Tents set up outside of the SVMHS hospital at the outset of the Covid-19 pandemc.

I frequently receive communications reflecting on the unprecedented times in which we live. While specifics of the Covid-19 pandemic are unique, human experience is replete with epidemics, natural disasters and manmade conflicts. These are often accompanied by fear, misinformation and blame.

The current pandemic, like many past challenges, forces us to attempt to reconcile conflicting information, scientific uncertainty, and political rhetoric while we make decisions. As our Health Department and elected leadership work to open our community, it is critical that we understand recent events and dispassionately consider the likely consequences of our next steps.

The early adoption of shelter in place in Monterey County immediately mitigated the number of infections and deaths. Early predictions regarding the likely numbers of individuals affected went unrealized—not because of modeling inaccuracies, but because of our successful implementation of social distancing.

These measures, however, have been misinterpreted as temporary initiatives designed to reduce the burden of illness while “the threat passed." While this remains our greatest wish, the reality is different. Social distancing effectively allowed our healthcare systems to prepare to care for the ill and to further develop public health competencies (such as contact tracing and quarantine sites). Over the last few months, much has been accomplished and we are certainly in a better place than we were when the county initially declared a state of emergency.

Unfortunately, however, the threat has not passed. The number of infections continues to increase and the number of Covid-19 patients on ventilators in our local hospitals (while manageable) has never been higher. Hospitals remain concerned about personal protective equipment supply chain and in-house testing capabilities.

Additionally, the current asymmetric geographic distribution of cases in our county is hardly comforting. If we learn nothing else from this pandemic, we should recognize from the speed at which this virus traveled across an ocean that there is little protection afforded by the distance covered in a 20-minute drive across our county.

Despite these observations, it is natural to seek to relax current restrictions. Understandably, we need to balance the negative economic, educational, and medical consequences of stay at home with what will likely be an increased number of infections as we open society. Maintaining social distancing, masking, and contact tracing/quarantine will be more critical than ever. While we are hopeful that the virus will “pass through” or mutate to an attenuated form, there is simply no convincing reason to expect this to happen.

Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, stated this week that we are in the second inning of a nine-inning ball game. As we reopen our community there is every reason to believe the number of new cases will increase. Our mission is to attempt to minimize these numbers as we await better treatments and a vaccine. Acknowledging risk, monitoring and transparently reporting infection trends, honestly communicating what we know (and don’t know), and working collaboratively is our safest path forward.

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(1) comment

Michael Slva

biggest problem is the stat that show who is at greatest risk. The over 70. Ages under 60 have a 0.1% death rate and over 60-70, 0.2%. Even Fauci wrote in the New England Med. Journal that this Covid-19 would see 1% death rate, however, in front of Congress, he states 10%. Which is true? Neither. This is turning out to be a bad flu season, like Swine Flu. Shelter in place isn't working-see Fauci's latest comments and this is political, not factual. Once again, the "modeling" is incorrect, just like with climate change. Modeling has to take into account that everything is equal, and you can't assume that since everyone isn't the same. Odd how no one cite's the recovery rates. This forced shelter in place lock down has hurt the 50K and under wage earners. Just the same people the Left claims to want to help. Sad.

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