COVID-19 Modeling Displays Importance of Social Distancing
Van Do-Reynoso presenting to the Board of Supervisors
By edhat staff
Santa Barbara Public Health Department (PHD) shared data and models of the coronavirus (COVID-19) pandemic, expressing the extreme importance of social distancing cooperation.
PHD Director Van Do-Reynoso presented an update on COVID-19 during Tuesday morning's Board of Supervisors meeting which spurred a discussion of the social distancing timeline as models predict through November 2020.
Before launching into the results of the current modeling, Do-Reynoso explained these numbers are based on real-time data and are not set in stone. "What I'm showing today is different than last week and will look different next week," she said. The long term projections are in a fluid state and may not provide precise data due to the uncertainty of the COVID-19 infection transmission rates and how to appropriately gauge social distancing measures.
Approximately 15% of the county's population is age 65 or older, making them more likely to develop serious COVID-19 related health impacts. However, Santa Barbara County has a lower population density compared to Los Angeles or San Francisco, which proves to be an asset, reported Do-Reynoso.
The Penn Model is recommended by the California Department of Public Health and is used as a rough estimate of what to anticipate. For reference, the University of Washington Model does not allow for variables to be estimated by population or density, so it can only predict on a statewide and national level.
The biggest predictor is of how Santa Barbara County will fare is social distancing, the percentage in social contacts going forward.
The Penn model uses the social distancing percentage and compares it with the number of available hospital beds. For example, if 40% of the population complies with the order, COVID-19 hospitalizations within the county are expected to peak on June 25 with nearly 1,200 hospitalizations. That's beyond the capabilities of currently available beds. With 45% social distancing compliance, the peak is expected on July 16 with 682 hospitalizations. With 50% compliance, it peaks on August 20 with 274 hospitalizations, and with 55% compliance, the curve is almost completely flat peaking on August 31 with 42 hospitalizations.
Do-Reynoso explained how this modeling helps for surge planning within hospitals, alternate care sites, and equipment acquisition.
The current surge capacity with the five hospitals within Santa Barbara County (Santa Barbara Cottage, Goleta Cottage, Santa Ynez Cottage, Lompoc Hospital, Marian Regional Medical) allows for 569 medical/surgical beds and 131 ICU beds, a total of 699 beds for COVID-19 patients.
Comparing the number of beds to the Penn Model graph, it shows we'll need at least 50% social distancing compliance to not overwhelm hospital capacity. At 40% compliance, it exceeds capacity, at 45% the gap is reduced, and at 50% its well within the current capacity of beds, however, access to ventilators is lacking.
The key takeaway is how important social distancing is to flatten the bell curve so as not to overwhelm healthcare facilities. Do-Reynoso explained there is no exact way to measure how well the community is adhering to social distancing rules, but PHD uses analytics from Google and Unacast. Based on that data, Santa Barbara County is anywhere between 40-60% compliant.
"That's the lack of preciseness in modeling, we don't have a hardcore gauge," said Do-Reynoso.
Alternate Care Sites & Medical Equipment
As of Monday, hospital beds throughout the county are at approximately 40% capacity with 50 unused ventilators. Of the total available hospital beds, 376 medical/surgical beds are available while 91 intensive care unit (ICU) beds are available.
PHD is looking to immediately secure 20 hotel rooms for COVID-19 discharged patients who cannot quarantine in their homes. By mid-April they hope to secure and additional 80 hotel rooms.
There is currently enough materials for 300 additional beds at an alternate care site, as well as the capacity for 100 more. These sites have yet to be finalized but PHD is recruiting staff. If local hospitals reach a collective 50% surge capacity, approximately 350 COVID-19 beds occupied, the alternate care site will be activated.
There are currently 97 total ventilators with 100 more requested as well as 500 disposables. Additional ventilators and PPE are attempting to be purchased by the hospitals.
Social Distancing Timeline
Based on the model's current predictions, social distancing may continue through October. Do-Reynoso re-stated that these models are not exact and they change very rapidly. However, she started seeing indicators in models that show if a community is doing well and lets up on social distancing, the curve does not complete the bell shape going downwards and can actually increase.
Supervisor Peter Adam expressed his concern about the economy if social distancing were to extend until November.
"If we go on until November, there's people that will be injured that don't get sick and I don't think were balancing the needs of those people trying to make a living out there very well. We're overfocused, maybe rightly so... but I just know there's a tremendous amount of pain being loaded into this system at this time that's largely undetectable because everyone is in their homes," said Adam.
Adam went on to express his concerns about the economy and suggested finding the people with the greatest risk and isolating them, likening the situation to throwing out the baby with the bathwater.
"We should start those discussions sooner rather than later until we run into failure, or rebellion, or whatever, ya know... at some point, people are going to stop cooperating and I don't think it's gonna last until November and then if we get to the point where we have to start arresting people... that's not America," said Adam.
Do-Reynoso stated she's unsure if maintaining social distancing orders until November is feasible. "I think it's a conversation that needs to happen in a variety of contexts and a variety of settings so that we as a community can land on a solution that is doable and protects vulnerable members of the community as well as safeguarding healthcare system," she said.
Supervisor Gregg Hart chimed in at the end of the discussion stating these are projections that help with future planning and show the biggest takeaway is social distancing is really important and it works.
Do-Reynoso agreed and stated these models are helpful tools and the next 8-10 days will determine what PHD will need to do differently in terms of modeling and planning.
Additional updates on COVID-19 and related items were presented at Tuesday's meeting and a subsequent press conference held by District Attorney Joyce Dudley. The summaries of the updates are provided below:
A representative from the Santa Barbara County Office of Emergency Management stated during they Board of Supervisors meeting they are still working to secure sites in the south county area to serve the homeless population.
Last month a shelter was created in Santa Maria that generally houses 50 to 60 people but has hosted a maximum of 71 people. The county is supporting the shelter with food, security, laundry, and cleaning services.
A location in South County has yet to be determined as partnerships and staffing have not panned out as expected. Law enforcement is reporting an increase in close encampments and the county is working to separate those camps and provide housing and essential services.
In a separate press conference on Tuesday, District Attorney Joyce Dudley announced they have received 11 reports of price gouging within the county. The DA's office has one full-time lawyer and one investigator assigned to these reports. In most cases, Dudley stated the increase was due to distributor costs passed on to the business owner, therefore not making it illegal.
In terms of businesses not complying with the closure orders, Dudley states her office hasn't seen much of that as it appears most people are following the rules.
In a separate press conference on Tuesday, Sheriff Bill Brown reported the number of inmates at the County Jail continues to be much lower than previous years. There are currently 693 inmates whereas, on April 20, 2019, there were 933 inmates. There's also been a significant decrease in the number of arrests brought to the jail. From March 2019 to April 2019 there were 645 arrests, this year there were 300 arrests.
Sheriff Brown also shared a positive story of local inmates helping healthcare facilities. In the jail's treatment program, a group of inmate volunteers has been making face shields for first responders and healthcare workers. They have currently assembled 800 face shields with the goal of making 2,400 shields in total.