Opening Shasta County Again

Over the last week, Shasta County Health and Human Services Agency officials have offered a clear message to the public: they are beginning to explore a limited re-opening of Shasta County. Unfortunately, they’ve said, until California’s Governor Newsom re-opens the State, Shasta County’s options remain limited.

“The State Health Officer’s order is in effect,” Donnell Ewert, head of the Shasta County Health and Human Services, said during Wednesday’s press briefing, “And we can’t do less than the State Health Officer has mandated.”

(Meaning that Shasta County, no matter how low our numbers, can’t sidestep State stay-at-home orders.)

Nevertheless, Shasta County is being impressively proactive as local leaders look forward to eventual freedom for all of Shasta County to work and play unsheltered. They’re developing a “Roadmap to Recovery Advisory Committee”, comprised of local government, business, education, faith and community leaders. The committee will work with the public health department and the Emergency Management Team to develop strategies to safely re-open the local economy.

“Right now we are in Phase 1,” Shasta County’s health official, Dr. Karen Ramstrom said. She went on to explain that when we move to Phase 2, — which will include allowing non-essential businesses to re-open — things will still be far from normal. “We will be in Phase 2 for the foreseeable future,” she added, stating that this phase likely won’t end until a vaccine is developed, perhaps in 12-18 months.

While Shasta County pends modification to the State of California shelter-in-place orders, President Trump has released a series of tweets which seem to indicate that he feels some governors are holding their citizens hostage by requiring them to shelter. Cue the stand-off between state and national powers. Trump’s plan for reopening, “Guidelines for Opening Up American Again” offers gating criteria to be used before beginning three phases of re-opening of local economies.

Specific, measurable criteria to determine when regions should re-open? Genius.

Unfortunately, these symptomatic criteria appear difficult to monitor, as they require documenting a downward trajectory of not only influenza-related-illnesses (ILI) but covid-like syndromic cases, something I have not yet seen data for in Shasta County, or at the state level.

A spokesperson from Shasta County’s Health and Human Services Agency, responding to me via FaceBook message, said that while Shasta County does track ILI, they don’t track covid-like syndromic cases. They report their ILI cases to the federal government. And although they don’t have ILI data available on a web site, they are happy to provide specific numbers to those who ask.

California’s Department of Public Health (CDPH) also tracks ILI. Most recent data on the CDPH web site is from the week of March 14th. There is no mention on that site of “covid-like syndromic case” tracking.

But the data is being followed. The CDC’s National Syndromic Surveillance Program web page is dedicated to ILI and covid-like syndromic case tracking by region. California is grouped with four other states/territories including Arizona, Guam, Hawaii and Nevada, with 135 hospitals reporting, so at least some regions of California must be tracking and reporting covid-like syndromic cases.

Still, if Trump’s gating criteria includes metrics that neither our state nor our local region seem to track, how will we enter his “Phased Comeback” allowing us to fully reopen America?

There’s more to say about Trumps plan, but let’s take a contrasting look at what California is proposing: “California’s Road Map to Modify the Stay at Home Order.” ‘Let’s not worry about totally reopening California’, the title seems to say, ‘We’d just like to see progress.’

Newsom’s plan outlines six indicators for modifying the stay-at-home order, each with key questions attached. And while the ideas outlined seem both common sense and comprehensive, the lack of ability to accurately determine when anything is actually occurring also seems to be a problem.

Unlike Trump’s clear (if difficult to track) gateway criteria (“14 day downward trajectory in ILI” for example), Newsom’s plan contains mostly questions with no real metrics by which to determine success. Take for example, the first indicator, which contains the key question “how prepared is our state to test everyone who is symptomatic?”

Yes, that’s exactly what we’ve all been wondering.

But asking the question isn’t really a plan, and it isn’t enough to bring us closer to modifying our shelter-in-place. And reading further through the plan raises other similar questions.

All this is indicative of a simple, and unsurprising truth, at both the state and national levels, and even across partisan divides: Our leaders haven’t yet figured out clear metrics that will allow them to decide when states or regions are ready to re-open.

So, even as Shasta County celebrates multiple days without a positive COVID-19 test, it’s unclear how much longer the pandemic may keep our local, state and national economies closed. (Update: One new case was diagnosed.)

As Donnell Ewert, head of Shasta County Health and Human Services Agency, said during Wednesday’s meeting, “We need to manage expectations.”

Annelise Pierce
Annelise Pierce is fascinated by the intersection of people and policy. She has a special interest in criminal justice, poverty, mental health and education. Her long and storied writing career began at age 11 when she won the Louisa May Alcott Foundation's Gothic Romance short story competition. (Spoiler alert - both hero and heroine die.) Annelise welcomes your (civil) interactions at AnnelisePierce@anewscafe.com
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22 Responses

  1. Steve Towers Steve Towers says:

    Theoretically, it makes sense for us to consider opening back up in a thoughtful, careful, step-wise manner.

