September 2, 2020 — Dr. Andrew Coren was sworn in as the county’s public health officer at yesterday’s Board of Supervisors meeting. Within minutes, he was taking part in one of several existential debates that is defining the country right now: whether public health is best served by measures that keep the virus at bay but increase isolation and economic hardship, or by opening back up and risking outbreaks.
Dr. Jenine Miller, head of behavioral health and recovery services, reported that by July of this year, the number of suicides in the county was up to 23, which is the same as it was for all of 2019. There were another three suicides in August, and increases in suicidal ideation and substance abuse. “There’s a lot of talk, and we are talking about it here, that we really are going to be experiencing — if we’re not already — a mental health epidemic, related to the covid pandemic,” she told the board.
Supervisors Ted Williams and John McCowen argued that the county needs more region-specific restrictions to save its small businesses, with both of them declaring that gatherings, not business activity, are the leading cause of spread. The numbers topped 700 on Monday afternoon.
Bekkie Emery, the manager of the DOC, provided new information about the professions of those who have tested positive for the virus. The majority are under investigation or not working, but it looks like retail and agriculture workers have been especially hard hit, with 32 in retail and 35 in agriculture.
Williams argued that he doesn’t see data from the state to support economic restrictions, like the ban on nail salons. “This is not the county,” he said. “This is the state of California, is indiscriminately targeting certain industries, which perhaps in an urban area, are creating cases, but are not demonstrated to have created cases in our county. And to me, that starts looking like a regulatory taking.”
McCowen called on his colleagues to agitate at the state level. He said he was up all night, preparing a letter to the governor, suggesting that “the local public health officer, in consultation with California Department of Public Health staff, is uniquely qualified to make case specific decisions, based on local data and experience, to impose greater or lesser restrictions than those mandated by the state.”
Coren agreed that research is valuable, while declining the opportunity to make decisions based on the limited information. “I do think there are differences between a small county and a large county,” he conceded. “But I can’t support giving me total responsibility on the basis of, we don’t have the research. Well, we don’t have the research. We rely on expert opinion because they have the research. And it takes a lot of time and a lot of money to generate valuable research. Otherwise, you base your decisions on anecdotes.”
He reminded the board that Mendocino County is in the top tier of the new four-tier system, and that it will take weeks of hard work to bring the numbers down and keep them down, before the county can ease some of the restrictions and keep its population healthy. He pleaded for patience as he spoke about the limitations of research, and time. He asked the board to support restrictions for another six months, after the smoke and flu season.
“The initial restrictions were a way to save lives,” he reminded the board. “And we have to keep the perspective clear on this. Yes, as a result there have been people who suffered. There’s no question about that. But there are people who are suffering without any restrictions, and if we quickly go back, we won’t be able to see what the effects of each step as we open up will have...at this point, we go with the research there is, and the expert opinion about how to modify it for a state, for a county, for an industry, and there are a lot of good brains working on it at the state level, that we don’t simply have here. And I can’t generate a report of what’s happening in the lodgings industry...I know this is painful. I know it’s painful on many, many fronts. But we don’t want more and more lives in Mendocino to be lost...you know, for the people who are having terrible mental health problems, for those who are having problems supporting their families because their businesses are going under, we need to think about supporting them as a community.”