Stay-At-Home Order Begins Friday
By Jondi Gumz
A day after Pfizer’s COVID-19 vaccine arrived in Santa Cruz County with the priority hospital workers, the number of county residents dead because of the coronavirus rose again, to 64 on Wednesday, and the regional intensive care unit availability dropped to 12.9 percent, triggering a stay-at-home order for Santa Cruz County takes effect at 11:49 p.m. Thursday and will remain for at least three weeks. After that, ICU availability will be reassessed weekly.
Staff at Dominican Hospital carefully unbox the first shipments of Pfizer’s COVID-19 vaccine. • Photo Credit: Shmuel Thaler
In eight days, the virus claimed 17 more lives, elders in their 60s, 70s, 80s and 90s. The increase is being driven by deaths at nursing homes, which account for 44 of the total fatalities. Underlying conditions have been a factor in 47 deaths, according to public health data.
Santa Cruz County reported 1,632 active cases Wednesday, bringing the total to 6,317 since the virus arrived in January.
In the state’s COVID strategy, which mandates stay-at-home orders when ICU availability falls below 15 percent, Santa Cruz County is part of the Bay Area Region along with Alameda, Contra Costa, Marin, Monterey, Napa, San Francisco, San Mateo, Santa Clara, Solano and Sonoma counties.
The order prohibits private gatherings of any size and mandates masking and physical distancing.
The cold locker in which the first shipments of Pfizer’s COVID-19 vaccine were delivered. • Photo Credit: Shmuel Thaler
“With our case counts at an all-time high and headed higher due to the Thanksgiving surge, our hospitals and health care delivery system are at the breaking point,” Santa Cruz County Health Officer Dr. Gail Newel said. “We urge all residents to adhere to state guidelines as closely as possible to minimize the spread of COVID-19 and help reduce impacts to our most vulnerable residents. Our actions now will help us return to our normal lives sooner rather than later.”
A New York State investigation of COVID case contacts from September through November found 74 percent were linked to private gatherings, 8 percent to health care, and 2 percent to restaurants.
The restrictions require individuals to stay home unless traveling for essential purposes, prohibits leisure travel and gatherings outside one’s immediate household, limits community and commercial activities, and will be in place a minimum of three weeks.
Closures
The regional stay-at-home order also closes hair salons, barbershops, personal care services such as massage, indoor recreation such as gyms and fitness centers, museums, bars, wineries and breweries; limits grocery store occupancy to 35 percent and all other retail stores to 20 percent, and ends outdoor dining at restaurants, allowing only take-out, pickup and delivery.
People can leave home to buy food, obtain health care and exercise. Non-urgent medical and dental care may remain open. Offices except for critical services must shift to remote work.
Schools offering in-person learning and child care may remain open if remote options are not possible.
Hotels are open for critical services but leisure travel is not allowed, and neither is overnight camping.
At places of worship, only outdoor services are allowed. Political protests can only take place outdoors.
To maintain physical and mental health, members of the same household are encouraged to go to a park, hike, walk or bike ride and practice physical distancing. The state guidance on youth and adult recreational sports, released Monday, details what is permissible.
With 1,632 active cases, Santa Cruz County’s contact tracing staff is stretched thin, according to Mimi Hall, director of the county Health Services Agency.
New App
Hall urged residents to download a new app for cell phones, called CA Notify, to help reduce the spread of the virus. The app became available on Dec. 10.
Once installed on a smartphone, the app tells if you have been exposed to someone who has tested positive for the virus.
With this information, people can make responsible decisions around quarantine and testing, which is essential for stopping the surge, according to Hall, noting that the app protects privacy because no personally identifiable information is collected.
People who opt in and get a positive test result will receive a code via text message from the California Department of Public Health.
“The more people download and use this app, the more helpful it is to our efforts to contain this disease,” Santa Cruz County Health Director Mimi Hall said. “It helps us save lives.”
More information is at www.canotify.ca.gov.
While the county’s cases have skyrocketed since Thanksgiving, the local situation is better than what’s happening statewide.
Santa Cruz County has 37.5 new cases per 100,000 population compared to 63.9 statewide.
The county’s positivity rate on tests is 6.5% compared to 11.3% statewide.
However, the county’s equity positivity rate, a measure of disadvantaged populations, is 14.8% which shows a gap that needs to be closed.
Lawsuit Update
A lawsuit filed against Watsonville Post Acute Center by the family of 94-year-old Donald Wickham, one of 16 residents who died of COVID at the nursing home, has been assigned to Superior Court Judge Timothy Volkmann, according to attorney Dvid Spini, who represents the family.
A status conference is set for March 10. Spini said he has not received response to the complaint from Watsonville Post-Acute.
