Wait and See

At the Monterey County Public Health Lab in Salinas, microbiologist Sarah Riddick uses a pipette to collect a patient sample to be tested for COVID-19. So far, none of the 15 local tests have come back positive.

The COVID-19 test kits – in plastic bags marked with a big red square and “BIOHAZARD” on the front – arrived at the Monterey County Public Health Lab on Friday, March 6, and by Monday, technicians had conducted tests on samples collected from 15 patients. Two separate tests are involved, one that requires swabbing mucus from the nose and one swab from the mouth. Technicians get a more accurate result from screening both samples, Lab Director Donna Ferguson says.

None of the 15 tests were positive, and county and hospital officials continued the drumbeat of “no confirmed cases in Monterey County” as of press time, attempting to keep public fears at bay. That didn’t stop people from lining up at stores over the weekend to buy out emergency supplies like toilet paper in case they get quarantined at home.

While Ferguson and her team at the Salinas lab were conducting the first COVID-19 tests the county has been able to complete on its own – previous patient samples were sent to labs elsewhere – there was for some a feeling akin to the click, click, click of a roller coaster as it climbs to the top of the first hill.

A case in Gilroy (in Santa Clara County) was announced on March 7. The next day, city officials announced it was a false positive. As of March 8, Santa Clara County has 43 confirmed cases and one death. Santa Cruz County officials announced two cases, one on March 7 and another on March 9, bringing closer to home the virus that originated in China and is spreading around the globe.

“We already have evidence of community spread in California, so it’s very likely we will have community spread in Monterey County,” says Monterey County Public Health Director Edward Moreno.

Monterey County hospital officials say their facilities are ready for that likelihood. At least three of the four hospitals – county-run Natividad and nonprofits Salinas Valley Memorial Healthcare System and Community Hospital of the Monterey Peninsula – set up tents outside their facilities in recent days to screen patients with respiratory illnesses, without exposing others, should the need arise. The tents were sitting idle as of March 10.

Hospitals are asking all patients a set of screening questions looking for possible cases of COVID-19. Craig Walls, Natividad’s chief medical officer, writes by email they are paying close attention to anyone with a cough, fever and those who have recently traveled. They are also spreading the word they want people to call medical facilities first before coming in.

A potential challenge that might lie ahead for Monterey County is its estimated 87,5000 residents age 60 and older who are at greater risk for COVID-19, especially those with asthma, heart disease, diabetes or compromised immunity. If a large number become infected and need hospitalization, it could put a strain on hospitals, although Dr. Martha Blum, an infectious disease specialist at CHOMP, says hospital officials have been preparing by meeting regularly and sharing information.

Blum says there is a prioritization plan in place that would allow hospitals to send the sickest patients to beds throughout the county if any one facility became overwhelmed. There’s also enough flexibility to turn regular rooms into isolation rooms. As for the number of ventilators in the county, Blum says there’s not a “high level of concern” that there wouldn’t be enough. She expects state and federal authorities to step in and help, as happened in Seattle, which experienced a high number of cases. According to news reports, however, local Seattle officials were frustrated by the pace of assistance.

“There is some benefit to not being the first community to be completely overwhelmed by this,” Blum says.

Testing continues, but county officials won’t say exactly how many tests have been conducted since the virus appeared in the U.S. in January. Questions about how many tests are on hand and whether there will be enough have gone unanswered.

Hospitals are following the U.S. Centers for Disease Control conditions for testing: those with a fever and cough or shortness of breath, as well as direct contact with someone known to have COVID-19 or travel in the last 14 days in an affected area. Officials are stressing that people should not show up to an emergency room or clinic if they have no symptoms or mild symptoms expecting to be tested. They will only collect samples from those who meet the guidelines for testing.

"We ask that those with no symptoms or those with mild symptoms stay home and contact their doctor's office or complete an e-visit instead of coming to the Emergency Department," says Montage spokesperson Monica Sciuto.

People should not expect to be tested if they have no symptoms, even if they have orders from private doctors, local officials say. Ferguson says the county lab needs to conserve testing supplies. County officials have not answered questions on how many tests are available.

SOME HEADS TURNED WHEN ORGANIZERS OF THE SEA OTTER CLASSIC ANNOUNCED ON MARCH 3 THEY WERE CANCELING THE APRIL EVENT, which draws upward of 70,000 bicyclists and spectators. A week later at the Monterey County Board of Supervisors meeting, county staff announced the new dates are Oct. 1-4.

“Postpone” is a word that Rob O’Keefe, interim CEO of the Monterey County Convention and Visitors Bureau, is living by since it became apparent tourism would take a hit due to COVID-19.

“There’s been a couple of substantial cancellations, but mostly postponements,” he says. “That’s happening across the industry. In most cases business isn’t lost, it’s postponed.”

He expects Monterey County’s second-biggest industry to take an economic hit in the short term, but rescheduling events means revenue is deferred rather than lost. He expects larger hotels and businesses will be able to weather the COVID-19 storm while smaller businesses will struggle. They may, for example, feel a pinch after cruise ship companies complied with a request from the city of Monterey to cancel all plans to anchor in Monterey Bay through at least the end of April.

Even if Monterey keeps cruise ships out of the harbor, Pacific Grove is part of the state’s response to the Grand Princess; as of press time, four passengers – who have not tested positive for COVID-10 – are being quarantined at Asilomar Conference Grounds. Up to 24 can be accomodated.

O’Keefe quickly pivots from loss of tourists and conferences coming from outside of the county to “staycations” and encouraging locals to enjoy the same features that attract tourists. With 25,000 hospitality employees, he says the MCCVB will continue pushing messaging that will keep them working.

“You don’t shutter up the shop in times of crisis, you assess, you adjust and you keep going,” he says.

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