    As a practical matter, the rest of the state probably fears that left to our own devises, we’ll want drop all precautions and get back to 100% normality tomorrow, like those fool protesters in Michigan. The coalition of Southern states that are rushing back to “we’re open” status has healthcare experts predicting a blow-up, to the detriment of the rest of the nation. Are the coastal counties of California (and the Tahoe-Sactown-SF Bay axis) wrong to assume we’re that reckless? It’s going to be assumed that we are, just to err on the side of precaution, until we prove them wrong. It may offend us that the rest of the state considers us their Deep South, and that county-by-county decision-making isn’t going to serve the greater good, but to some degree we deserve the side-eye.

    Also, we tend to exaggerate how the rest of the state sees us—to think they’re holding us back or down out of some sort of control-freak spite. Truth is, they’re generally not thinking about us at all.

    • Steve, it DOES make sense for us to consider opening back up, as you say, in a thoughtful, careful, step-wise manner. I’d like to think people would do that instinctively, without a lot of guidelines. We shall see.

    • Avatar annelise says:

      Steve, I agree with your first sentence. That’s why I’m curious about metrics that could help differentiate regions. If our positive tests are tracking downward or below a certain number for 14 days, does that mean our region could have a limited re-open despite what’s happening in SF or SB? Could Newsom or Trump develop such metrics that would help regions like ours begin to re-open? I felt Trump was closer to it but I don’t really understand what the difference is between influenza-related illnesses and covid-like syndromic cases, and why (or if) we should track both. Of course Trump’s plan is just a guideline for the governor to use. I’d like to see Newsom add some more definitive metrics that would allow for potential regional re-openings of areas like ours when it’s safe. I’m glad public health experts are behind these decision . . . they seem very complicated!

  2. Annelise, what a great conversation starter for this morning. This paragraph hits the nail on the head:

    “All this is indicative of a simple, and unsurprising truth, at both the state and national levels, and even across partisan divides: Our leaders haven’t yet figured out clear metrics that will allow them to decide when states or regions are ready to re-open.”

    Exactly right. And that’s so frustrating for everyone.

    • Steve Towers Steve Towers says:

      Something that forever amazes and frustrates me about Americans is our steadfast belief that nothing anyone else in this world does with success applies to us. For example, there are easily over a dozen healthcare systems in the world that work far better than ours across every metric—cost, performance, satisfaction—but we act as though we can’t possibly borrow a single idea. So instead of universal healthcare, we have people asking for money to pay their medical bills on begging websites.

      With COVID-19 there are at least a score of countries that have obviously handled the crisis better than we have and are now well into some degree of opening up. Where is our discussion of what’s working and what isn’t elsewhere in this world?

      Clearly, part of the solution is extreme testing and contact-tracing. I give Trump an F for his performance in the face of this crisis, but it’s been about a month since Gov. Newsome made it clear that we can’t depend on Commander Shinsplints to lead us through this war.

      So where is California’s comprehensive, home-grown test-everyone/contact-tracing program? Newsome has been effective on the curve-flattening side, but until I see the comprehensive testing and contact tracing that will allow some degree of opening up, I can’t give Newsome any better than a C-.

    • Avatar Annelise Pierce says:

      Doni, and frustrating for our leaders too I bet. I wanted to highlight the bipartisan confusion because I think it’s a terribly complex problem. I want to see relief for our businesses and those out of work. But how to get there feels really fraught with peril. In a way the County is lucky to have to defer to the higher ups, in another way it leaves us feeling trapped.

  3. Avatar bruce vojtecky says:

    Annelise, our Phoenix reporters feel the same frustrations you do as the local officials can’t seem to really say anything. They say they are looking at the models but won’t say what those models are. And they flat out refuse to divulge where the COVI deaths are occurring saying there are privacy issues. Governor Ducey was MIA for a week and still hasn’t really made any time line to open Arizona. I personally think he is waiting to see how it goes elsewhere. With northeastern Arizona, the Navajo Nation, shut down and under quarantine that could affect any opening in any state as Interstate 40 goes right through the center of the Navajo Nation.

  4. R.V. Scheide R.V. Scheide says:

    One of the missing metrics is this: How large of a percentage of the total population do you have to test to get an accurate picture of the virus in your community? How much contact tracing and surveillance tracking must be conducted? I haven’t been able to find any fixed values for these types of testing. Shasta County has only tested .5 percent of the population so far. If they’re not testing asymptomatic people, then we simply have no idea how far coronavirus has penetrated here.

