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May 4, 2020 Health Officer Statement

Health Officer Updates Health Officer Statements

Please read or reread my statements below from 4/13/20, 3/23/20, 3/16/20, 3/10/20, 3/5/20, and 2/27/20 to get a better understanding of where we find ourselves today and actions you can take to protect yourselves and your family.  

Without doubt, we will get through this, but it will remain difficult for all of us for a long time.  You must prepare yourselves for the possibility, that as restrictions loosen now, that they may need to be reinstituted at a later date.  The new Order, effective today, is being extended for four weeks.  It is being extended, in its current form, reluctantly. It is clear San Mateo County is moving into the next stage of this crisis and that we will require a different framework to balance many competing interests. An Order based on a framework of essential and non-essential business categories was absolutely necessary and appropriate in the earliest stages of this crisis. I am very grateful that the State issued an Order based on this framework several days after we in the Bay Area did. If we continue to have the public’s cooperation, I have great hope that the indicators we are monitoring will continue to improve and this Order can be revised before May 31, 2020 in a manner that focuses more on behavior (social distancing, face masks, etc.) and risk of disease transmission in contrast to categories of businesses (essential vs. non-essential). However, for me to issue such an Order, the State first needs to revise its Order to allow it. While, the Governor has indicated that the State will do so in weeks, not months, the actual date is uncertain. Modification by the State of its Order is a pre-requisite for such a change here.

We are entering the period of trade-offs as mentioned in my last statement.  This period will require gut-wrenching decisions, both by policy makers as well as individuals and families, as we slowly reopen certain segments of society.  This is a balancing act of the most unprecedented kind.  You will have to make your own decisions as to the level of risk you and your family are willing to take on as the restrictions loosen.  And your decisions are not yours alone as they will affect others in unpredictable ways.  The decisions I need to make about the slow reopening are based on public health considerations balanced by many other competing interests.  These decisions allow activities that, while allowing the spread of the virus, are specifically designed to slow spread in the population and therefore reduce the chance of an uncontrollable and unmanageable surge.  The surge that you have seen in other places in the US and world, but, thankfully, have not seen here, was probably due to the early and aggressive action here.  

These decisions about restrictions are not designed to eliminate all transmission.  People at all levels of risk should know, if they venture out, and interact with others outside of their households, that they have a chance of getting infected and passing the virus on to their household members.  For example, the loosening of restrictions on summertime educational and programmed activities of children for all ages in small groups is one of the loosened restrictions in the current Order.  This reduces the chance of spread in the children who participate by allowing these activities only in small stable cohorts of children, but it does not eliminate the spread.  Children who participate in these activities have a higher chance of getting infected and taking it back into their families than those who are never let out of their house.  The balance here is the developmental needs of children, who may have lifelong adverse ramifications if these needs are not met, and the risk of transmission to high risk family members, which may or may not result in serious illness or death.  Letting children interact more, even in small stable cohorts, must also take into account the needs and risks of the adults who staff these summertime activities.

These reopening decisions are not done without many other considerations.  They are coupled with an aggressive containment strategy, a much more widespread testing strategy and hardening of the healthcare system with additional equipment, PPE and surge capacity.  The testing and containment strategy work in concert to try to rapidly identify cases and contacts to cases, investigate those cases and contacts, and isolate the cases and quarantine the contacts with close monitoring.  A large public workforce is being mobilized to undertake these endeavors. 

The next step in reopening businesses will probably be to allow those, regardless of what the business does, that can comply with and implement social distancing protocols to reopen under those procedural constraints, somewhat similar to what you now observe in grocery and other stores that are open.  These businesses should now begin thinking about how this would apply to their operations and what modifications need to be made.

Unfortunately, deaths due to the virus will continue at a significant level.  People at high risk should continue to take all precautions to avoid infection.

As always, special thanks to our first responders, law enforcement, healthcare, public health, grocery store and other essential workers who are keeping us healthy, safe and fed during this crisis.