Q&A: Butte County Public Health Director On COVID-19 Church Incident, Health Officer's Resignation

May 18, 2020

On Mother’s Day, a person infected with COVID-19 attended a religious service in Butte County, potentially exposing more than 180 people to the disease. 

On Monday, NSPR’s Andre Byik spoke with Danette York, public health director for Butte County, about the incident and how the county is responding. He also asked about the recent announcement that the county’s health officer, Dr. Andy Miller, will be resigning July 10. Here are highlights from their conversation.

Interview Highlights

On what happened with the Mother’s Day church incident in Butte County

The way we understand it is, there were approximately 180 attendees at a gathering on Mother's Day. And following that day, the very next day, one of those individuals tested positive for coronavirus. And anytime someone tests positive for coronavirus or any communicable disease, public health gets involved to do contact tracing investigations. So we work with the individual that has the virus to learn who all they were around for a previous set time period. And then we start contacting those individuals to let them know that they have potentially been exposed to a communicable disease and ask them to self-monitor to make sure they don't start showing symptoms and what to do if they do start feeling symptoms and ask them to self-quarantine, so they don't potentially expose others. And so that's why this case was no different than any other case we have followed the same procedure. It was just for a larger amount of people than we may typically see.

On whether all those potentially exposed have been tested

No, that is not what I understand. We worked with our healthcare partners to establish a testing site for people to come and get tested if they so choose to do so. It is not a requirement that people get tested. We recommend it, but we don't require it. And so information was given to all of those that attended and some did attend to get tested. And some have not — to our knowledge. They may have been tested in other places.

On whether the county has enough contact tracers

We do because as public health, that's one of the integral parts of public health on a regular basis. So like I mentioned, any communicable disease requires some contact tracing work. Early on into the COVID-19 response, we added some people to our contact tracing team, we had 12 people assigned originally. Since that time, we've had numerous people go through additional training. And so now we have a much larger number that's available to us to work on contact tracing, and we are sending even more people through training coming up either this week or next week. Most of these today are public health staff, but some are even other county agency staff who are volunteering to help us with contact tracing. 

On whether new positive cases are expected

We have the anticipation, I would say anticipate more than expect, but we do anticipate with the expanded amount of testing that we have available to us now, we will see more cases. And so yes, we're planning for that as a just-in-case scenario, so that we have enough contact tracers available to respond as needed. 

It varies greatly. It's a case-by-case basis. So you know, one person who has the virus may have only been in contact with one other person. And so that contact investigation goes really quickly. We talk to that one individual, give them the information that they need to self quarantine to prevent exposing others. And it's done. And that is assuming that both parties are cooperative. And then it can go to a much larger scale, just like the instance we're talking about where 180 people or a few over that were exposed. And so trying to reach every one of those individuals or family units, because some of those were children, and making sure that they have all the information they need to protect them, takes quite a bit longer.

On whether people typically cooperate

Again, it varies. Some people are very cooperative. Some people have the fear of government, even though it's just public health trying to help them and our community, there are levels of fear that people don't want to talk to any government agency. And so trying to get in touch with them and help them understand that we truly only want to help them — we're not there to have any type of policing powers — takes a good bit of skill and time on our nurses part to have that conversation with every person.

On whether public health has enforcement authority

It varies. In specific cases, a health officer does have the authority to implement isolation and quarantine orders. If someone refuses to isolate when they are contagious or infectious, and could be putting the public health in danger by going out. 

As far as closing gatherings, that is not something that public health is doing. Gatherings are currently listed as a stage three event in the governor's state order. And while Butte County was fortunate enough to be able to move further into stage two, under the state's orders, we do not have the authority to move into phase three or move things from stage three to stage two. So, you know, gatherings — any type of gatherings are under stage three and not permissible under the state order at this time.

On whether County Health Officer Dr. Andy Miller’s resignation came as a surprise to the department

No. It's unfortunate that it is sooner rather than later. But Dr. Miller works under a contract and his contract is up in October of this year, and he did not plan to renew his contract. This was even before the COVID-19 response started, but he made the decision that the timing is difficult to just end the contract in the fall, because of the difficulty in locating a health officer. So he made this decision to help us in order to help us have someone on staff and somewhat oriented to the role in time for the annual fall disease season, so to speak. Flu season comes at that time. There's a potential that COVID can be a heavier workload in the fall. And so that's one of the reasons that he made the decision to leave in July instead of waiting until October.

On finding a new health officer after Miller's departure on July 10 

We have already started a recruitment process. The recruitment has not been posted yet, but we're developing the documents and the information that we need to get out and we are looking at some contingency plans for a potential interim health officer to serve until we find a permanent one as well. 

On whether there were disagreements between Miller and the department as the county moved further into Stage Two

None whatsoever. There has been no disagreement.

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