In today’s COVID media availability, Humboldt County Deputy Public Health Director Dr. Josh Ennis took questions on modeling and statistics, asymptomatic transmission of the virus and whether or not businesses can refuse service to people who refuse to mask up.
Rough Qs and As transcribed below, with the minute marker attached if you’d like to hear it verbatim from the doctor’s mouth.
(0:00) Can you provide an update showing how the modeling has changed since modifications have been made to the county’s shelter-in-place order? When is the peak for deaths and hospitalizations now, and what is the percentage of mitigation now?
Ennis said that he’d like to talk about modeling, and why the county ran and presented data from COVID modeling a couple of months ago. The county used it, back then, to bookend two extreme scenarios that the county could be faced with — the spread of COVID in Humboldt with extreme shelter-in-place orders remaining in place, and with no shelter-in-place order at all. It’s very hard to apply modeling to day-to-day disease tracking, but state health officials are attempting to do that sort of work.
Ennis said that we have clearly avoided the worst-case scenario that the county modeled originally. But we are still very early in the spread of the disease, and cases are so few, that day-to-day forecasting is swings wildly with each new data point. At this rate of variability, modeling is not so useful as a forecasting tool.
Percent mitigation: They’ve modeled mitigation at 40 percent.
(3:08) How is the modeling expected to change as the county moves from Stage 2.5 to Stage 3 in the governor’s reopening road map?
That’s a hard question to answer, because the modeling doesn’t really apply at this point, Ennis said. Again: The modeling we did initially talked about the two extremes of intervention, and that helped inform us about strategies going forward and to plan for hospital surge.
But the number of cases we have is so small at this point that modeling becomes unhelpful, Ennis said. If there’s an outbreak because of a large gathering, say, and one person there has it — all of a sudden you’d have a much different picture in the county than whatever a model would predict, at this point in time.
(4:02) The state’s COVID website reports the number of people currently hospitalized due to COVID-19 in Humboldt County, and also the number currently hospitalized and in the ICU. Are these figures accurate? Why does the county not report them? Also, why does the state’s total number of confirmed cases differ from the county’s?
The state’s numbers for hospitalizations are accurate, Ennis said. They are compiled directly from hospitals. However, their figures lag several days behind what we are actually experiencing on the ground in Humboldt.
As for the case numbers, that information is pulled from a state database and it is inaccurate. The state database has duplicate tests which need to be reconciled. Also, sometimes it gets addresses of residents wrong. The county is looking to help the state get that in order.
The county’s numbers are very accurate, Ennis said.
(6:10) We currently have the fewest number of active, confirmed cases that we’ve had at any point within the last 30 days, despite the county significantly loosening restrictions in the interim. What conclusions can you draw from this fact? What questions does it raise in your mind?
Conclusions: Shelter-in-place really did work, Ennis said. People were still traveling after the shelter-in-place order, and that was one of the big drivers of new cases in the county. Now people are taking this more seriously, on the whole.
Questions? The counts are dropping very low and we’re opening up. The county has been thinking about its long-term response. How are we going to monitor the disease? How can we find the asymptomatic carriers? If we get too far ahead of ourselves and the disease starts to spread quickly, how do we respond?
(8:20) Can you break down our 100+ cases by race, income level, education level, the percentage of essential workers, etc.?
Ennis said that they are collecting data on race, but not on education or income level. The county is in the process of creating a dashboard that will provide that information.
(9:45): Can you talk about transmission by asymptomatic people, in light of the WHO director’s recent comments and clarifications on the subject?
The director originally stated that asymptomatic transmission is very rare, Ennis said, but later clarified that she wasn’t talking about modeling that suggested that it is a bigger driver.
Ennis said that when he first heard her comments he thought: That can’t be, because he has seen with his own eyes, here in the county, where asymptomatic people have spread the disease. It’s clear to the county that this is occurring here.
There was some confusion, Ennis believes, in the director’s remarks between asymptomatic and PRE-symptomatic people — the latter being people who have contracted the disease but have not YET shown symptoms. Some early studies lumped them together.
But it’s a mischaracterization to say that asymptomatic transmission is very rare, Ennis said.
(11:40) Can a business refuse to allow people from coming inside if not masked?
Yes. It’s not required that they do so, but they can, Ennis said.
(12:00) What about those who are exempt from wearing masks?
Ennis said that the county regularly tries to remind everyone that some people cannot wear masks.