    • Avatar Annelise Pierce says:

      RV: Trump’s plan also calls for downward trajectory of positive tests as a percentage of total tests with a flat or increasing volume of tests. But it also very much depends who we are testing. Are we really testing everyone symptomatic? Are we testing health care workers and grocery clerks?

  5. Avatar Anne Thrope says:

    Covid19 hasn’t been all bad. Democrats are now embracing state’s rights while Republicans chant “my body my choice.”

  6. AJ AJ says:

    My body, my choice? Only if you don’t have a uterus!!

    • Avatar Liz Zanze says:

      I find this so ironic to see men armed with machine guns complaining about the government is controlling their bodies!

  7. Avatar Common Sense says:

    It all boils down to testing. Testing and more Testing. Antibody testing would help. This Virus was here in California, 1-2 months before anyone tested positive. If it was like that here, it was probably like that in NYC and other areas.
    There are Many in S.F and the Bay Area that travel to see family in China.

    We need to look at the Vacation areas also. They start opening up things and people start taking their Vacation to California Cities and Beaches, things start Spiking Upward.

    The way it is now is like having a “Designated” peeing area in the Kiddie Pool!

    There Millions in this Country that have or have had it.Some can still infect many are past that period.

  8. Avatar Common Sense says:

    21% of people tested have Antibodies in NYC. It’s been in our Country longer that first thought. Many more have had it than originally thought. If they go back too early, to business as usual, this will do what happened in NYC.

    https://www.cnn.com/2020/04/23/health/us-coronavirus-thursday/index.html

  9. Avatar Sandy McNamara says:

    Multi-billionaire Bill Gates gave the CDC $10 Billion in 2010 and in a TED talk in 2015 he predicted this pandemic. Dr. Fauci has worked for the Nat’l Institute of Health (NIH) and Nat’l Institute of Allergy and Infectious Diseases (NIAID) of the Federal Government since 1984. He makes $400,000 per year. Dr Fauci gave a talk in 2017 and predicted this pandemic and Bill Gates pledged $100 Million to Dr. Fauci’s research and development projects.

    Bill Gates has also pledged $Billions of dollars to create factories around the world to develop and prepare 7 Billion vaccines.

    The first batch of tests that came in from China were ineffective and produced false positives. The disease was supposedly started by bats or a fish market or possibly as a bio-weapon out of a lab. Now Gov Newsom has made a deal with a Chinese manufacturer of electric cars to buy $1Billion dollars worth of masks and other protective gear. The list of corruption and cover-up and “follow the money” stories found in various newspapers, magazine articles, and reporters around the world is staggering. Sorry I’m not including all the references for this information. It’s a lot of work and most people don’t believe it or decide that I’m a tin foil hat wearing conspiracy theorist.

    It seems that no matter how much money is spent and how many medical experts and scientists are working on this problem they don’t seem to be able to do their job. Or, possibly, there are ulterior motives for letting chaos reign. Meanwhile they’re collapsing the world economy. 26 million Americans have filed for unemployment in recent weeks. While I don’t trust Trump I do understand that he is not a doctor or epidemiologist. Blaming him for this pandemic in any way is just divide and conquer politics at its best.

  10. Avatar Chad Magnuson says:

    What we know concerning the modeling of the stay at home mitigation is that it works.
    While simple it is effective. More effective than anything else on the table.
    As the experts say a vaccine is the answer. It has not been developed nor has it been approved.

    I’m willing to listen to the experts before I support phase 2 and reopening on a mass basis.

  11. Frank Treadway Frank Treadway says:

    Meanwhile, and related to this story, is the $300,000.+ funding Shasta Co. Board of Sups and the Housing Division is about to receive from CA & the Feds. These funds are to deal with the virus and specifically to shelter those on the streets of Shasta Co. I’m told there’s a Task Force to decide such. Who are they, when do they meet and what is their criteria for spending these funds ? The funds are supposed to be used for sheltering folks in motels/hotels. How many motels in the area are empty ? Most are already filled with those on SSI who pay almost all their monthly check on these one room spaces. As has been mentioned before, Redding has a perfect ready-to-occupy motel, the former Redding Inn, on Pine St. A non-profit could buy it, rehab it and place up to 50 street folks in a short period of time. It’s about as NIMBY proof as a place could be. Or, a coalition of non-profit and the county could get this up and running ASAP. I hope the BoS move quickly and wisely with these funds and provide community input. This is thinking out-of-the-box time.

    • Avatar Chad Magnuson says:

      Based on the past performance of the SCBOS the homeless will not see much direct support from this money.
      The reality is there are many closed down facilities that could be retrofitted and provide homeless shelters.

  12. Avatar Mari says:

    At this point do we know how many people have been tested countywide? And of those people that have been tested, is there information about how many are asymptomatic? If this information is available, where can we find it?