Spini, who is with Scruggs, Spini & Fulton in Santa Cruz, said the firm has heard from some other families about COVID-related deaths at that facility.
“We are in the process of investigating these other claims, as everyone’s experience is a bit different,” he said. “We have also heard from families who lost family members to COVID at other facilities.”
When the Wickham case was filed on Nov. 10, no other nursing homes in the county had had a COVID death, but now that has changed.
Santa Cruz Post Acute has also reported 16 COVID deaths, and 10 people with COVID died at Pacific Coast Manor in Capitola. Two people with COVID died at Hearts & Hands Rehab in Santa Cruz. A few deaths were reported at residential care homed for the elderly.
Spini said the question will be whether each nursing home had specific failures in their infection control protocols, whether this is a systemic problem within nursing homes as a whole, or whether this is simply an unpreventable consequence of the virus.
He added, “One thing that we are learning is that at several facilities the elderly residents, once diagnosed with COVID, were essentially denied access to family members. Obviously, in-person visits are not practical. We are finding that even telephone or video conferencing communication was not being facilitated. This creates new concerns for these residents who knowing they were facing the end had to do so without any communication with their family or loved ones.”
So many deaths have occurred that county Public Health spokeswoman Corinne Hyland created a spreadsheet to keep track.
Initially, many of the COVID deaths were in the Latinx community, which saw a majority of the cases, but now the numbers have evened out, with 33 deaths of Caucasians topping the 23 Latinx deaths.
A record number of COVID cases in nursing homes is being seen nationwide, prompting the nursing home lobby to ask Congress for financial aid to hire additional staff, conduct testing and buy personal protective equipment.
“Our worst fears have come true as COVID runs rampant among the general population, and long-term care facilities are powerless to fully prevent it from entering due to its asymptomatic and pre-symptomatic spread,” stated Mark Parkinson, president and CEO of American Health Care Association/National Center for Assisted Living, which represents 14,000 facilities across the nation.
Age, Underlying Conditions
Nursing home residents are typically older adults with multiple chronic conditions, making them most vulnerable to COVID-19, according to the AHCA/NCAL.
Hyland’s spreadsheet shows that is true locally.
The most deaths, 27, were among those 90 and above – including some centenarians – then 17 deaths of people in their 80s, eight deaths of people in their 70s, nine deaths of people in their 60s, a handful of deaths of people age 40 to 59, and no deaths of younger people.
Since residents at nursing homes and care facilities are not allowed to leave the premises, health officials believe staff are bringing the virus in.
COVID-19 is so new “I think there’s just a huge learning curve,” Hyland said.
CVS Delivery
Hospital workers are first in line to get the COVID vaccine, and Santa Cruz County got 1,950 doses for them on Dec. 15, divided between Dominican Hospital and Watsonville Community Hospital.
Nursing homes will get the vaccine from “a different route,” going through pharmacies such as CVS, Hyland said, noting that she does not have a date yet.
CVS earlier announced plans to hire thousands of workers to help distribute the vaccine.
The lawsuit filed against Watsonville Post Acute noted staff working at multiple facilities, increasing the likelihood the contagious coronavirus would spread.
Hyland said a policy requiring staff to work at only one facility would not work because “people are trying to make ends meet.”
“Many staff do work in several facilities, so when there is an exposure, a notice is sent to all facilities,” she said. “If there is an outbreak at a facility, no new admissions are taken.”
For example, admissions were halted in October at Watsonville Post Acute, but now there are zero cases and the facility currently accepts new residents.
California Department of Public Health, which licenses nursing homes, and California Department of Social Services, which licenses care homes for the elderly, “remain active in trying to mitigate outbreaks.”
Asked about personal protective equipment for nursing homes, Hyland said the county has PPE resources that facilities can tap. N-95 masks must be fit properly to prevent the virus from spreading, and she said the county has offered resources to nursing homes for that since April.
“We are currently contacting facilities and asking them to review those plans and ensure they are following proper infection control measures,” Hyland added.
•••
County COVID Deaths
As of Dec. 16
Age
90 and up: 27
80 to 89: 17
70 to 79: 8
60 to 69: 9
50 to 59: 2
40 to 49: 1
Race/Ethnicity
White: 33
Latinx: 23
Asian: 4
Black: 1
Other: 1
Unknown: 2
Underlying Conditions
Yes: 47
No: 17
Skilled Nursing/Residential Care
Watsonville Post Acute: 16
Santa Cruz Post Acute: 16
Pacific Coast Manor: 10
Hearts & Hands Post Acute: 2
Montecito Manor: 1
Maple House II: 1
Total: 46
Gender
Male: 30
Female: 34
Source: Santa Cruz County Public Health