While sheltering in place with my family during this unprecedented crisis, like so many of us across our community, I wonder about the arc of this pandemic and the road ahead.
Santa Clara County Health Officer Dr. Sara Cody’s courageous decision to enact the nation’s first shelter-in-place order was clearly the right call. Dr. Cody and her fellow Bay Area health officers’ strategy saved lives. We are on the right path. We should begin work now with Bay Area counties to plot a regional exit strategy that will bring us out of the shutdown in a safe, thoughtful and compassionate manner.
A recent report from the American Enterprise Institute, as well as statements from Dr. Anthony Fauci and Dr. Cody, point us in the right direction.
They emphasize that in order to safely move away from the broad community-wide approaches on which we are currently relying, we will need to assure the following conditions:
1. Hospitals must be able to safely serve everyone in the Bay Area. We must not only have adequate beds and medical supplies for patients, but also Personal Protective Equipment for our frontline health care workers.
2. Testing kits must be broadly available for everyone with symptoms and for those at higher risk, such as patients and staff in nursing homes or other congregate settings.
3. Systems must be in place for robust case investigation, rapid isolation, and contract tracing. This is the bread and butter of public health for finding and stopping cases before outbreaks flare up.
4. Health officers must see a sustained reduction in cases for at least two weeks – the incubation period of coronavirus.
It is these benchmarks – not a prescribed timeline — that should guide our preparation.
As expert physicians, our health officers in Alameda, Contra Costa, Marin, Sonoma, San Mateo San Francisco and Santa Clara counties will make the call on the health orders to respond to COVID-19.
As county supervisors, and other local, state and national leaders, we share in the responsibility to put their orders into practice. This includes providing the funding, staff, and systems to get the job done. While some of this planning may come from national and statewide efforts, it will ultimately fall to local governments, including Santa Clara County, to make the final decisions and act.
I will be calling on my board colleagues to join me and direct county administration to convene a team of local leaders to plan an exit strategy from our current shelter-in-place, under the leadership of Dr. Cody. I encourage my colleagues in other counties to join in this effort.
While our public health officers’ primary effort will be focused appropriately on managing the current emergency, experts from public health, academia and the private sector should begin now to develop a plan for a step-down to more targeted restrictions along with preparations for the testing, technology, staffing and supplies that will be needed to safely make that transition.
I am deeply grateful for the leadership of Dr. Cody and her fellow health officers across the Bay Area. Their decisions may have been seen as too early or too aggressive by some initially, but it is now abundantly clear that their efforts “flattened the curve” of the coronavirus.
Dr. Cody on Tuesday shared some modeling that showed the actions Santa Clara County has taken will likely limit the spread of the virus to between 2,500 and 12,000 cases countywide by May 1. If widespread mitigation, including the stay at home order, had not been put in place, we could have expected upwards of 50,000 cases. This translates to real lives saved through our collective sacrifice. While models are not absolute predictors of where we will end up, the comparative experiences of our community’s early action with others that are now scrambling to scale up their responses confirms that we are on the right path.
Staying home saves lives. So does planning ahead. Santa Clara County and the Bay Area can lead the way on both.
Susan Ellenberg represents District 4 on the Santa Clara County Board of Supervisors.
