SLO County’s irresponsible coronavirus plan

March 13, 2020

Director Penny Borenstein

OPINION by NICK JENKINS

I watched today’s San Luis Obispo County Health Department briefing with dismay. Director Penny Borenstein is leading this county down a dangerous path. She used the words, “I am going out on a limb,” regarding not closing schools down. Indeed she is. But, she is bringing all of us out on that limb with her.

Director Borenstein is using flawed logic in her assessments and is proving that she has a poor understanding of both epidemiology and statistics.

Director Borenstein is recommending schools stay open because global data about infection rates in children indicates that they account for only 2 percent of infections and exhibit mild symptoms, thus the risk to the children is low. However, children should be considered the most likely vector for the disease.

Because children exhibit the mildest symptoms from Covid-19 infection, and because testing resources are scarce and thus being allocated based on severity of symptoms and risk factors, children are the least likely to be tested. This is what is accounting for the skew in data towards low rates of infection. Since there is no endemic immunity to this disease, children are being infected with at least the same frequency as the rest of the population.

Furthermore, since children often do not practice the hygiene and social distancing habits being recommended, they are perhaps even more likely to become infected. Thus, because they exhibit the mildest symptoms, are the least likely to be tested, and practice the poorest hygiene, they have the highest likelihood of carrying undetected infection and spreading it both within the schools and within their homes. Any epidemiologist will tell you that for precisely these reasons children are like little viral reactors and a common disease vector.

Additionally, to be making the claim that we have no cases of Covid-19 in SLO County, making the risk low, and then using this as additional justification for keeping schools open is also flawed logic. To date, the County has only conducted 37 Covid-19 tests within a County whose population is over 234,000. This represents a sample size of  0.01%. To make any conclusions based on a sample size this small, especially when a large percentage of people with symptoms which do not conform to present testing criteria are being excluded from testing, is highly irresponsible.

The policies Director Borenstein has recommended, and by which the county, school districts, and colleges are basing their decisions, are highly flawed and setting this county up for a tsunami of patients at local hospitals. Our healthcare network will become quickly overwhelmed if we continue down this path.

I must recommend that the county replace Director Borenstein with a properly qualified incident commander to take over the county’s planning and response to this developing situation.

All resources should be devoted to limiting the spread of the virus by taking early and aggressive measures to restrict public movement and congregation, increasing the county’s testing capacity to allow for screening rather than simply testing of seriously/critically ill patients, and developing and supplying excess treatment capacity within the local community (perhaps a triage center at Camp San Luis Obispo).


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CDW

Folks,


I AGREE with Mr. Nick Jenkins!


It is perilous, even deadly, to believe that those in positions of responsibility will, in fact, act responsibly.


We are seeing the breathtaking ignorance of Public Health Director Penny Borenstein on full display, and her poor judgement will affect us all and cost human lives. The recent announcement to close the schools is too little, too late, and they never should have opened up after winter break.


History is ripe with examples that clearly indicate that the earlier the response, the more effective the measure, so NO PARENT should be duped into sending their student to a public school classroom unless and until this pandemic breaks. The mindless idiots who run our public schools just want the kids there because that’s how they collect ADA reimbursement from the state.


Your kid’s health was literally used as fodder for some school district bureaucrat to collect money.


CentralcoastRN

Dr. Borenstein is in a “no-win” situation here. She based her position on current data, and even if you poll the Public, there are mixed opinions. I would not want to be her right now.


A public health officer consults with the California Department of Public health, other County Public Health officers, Centers For Disease control, and reads every piece of literature available. She made her decision based on a meeting of Public Health experts. I attached links, and her advice on in sync with expert recommendations.


Aside from statistics, (which can be debated for various reasons) there are pragmatic issues. How many health care workers are parents? How can healthcare workers report to work if they have kids at home? Our SLO community has trouble recruiting and retaining nurses due to cost of living. Very few nurses have the specialized skill set to work in an ICU/CCU. So if there is an uptick of cases (which I have NO doubt will occur) who will take care of all of SLO county’s critically ill?


