As the coronavirus case count continues to rise in Fresno County, interim Health Officer Dr. Rais Vohra predicts the pandemic will only get worse over the next month, considering recent trends.
Data from the state, reported Monday, showed Fresno County hospitals had 116 COVID-19 positive patients. On June 21, that number was 73. The county also had 30 coronavirus patients in the ICU on Monday.
Both the number of hospitalized coronavirus patients and the number of coronavirus patients in the ICU are a considerable amount higher than any previous point over the last few months. The number of hospitalized patients had hovered around 60-70 since mid-May, and the number of ICU patients had not increased over 22 until last week.
“This last week of having increasing case counts gives me a lot of indigestion going into the rest of the summer, and I think July is going to be very tragic in terms of the number of hospitalizations and the number of fatalities that we see as a result of COVID-19 – just given the fact that we’ve already seen such an uptick in the number of total positive swab results that we’ve got,” Vohra said.
However, the hospitals are not overrun. Vohra said the county has 270 ICU beds, about 200 of which are currently in use for all illnesses, not just coronavirus.
The number of hospitalizations, deaths and the total case count usually trails behind by a couple of weeks, Vohra said, meaning any outbreak or increase seen over the past week will likely show up in greater numbers over the upcoming weeks.
Tuesday’s data reported by the county saw the total case number increase by 197 to 5,008, while the number of active cases reached 3,713. There have been 1,222 patients who have fully recovered, and 73 individuals have passed away.
From June 21 to Tuesday, the number of total cases increased by about 1,600, and the total positivity rate since the county started testing in March is 8.3%. The positivity rate from Monday to Tuesday came in at 6.6%, which is lower than the previous week’s rates that were routinely hovering between 8-10%.
Bar closures
On Sunday, California Governor Gavin Newsom announced that the state is ordering bars in seven counties to close after spending two weeks on the state’s targeted engagement list due to a concern over the recent coronavirus case numbers.
With Fresno County on the list, Vohra signed a Health Officer Order directing all brewpubs, breweries, bars and pubs to close until further notice.
“I know it’s a hardship,” Vohra said. “I really had a lot of mixed feelings about signing the order, and really I do understand the rationale behind it, but I know that for those who work in this industry and for those who enjoy patronizing these businesses that this is a hard step to take. But this is really an important step for us just based on the data that we have.”
Vohra said the county has had full compliance so far with bars and restaurants that have a bar area.
Fresno County Public Health Director David Pomaville said there has not been a direct correlation to community spread of COVID-19 in bars in the cases that the department has investigated, but there is evidence of spread in bars in other parts of the state.
Pomaville also said the decision to close bars will not make a difference with the pandemic numbers and statistics in the county.
“I think collectively, this in and of itself is not going to change our statistics,” Pomaville said. “It’s not. This is an indicator that we are not doing as well as we should be doing with regard to controlling the community spread in our community and throughout California. So it’s the beginning of ratcheting down.
“We are very hopeful that people will stop and take what Dr. Vohra talked about very seriously and have pause with regard to how much activity they’re having and interaction they’re having with other people at this point in time, at this really critical juncture heading into Fourth of July.”
Targeted engagement list
Although Fresno County has been on the state’s watch list for over two weeks now, that has been a blessing in disguise, Vohra said, getting the state to take notice of Fresno County and send much needed help and resources to the Valley.
“It has precipitated some productive dialogue,” Vohra said. “I think it really got the state’s attention that our jail had an outbreak. I think I’ve never seen the state act so quickly to get on the phone with us, to really ask, ‘Hey, what’s going on? How can we help? What’s the situation, and how can we support you?’
“So I think things like that really do help. The state knows that we do have a large, vulnerable population and that this virus is affecting many of those residents currently, and I think that we are on the state’s radar to help deploy resources.”
Vohra credited the state’s recent involvement with Fresno County as the reason why the county received its third high-throughput testing site – the new OptumServe site in west Fresno that began operations this week – from the state.
“There are good things that are coming out of being on that targeted engagement list,” Vohra said. “It’s not all punitive.”
Alternative care site
If the positivity rate remains above 8% and the number of hospitalizations continues to rise in July, the county may need to look at jump starting the alternative care site at the convention center in downtown Fresno, Vohra said.
The county received the site from the state in April but has not had to use it yet to this point.
“We will need to start considering how we can activate that alternative care site,” Vohra said. “I definitely don’t want to do it, but I definitely recognize that the way things are going, that July will be a critical month for us to see whether we do need to ramp up that resource.”
One issue though with securing the needed resources from the state, Vohra said, is that Fresno County will see a spike in cases at the same time other counties throughout California are.
“What I do worry about though is that at the same time that we will need to take that step, many other counties will be in the same boat, and everyone will be requesting the same resources from the state,” Vohra said. “It’s not like we are alone in this.”
Contact tracing
In order to keep better track of contact tracing and mitigate the spread of the virus, Vohra recommended that people keep a contact diary detailing all interactions and places someone has visited in a day.
“A contact diary actually forces you to really be mindful of where you are physically, where you went, how long you spent there – doesn’t have to be very fancy or complicated, but anything that can help jog your memory,” Vohra said. “Because that’s exactly what our contact tracing team is going to ask you if you end up having a positive case or even if you end up being in close contact. ‘Where have you been for the last 48 hours?’ And if you keep a contact diary, then that’s just one less thing that you have to keep active in your mind.”
Vohra said other countries have been successfully utilizing contact diaries, but it has not caught on yet in the US.
“It’s also another sort of very hard recognition if you’re getting out too much,” Vohra said. “If your contact diary is taking up pages and pages every day, then maybe you’re getting out and around too much. Maybe you’re putting yourself at more risk than you need to be. So that’s another reminder that if you’re having many many social contacts throughout the day, then you yourself are at risk. And if you’re asymptomatic, you’re actually at risk of spreading this to other people.”
