Hospitalizations remain low and reopening safely continues

On Wednesday, San Luis Obispo County held its weekly coronavirus press briefing, discussing a surge in positive tests, clustered outbreaks, facemasks, reopening sectors and racism.

SLO County Public Health Officer Dr. Penny Borenstein addressed the agenda issues and answered questions regarding the pandemic as locally relevant.

Public Health COVID-19 Checkup

With 52 cases over the past five days, and 20 positive results reported today, the spike in cases provides fodder for community discussions about the urgency to reopen county economic activity. Borenstein rode through Wednesday’s briefing with her usual gait, assuring that her office is taking measured and evidence-based actions in protection of which it is responsible.

Continually, her position focused on severe cases, hospitalizations, and ICU residency — all of which remained low throughout the 52-case spike.

Of the 20 new cases reported Wednesday, only one required hospitalization.

“We continue with a good metric in the severity of the disease,” Borenstein said, “but our day-over-day case numbers continue to rise somewhat.”

Two main clusters added a bulk of new cases — one being a SLO-based care facility and another a family graduation party in Atascadero.

The process by the County in combating spread perpetuates positive testing, as contact tracing and testing elevates percentages of positive tests. The corralling and quarantining of infected patients slows the spread while simultaneously increasing positive test results.

“We continue to get robust data from each case and do contact tracing,” Borenstein said. “With the exception of one case, a large number of our cases did emanate from a graduation party. As I have been saying all along, these types of gatherings are the best way to spread the disease.”

Borenstein reported on the outbreak in a San Luis Obispo-based care facility, where a total of 10 cases have been 

“We have tested all the individuals who are residents or staff at the facility,” Borenstein said. “So we have a baseline for testing for everyone associated with that facility.”

For the past three months, Borenstein has fielded criticism from both extremes of the pandemic arguments — simultaneously defending the opposite public mandates to reopen the economy and keep it shuttered. Throughout the pandemic, her positions on public health recommendations have rarely shifted as she maintained a close relationship with health-related facts regarding the coronavirus outbreak in SLO County.

In the wake of the highest single-day case count, Borenstein reflected on the vulnerability of the community to coronavirus, especially where the elderly are concerned.

“It is a moment of pause that we are not immune to having these outbreaks,” Borenstein said regarding the care center.

Facemask Concerns and Cautions

During Wednesday’s press briefing, much of the social media comments involved opinions on face coverings, which is one area where Borenstein has shifted her position over the course of the pandemic. Her initial response concerning face coverings dismissed any considerable level of safety, but since has encouraged wearing masks in a variety of scenarios — stopping well short of mandating masks by way of a public health order.

“I still get an awful lot of input from the public in both directions about the importance of face coverings,” Borenstein said.

As fire season begins, Borenstein cautioned the public about considering those facemasks worn to prevent spread of COVID-19 to be a defense against smoke inhalation.

“I want to report that people should not have that level of security,” Borenstein said, “especially when wearing either a surgical facemask or a cloth covering. It is not believed to be protective of the particulate matter that you see in wildfire smoke.”

Borenstein recommended that people avoid smokey areas, and that the N95 respirator is the only protective measure against wildfire smoke.

She also promised to address the wearing of facemasks as protection against the spread of COVID-19, referencing updates in medical literature.

“I do want to say that the evidence in favor of and in support of the effectiveness of face coverings in situations where you cannot do physical distancing, for extended periods of time, particularly indoors, face coverings are an additional protective measure and should be utilized.

“It will slow the spread of disease and can potentially stop recurring waves of outbreaks, or interrupt outbreaks. It potentially allows us to fully open our economy. If we continue to see huge rises in our cases, [facemasks] may be one way to slow the spread.”

Borenstein also addressed the use of chemical cleansers in response to reports of increased calls to poison control centers concerning cleansers and disinfectants.

“Hot water and soap are one of your best cleansers,” Borenstein said and recommended best safety practices when using bleach or other cleaners, including the avoidance of mixing chemicals.

Personal Care Sector Opening

“This refers to nail salons, body art and tattoo parlors, facial services in the form of waxing and electrolysis, and massage therapy are all part of the same guidance,” Borenstein said.

She added additional guidance to the sector opening, referencing both the importance of opening the economy as well as the need to prevent spread of COVID-19 to retain the health marks to defend continued opening.

“We need to support the reopening of our community,” Borenstein said. “We need to do it safely. We need to do it smartly. But we need to support the economic engine and the financial well-being of our community.”

She continued to caution the latest sector, and discouraged opening of personal care service in small quarters.

“This is one area where I ask our providers to be smart and delay at least another couple of weeks incubation period,” Borenstein said.

She offered concern that the full range of services that have opened is a potential for spread and caution should be taken.

“I want thank people in advance for complying with that,” Borenstein said. “I know there are definitely people whose sole business would remain shuttered on the basis of what I’m asking, but we ask those businesses, including the wedding industry, to comply.”

Declaring Racism a Public Health Emergency

In light of the national discussions and police reforms, the San Luis Obispo City Council approved a resolution recommending that public health officials declare racism as a public health emergency. When pressed on her position, Borenstein reported she had not been spoken to on the subject by members of the SLO City Council or others and was not prepared to make a decision.

“I have not had consultation with the council or members of the community on that front,” Borenstein said. “I know that racism is an issue in our community and we are seeing action that is trying to address that. As to declaring it a public health emergency, I am not prepared to do that at this time but I’m open to dialoguing with members of the community on the concern.”

Dedicated COVID-19 Updates

Dr. Penny Borenstein, County Health Officer, is a Public Health & General Preventive Medicine Specialist in San Luis Obispo, CA. She is not accepting new patients.

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