What about the Costco workers, grocery store employees, public servants? Should they bring their kids to work?


Closing schools prematurely… letters that went out have varied. Based upon CDC recommendations, kids will probably be out closer to 4-6 weeks. Several districts are going to re-assess closures at the end of March, but cases will occur, and THEN they really should be closed. That means we shuttered schools POSSIBLY UNNECESSARILY for 2 weeks.


Calling for a National Emergency was necessary to free up $$ for services. Possibly National Guard activation too to stop people from hurting each other due to panic.


I’m not in the mood for debate, and there is MUCH to debate. I don’t think we should be calling for her resignation because she is doing her job. The SLO health department is literally standing outside and doing “drive by swabbings” of persons at high risk for Coronavirus. They are testing. They are surveilling. They are working with local community medical providers. They are making sure people aren’t being tested outside of criterion so that we have swab for people who REALLY need tested.


Agree, don’t agree.. I don’t care. I want people safe. I want common sense to rule the day.


Ricky2

The problem is precisely that Penny Borenstein is NOT exhibiting either common sense or good epidemiological management. She’s weeks behind what the governor is attempting to do. Why is that if she’s so on top of things? She’s weeks behind what public health officers to our near north (Bay Area) are doing. Why is that? We know, despite lack of testing, this disease is here right now. Already. Fiddling while Rome burns? I think the author makes very strong points, that Borenstein’s leadership is lacking. Thank goodness the school districts ignored her and shut down anyway. As for hand wringing about alleged hardship on parents if schools close, I’d rather have my kids healthy and staying at home, even on their own, than going to school till they’re infected with a fatal illness just so an epidemiological bumpkin can prove some point.


RalphKane

Where does she plan to quarantine the coronavirus homeless? After somehow contacting and testing them…


Bring in FEMA for a quarantine camp?


CentralcoastRN

Camp Roberts and Camp SLO could absolutely be utilized for quarantine. The local National Guard and truck in supplies to make both sites acceptable staging areas to quarantine. Any I’ll persona needing hospitalization can be transported to more appropriate medical facilities.


Laughlines

There really aren’t that many suitable facilities at either location. Camp SLO only has about four barracks buildings on the main post, with a few more badly dilapidated buildings over by CCC. The CSLO chow hall seats about 150 or so, because one side of it is restricted to the Grizzly Academy. So you’ve got hundreds of kids at CSLO who’d be sharing the chow hall. At Camp Roberts there are more barracks, but they’re all one-half to almost one mile from the chow hall, which can seat 200-350 at a time. Neither post has a hospital. Camp Roberts has the SRP site where troops get checked out prior to deployment, but it’s old and severely limited. The logistics of housing, feeding and treating patients at these posts would be a great deal more complex than I think you realize. I’m not trying to be dismissive of your good intentions, but having spent the last 14 years in the Cal Guard, I can tell you that both installations are severely deficient for what you propose. The big active duty installations like Edwards AFB have the infrastructure to accommodate something like that, our ancient and, frankly, historically neglected Cal Guard installations just do not. Respect.


bookbottled

I think at this point we’re talking about tents, not buildings…and for triage, not treatment.


CentralcoastRN

I hear you. They are run down. I mention these two because SLO County has used these sites and Rancho El Chorro for disaster drills. I think with Red Cross and recently freed up funding, that supplies could be brought in to house people and test people. Anyone who shows symptoms would definitely need to be transported to a hospital. It will be interesting to see what happens.


We now have a confirmed case. https://www.google.com/amp/s/amp.sanluisobispo.com/news/health-and-medicine/article241148456.html


Myself

Setting up for something like this should not be a big problem, the Feds have a list of contractors for the fires, the list is just about endless, food units, sleeping trailers, big tents,latrines,logistics, food trailers,potable water trucks, laundry units you name it its there, how do you think we function on these large fires, its a city with in a city, a couple days and its set up, the red tape to get it would be the biggest delay, the equipment is there it would be getting the Feds to help out.