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Q&A: Butte County Public Health Director Provides Update On COVID-19, Search For Health Officer

Butte County has recorded a steady increase in COVID-19 cases over the last month, which was something health officials say they expected as the county moved through the phased reopening plans. 

NSPR's Andre Byik recently spoke with Butte County Public Health Director Danette York about the increase in cases and the metrics officials are watching going forward. 

But the first thing Andre asked was about the departure this week of the county's Public Health Officer, Andy Miller, and the plans are in place to find his successor.

Here are highlights from their conversation. You can also listen at the top of the page.

Interview Highlights

On the search for a new public health officer, and covering his duties in the interim

So we already had a memorandum of understanding, or MOU, in place with Yuba County to provide health officer coverage anytime there's an absence. So Dr. Luu, who is their health officer, will be covering for us for the next 30 days. That's what we're starting to look at initially, and then as we get closer to the 30-day mark if we need to renew that we can or extend it. In the meantime, we had already started our recruitment process for a permanent health officer. And we actually have the first round of interviews are scheduled for tomorrow afternoon, and the position is posted and will remain posted until filled.

On the duties of a county public health officer

Dr. Lu will be providing mainly communicable disease oversight and including coronavirus, but there's other duties that fall to health officers and they vary somewhat based on the jurisdiction, but are pretty standard across the state as well. So anything distinguishing between the public health director and the public health officer, I say that I use the terms that I'm the administrator, she, in this case, will be the medical person. So I have an administration and leadership background. I have no medical expertise. And so I have to defer to them for anything that comes up that are medical questions.

On the rising number of COVID-19 cases in the past month

Well, anytime there's an increase, even if it's one, it's a public health concern. Alarming may be too strong of a word, because we did expect the cases to rise when two things happened. One was increasing testing capacity which we have done here in the county, and opening some sectors back up. So more people are out and about. And more people are getting tested even if they're not showing symptoms. And so we are finding more cases of the virus in asymptomatic people, meaning they have no symptoms. 

On metrics being evaluated when it comes to the county’s ongoing reopening

So what we did was we reviewed our reopen plan and aligned it with the state's metrics. So the state created metrics that they'll be watching for every county and reaching out to counties that meet a certain threshold in certain metrics, and offering to help, looking to see what we need as far as resources or any technical assistance that they could provide. That would help us get back to below that threshold. And so some examples are the case rate, of course, based on how many cases you have per 100,000 population. And then hospitalization use rates and usage of ventilators or people being in the ICU is another. Testing capacity is one as well.

On how Butte County is performing under those metrics

We're doing fine. We actually have not met any of their established thresholds for concern except for one and that is, in our attestation document, we were requested to comment on what our testing capacity is in the county and their metrics instead of looking at capacity, they're looking at how many actual tests are performed. And so that's the one metric that we are not performing at the level they would prefer us to, meaning how many people are actually getting tested. However, there's a seven-day lag. They look at that on a seven-day average, and there's a seven-day lag for it. And I make that point because the OptumServe testing site at the Silver Dollar Fairgrounds has actually picked up in usage over the last week or so. And we have also done a media campaign to make sure people are aware that they can go get tested without even having symptoms, and more people are taking advantage of that now. And so we anticipate that that one will change as well and then we would not be meeting any of those thresholds of concern.

On whether there’s a risk of losing the OptumServe testing site

I think there is always that risk because this is a state-operated site. And if people are not utilizing it or showing that we have a need for it, they could always determine that the need is not there and pull it out. There was never an immediate risk to that. They send us an email weekly to give us our data on what the usage number is as far as a percentage of the capacity. And they informed us in one of those emails that that could be a consideration at some point, but they were not there yet. And they did shortly after that let us know that they have extended the OptumServe site to go through the end of July as of right now, as long as the need is still here and the usage is up. 

On whether limited testing limits the county’s ability to understand community spread

I think yes, it does hamper it somewhat. We encourage people to get tested, especially if they have any symptoms or concern. But regardless of whether people get tested or not, the key message is that it is in our community, it is spreading. We can tell that by the number of cases increasing. So taking all of the precautions seriously and performing those mitigation efforts continues to be of the utmost priority. You know, wash your hands often, keep that social distance and wear a face covering whenever you do have to go out

On whether the county has considered a mandatory order for face coverings

We have not here in Butte County. There is a conversation going on at the state level about whether or not mandatory masking order should go into place. I don't know where they're at in that discussion, but here in Butte County, we have not even considered to do a mandatory one at this time. We do highly recommend it and trying to educate people on how it is helpful, so that people will be encouraged to do so.

[Editor’s note: As of Thursday, updated guidance from the California Department of Public Health requires all California residents to wear face coverings while out in public.]

I think the county as a whole is in a pretty good space right now. But beyond that, when you start mandating something, it's helpful to have some sort of enforcement in place to enforce that mandate. And that would be a very difficult thing to enforce. And we try not to take away people's rights as well. So it's finding that right balance and as of right now, the balance is highly recommending but not mandating.

On whether there’s concern more people will get severely ill or die as people resume normal activity

From public health's perspective, absolutely, that's always going to be a concern in a novel virus like this. This one in particular, because we've seen such a wide range of how it affects people. There's many people that have no symptoms, some that have very little symptoms, and then of course, some that it makes them severely ill and even causes death. So there's always that concern that those will increase. Again, it's finding that balance.

This interview has been edited for brevity and clarity. Click the “play” button to listen to the entire interview.

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