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Written by: David Santos

Published: 04 May 2020

Created: 04 May 2020

Last Updated: 04 May 2020

Walk through our hospitals, and you’ll notice something: silence.

Our hospital corridors, usually bustling with caregivers and patients, have been unusually quiet these past few weeks. Many of the beds in our inpatient units have gone unfilled. The number of patients suffering from heart attacks, strokes and chest pains has appeared to decline. Fewer emergency surgeries are being performed and nonemergent surgeries are being postponed.

While fewer emergencies may sound like cause for celebration, we know that the reality is grim. As much as we’d like to believe it’s because people are not suffering from life-threatening conditions, we know that’s not the case.

Across the communities we serve, loved ones, including the elderly and medically vulnerable, have been delaying or avoiding care out of fear of coming to the hospital during a pandemic. In other cases, our community members feel a sense of duty to avoid the hospital to not overwhelm healthcare resources.

It’s not an isolated issue. The number of hospital visits are dropping around the world – an unusual occurrence at the tail end of flu season.

We’ve seen our community take extraordinary measures amid this pandemic to practice responsible social distancing, “flattening the curve” and keeping our healthcare workers safe. We’re grateful for that, but the measures – meant to prevent an unmanageable surge of COVID-19 patients – have had unintended consequences.

At Adventist Health, the number of people coming into our emergency department has decreased by more than half across our multi-state system.

This is distressing for those who are suffering from otherwise minor conditions that can worsen without immediate medical care. A man in one of our communities, for example, took a bad spill off his bicycle and fractured a bone. He called the hospital to see if it was safe to come in for treatment.

Let me answer his question for everyone who might be asking themselves the same thing during this pandemic: Yes, our hospitals are safe. Emergencies happen, and you should never delay care.

We recognize that some might fear going to the hospital during these uncertain times. But we should never let fear get in the way of receiving needed medical care. If we allow it to, then this pandemic will have indirectly claimed more lives and wreaked more havoc than it should have.

Our community has done its job socially distancing. That has provided us adequate time to prepare for any potential surge of patients, put into place infection prevention measures to halt the spread of COVID-19 within our hospital walls, and most of all, keep our patients and caregivers safe.

Adventist Health Clear Lake wants to continue keeping our community healthy and safe. Part of that is providing safe, high-quality emergency care. Emergency care should never be put off or avoided, especially during a pandemic.

Emergencies happen. Please don’t delay your care.

David Santos is the president at Adventist Health Clear Lake in Clearlake, California.

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Written by: Sheriff Brian Martin

Published: 02 May 2020

Created: 02 May 2020

Last Updated: 02 May 2020

The Lake County Sheriff’s Office’s role is to ensure people’s constitutional rights while providing for public safety. Almost always, this is a precarious balancing act, weighing various statutes, court decisions, authorities, and the overall benefit to society. As we’ve seen during this COVID-19 pandemic, restrictions to our fundamental freedoms that have previously before been unheard of on the scale that we now see, have become commonplace.

There will likely be years of debate, research, and arguments over the effectiveness of these measures. Some will say that these measures saved countless lives. Some will say that the modeling used to justify these measures was inaccurate and based more on anecdotal than scientific evidence. Some will say that nothing will stop the inevitable spread of this virus and that it’s not nearly as lethal as we’ve been told. Many people wonder if they’ve already had it. We’ve been told that we need to stop this at all costs from getting into our community. We’ve been told that we need to let it permeate our community in a controlled manner. We’ve been told it has a high mortality rate. We’ve been told that the mortality rate isn’t known because of inadequate testing.

This is the first time in over 100 years that this country has dealt with a pandemic with such potential. We will become the authorities and experts as the situation progresses. I certainly don’t have the answers to these questions, and I don’t know that I ever will. However, one thing that can’t be argued is that these restrictions on our movements, our employment, and our ability to conduct our daily lives have resulted in financial devastation to many, and will have long-lasting adverse impacts on this community which will add to the previous years’ disasters. This situation can’t continue and the people I represent won’t allow it to continue indefinitely.

Following Friday's protest in Lakeport, I spoke with one of the attendees. The subject of the sheriff’s office’s enforcement of the shelter in place and various other Public Health officer orders came up. From the start of this event, the sheriff’s office has taken an approach to enforcing these orders with an emphasis on education and voluntary compliance. We have always reserved actual enforcement by citation or arrest as a last resort, and only for those engaged in other criminal activity. We have never arrested or issued a citation to any person simply for violating either the state or local Public Health officer’s order. The few amount of enforcement actions, above simple education and warning, that we have taken were for people engaged in criminal activity beyond simply violating the Public Health orders. Violations of these orders are punishable by up to a $1,000 fine and/or 6 months in jail.

Among the things being protested today was the continued closure of Clear Lake. The lake was closed to dissuade people from coming into Lake County from other areas that were experiencing reportedly higher incidents of COVID-19. When this decision was made, we wanted to be sure we either kept COVID-19 out of Lake County. We were successful for longer than the vast majority of the state. As seemed to be inevitable, we detected some positive cases. There was no hospital surge. There were no mass fatalities. As of now, only 7 seven confirmed cases have been identified, and 6 of them are reported to be recovered. Sewer testing seemed to indicate more community spread as positive results were found in 4 of 4 systems that were tested at one point. Those same systems have subsequently been found to be free of COVID-19. I question whether or not the emergency used to justify these actions on our populace still exists.

