Second COVID-19 case; mathematical models predict grim scenario

Mar 25, 2020

March 25, 2020 — Public Health Officer Dr. Noemi Doohan announced the second confirmed case of COVID-19 in Mendocino County yesterday, as she reported to the Board of Supervisors on a revised, much stricter shelter in place order. The new order is effective until rescinded and mandates the closure of all parks. Outdoor activities are limited to those that can be initiated from home and do not involve the use of a motor vehicle or public transit to the location of exercise. 

Beloved outdoor recreation spots started to get shut down as early as Monday morning. County workers were wrapping orange fencing around the playgrounds at Low Gap park at about 8am, and the dog runs were padlocked. Picnic tables are now plastered with orange signs, telling would-be visitors not to bother, even as poppies and wild fruit trees are bursting into bloom.

Postponement was the order of the day at Tuesday’s meeting, as it is all across the world right now. Supervisors decided to table any decisions on an industrial hemp ordinance, and passed another ordinance prohibiting some evictions in the unincorporated parts of the county until May.

All of it, of course, is in response to the pandemic that’s put everything on hold, though only two tests out of a reported 124 have turned up positive so far.

The first reported positive test was on the South Coast, and the second is an unspecified area of inland Mendocino County.  Because hardly anyone is getting tested, there’s not much epidemiological data to go on. But mathematical models provide a grim scenario.

Doohan said the county has the capacity for 45 people to be on ventilators in ICU beds, and 1800 people needing ICU care within a year. “That’s the moderate scenario,” she said. “That’s where we have some slowing down of the curve. And there’s another piece of information here that’s very sobering, that the people that get very sick with COVID-19 have what’s called ARDS, so it’s Acute Respiratory Distress Syndrome. This is a condition where the lungs become stiff and it takes a long time to get better. So we’re seeing people being on ventilators for eight weeks. So you can imagine that if you have 45 vents taken up by people who are going to need them for eight weeks, you know we do not have the capacity to respond to 1800 people needing ICU care in our community. So the question of how many people would die? My estimate would be 1800.”

Deputy Public Health Officer Dr. James Flaherty added that even if hospitals had all the ventilators they’d need to treat a potential 30% surge, there’s not enough knowledgeable staff to run the equipment. “We can have all the ventilators in the world, but if we don’t have the licensed respiratory therapists...to run these ventilators, we can’t run them...so our surge capacity is limited by staffing, not by equipment.”

Jen Banks of Coastal Valley EMS Agency said the three hospitals had gotten a survey on Sunday to assess surge capacity. She gave a snapshot of Mendocino Coast District Hospital’s situation, which she said has fourteen ventilators, as well as other equipment to support respiratory problems. The hospital has three respiratory therapists and is looking to hire a fourth, as well as other full-time staff to support a surge. “They are actively working on a tent going up that can be used as a ward to cohort COVID patients. So there’s a lot of planning going on like this with each individual hospital in the county,” she told the board.

“So we can create a firewall with shelter in place,” Doohan concluded. “But it will only work if shelter in place truly happens.”