccine, what i can say is that the the vaccine has undergone clinical trials with thousands of people receiving it over the last many months. What i hear from several friends, colleagues, even family members, is that they don't want to be the first person to receive the vaccine, and my response to that is, "thank goodness you won't have to be the first, because we've had people who have volunteered to be the first as part of these clinical trials. who have been closely monitored and the federal government and the state government as well as multiple experts in vaccinations, public health, and health care are reviewing the output of those trials and providing that data information and recommendations to us."

Media Question: (low voice).

Dr. Tong: because that is ever evolving i'd rather not mention specific hospitals right now at times it's not it's not a blanket suspension or cancellation of surgeries, um sometimes it's on a day by day basis, so um uh it evolves sometimes even hourly.

Media Question: Is that a county owned hospital or a hospital within the county?

Dr. Tong: both.

Meia Question: um i wanted to see um how did you arrive at 150 miles being the the distance that you felt needed enforcement? is there any idea of maybe evolving or changing that? and do you have a plan for more step-up enforcement if it turns out it's not working?

Jame Williams: sure. so the first question was how did we arrive at 150 miles as the radius, and the second question was is there a plan for stepped up enforcement if it's if uh the current situation is not adequate ...

Media: and you might change 150 miles?

James WIlliams: and whether the 150 miles may change? The 150 miles was arrived at trying to come up with an appropriate area that would account for the fact that there are a lot of people who travel for work on a regular basis or live and work across county borders within a few hours of Santa Clara County, but wanting to ensure that folks who that where there's significant surging cases such as from Southern California, such as from other parts of the United States. People may be coming in by air or from long distance travel, would be subject to the quarantine, and so the 150 pretty much covers that sweet spot between the two in a clear demarcated manner. We, of course, will be always examining as we have with our other directives, their efficacy but also whether updates need to be made. We've done that throughout the course of the pandemic with every single subject matter and area, and this will be one of them, and we'll also continue to look at what's happening elsewhere in the state, what's happening elsewhere in the United States, and what's happening of course locally with our cases in the surge. And finally with respect to enforcement, we continue to evolve that program. We absolutely encourage people if they have concerns about this or any of the health orders to to bring those to our attention at sccCOVIDconcerns.org, and we do follow up on those, and that that program continues to expand in an effort to really promote, across the board, adherence with these really important and critical uh safety precautions.

Roger: We'll go one more, or two more final questions start with CBS.

Media Question: um mayor Sam Liccardo has admitted to violating the state mandate for private gatherings, does he face any repercussions or any consequences? We have become recently aware of that issue and and that's something that's under review.

Roger: Cameron.

James Williams: uh james uh i'm wondering if uh we hear a lot about the fact that there may be a new shelter in place over statewide uh are there plans in the works for that now? what would that look like? similar to what happened in march? uh so we know this the same news that all of you are aware of uh from the state, uh where the governor made clear that if things are not looking good, and he talked about hospitalizations and ICU capacity specifically, at his press conference, that the state is prepared to take further measures. What, what i would say is that, from our perspective, we think it is absolutely critical that there be bold and swift state and federal measures to deal with the surging cases that that's happening across California and across the United States. One thing we do know is that our local measures by themselves are not enough, they're not sufficient, without these broader steps being taken at the state and federal level, both, and we really would like to see the state and the federal government taking those appropriate steps in order to ensure that we're all much safer, and to ensure that community transmissions at a much lower level.

Roger: we'll close up the final question from the Mercury News.

Media Question: (low voice).

James WIlliams: so the question was the CDC, just today has, issued some revised quarantine recommendations. we will be reviewing those they are actually a bit nuanced, a little more nuanced, i think than some of the initial reporting, and that will be reviewed by public health, and as appropriate and if necessary, we may make adjustments but as of right now the county's quarantine requirement is 14 days across the board.

Roger: we'd like to thank everyone for being here. we will be available for questions in other languages including Spanish, Chinese and Vietnamese and enjoy the rest of your day, and thanks again.