Since March 19 when this order went into effect, the sheriff’s office has arrested 15 people and issued six citations for violations of the Public Health officer’s orders. That averages out to about one person every other day who has had an actual enforcement action taken against them. This is out of over 700 contacts that we’ve had responding to reports of such violations. These citations issued to and arrests of people for these violations were not for the sole act of violating a Public Health officer order. As stated earlier, they were for people engaged in other criminal activity while violating the order. I am proud of the restraint, discretion, and judgment my staff has displayed while carrying out their duties.

We at the Lake County Sheriff’s Office will continue to take this posture as it is not my desire to punish people with measures that may result in these fines or imprisonment for engaging in otherwise lawful activity. I won’t use this opportunity to make criminals out of people who aren’t. People in Lake County, and in many parts of our country, are already suffering due to the loss of loved ones, loss of income, and loss of many of their freedoms.

For those who would say that I’m countermanding the Public Health officer’s orders, I’m not. His orders remain in effect and lawful unless proven otherwise by some higher authority. In fact, I encourage people to abide by them as many of them do serve to keep you, and those around you safe and healthy. The law surrounding enforcement of these laws grants sheriffs discretion. I have used that discretion, and will continue to use that discretion, in a manner that does not impose additional damage to those already damaged.

The lake remains closed to motorized vessels in accordance with the Public Health officer’s orders. I encourage people to respect that order. The quagga mussel sticker program remains in effect and we will strictly enforce that as has been our practice.

I encourage people to socially distance. I encourage them to wear masks when entering businesses. I encourage people to cover their cough. I encourage people to wash their hands. I encourage people to limit their travel to slow the spread of this disease. I won’t make them criminals for choosing not to.

This shut down of society can’t continue indefinitely. It’s time to evaluate our measures and make adjustments. Are we going to continue with the closure of the lake to keep people from out of Lake County away and while doing so keep our own residents from enjoying the wonderful opportunities it has to offer? If so, many people will stop listening and simply violate the order. Others will choose to visit waterways that are nearby and open such as the Sacramento Delta, the Sacramento River, Lake Shasta, and any other waterway that is open. Many have already done so.

There were good reasons for doing this, but it’s time to ask ourselves if it’s necessary to continue. We may already be beyond the point of irreparable harm to our community. If we’re not already, every day we continue brings us closer.

Brian Martin is the sheriff of Lake County, California.

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Written by: Gary Pace MD, MPH

Published: 13 March 2020

Created: 13 March 2020

Last Updated: 13 March 2020

If you are watching the news, you recognize that the novel coronavirus situation is rapidly changing.

The World Health Organization now says that we are in a “pandemic,” the stock market is dropping quickly, colleges are closing around the state and some sports events are beginning to be cancelled. Yet there are still only about 1000 documented cases in the United States, and a handful of deaths at this moment. Are we overreacting?

In Lake County, we are still at low risk of getting coronavirus. We have not had any people testing positive yet, but we have only been able to do a limited number of tests.

There is no known community spread, but there may be some people with the virus in our county that we haven’t been aware of.

At Public Health, we have been monitoring some returned travelers, and following some sick people who have been tested, but so far there have been no positive cases here.

We did declare a “Local Health Emergency” and the Board of Supervisors ratified it on Tuesday, March 10. This was not done to cause more anxiety, but is meant to allow us to make changes quickly (if needed), to request supplies and staffing (if needed), and to access emergency State and Federal funds (if needed).

Also, the California Department of Public Health came out on March 12 with strong recommendations limiting group gatherings:

– Postponing or canceling non-essential gatherings including 250 people or more;
– Smaller gatherings should be held in venues that allow social distancing (keeping 6 feet distance between people);
– Canceling events of 10 or more people that are in vulnerable groups—senior citizens, immune-compromised.

This is a significant change, which reflects the intention to limit mixing of people, thus preventing the introduction and the spread of the virus.

As seen in Washington state and Italy, once the virus gets a firm foothold and starts spreading, the situation can get to be difficult to manage. It appears that strong attempts to slow or stop this spread by limiting group gatherings and social mixing can be effective.

County agencies, schools, and healthcare providers are in regular communication in order to prepare and adapt to the changing environment. We are also involved in regular communication with the public. Our website is becoming a good resource, and there are some documents translated into Spanish. We are also trying to provide weekly press releases and a social media forum hopefully starting next week.

With no cases currently identified in the county, but with the situation worsening in the larger Bay Area, we are recognizing that we are in a unique situation and that limiting large group gatherings may allow us to prevent the virus from getting a solid foothold here, or at least slow down the process, and thus minimizing impact on the healthcare system.

Our particular concern is our most vulnerable populations – the seniors and people with underlying medical conditions.

Overall, we want to continue to try to walk the line between adequate, reasonable preparation for what may come down the road, without causing unnecessary concern or panic.

We live in a resilient community with reasonable, practical leadership. If we are very lucky, this outbreak may pass by Lake County without significant impact, but we appreciate the diligent efforts by so many of our community agencies and partners to prepare for the possibility that we do begin seeing cases.

Gary Pace MD, MPH, is the Public Health officer for Lake County, California.