County remains on worst tier in new color code despite progress
Foster Farms shuts down for week of testing, cleaning
Merced County is stuck in purple for the time being.
Governor Gavin Newsom’s new COVID-19 reopening rules establish a four-tier, color-coded system that counties will move through based on their number of cases and the percentage of positive tests. The new system took effect on Aug. 31.
“We’re in the purple tier,” explained Dr. Kristynn Sullivan, Merced County’s supervising epidemiologist. “We have to have metrics to bring us into the next tier for two weeks before we can actually move to the next tier. Currently, Merced County is at 296 cases per 100,000 residents. The positivity rate is improving. We’re now at 9.8 percent, which is still above the threshold of 8 percent, but we are getting there.
“We need to get to 8 percent and our case rate below 100 per 100,000 for two weeks, and once we do that, we move into the next tier, which is red. Once we move to red, we have to be in red for two weeks, and then we can reopen the schools.
On a positive note, Dr. Sullivan pointed to “dramatic improvement” in data over the last few weeks.
“The number of cases has dropped quite a bit, according to data reported on Aug. 27 for the 14 days prior,” she said. “Two hundred and ninety six cases per 100,000 residents is still not good, and we’re still in the Purple Tier. But we’ve made a dramatic improvement, although we’ve still got a way to go.
“I think we are seeing a decrease of disease in the community so it’s going to be really important that people keep masking and practicing social distancing and all those things because we’re heading into Labor Day weekend and we’re heading into flu season. We’re making progress, and we don’t want to see a setback as we get closer to flu season.
“Fatalities from COVID have not improved at the same rate as our cases have.
“Fatalities lag the cases, because people are sick for awhile, then hospitalized for awhile, and then they pass.
“Typically, we first see a change in case numbers, and then we see a change in hospitalizations, and then the last thing we see is the change in fatalities.
“We saw the spike in cases in late June to early July, and then we saw the spike in hospitalizations in mid-July, and the fatalities started to pick up in mid to late July into August.
“In June, we had five fatalities; in July, we had 44 fatalities; in August, we had 61 fatalities but we may be reporting more since August just ended.
“The next thing we expect to see now is our fatalities starting to go down.
“It’s so important to keep our case count down because that’s how we prevent fatalities. A lot of people are asymptomatic or have minor symptoms but they spread it to people who then have really severe disease or pass, and by the time they pass it, there’s nothing we can do to prevent it; that ball is rolling. The only way to prevent fatalities is keep our case count low by social distancing, wearing your mask, limiting the number of people that you see and the size of gatherings, even in families, washing hands, and not going anywhere when you’re sick. But again, because so many people are asymptomatic, it’s also important to maintain social distancing even when you’re feeling okay.
“On Sept. 1, the total number of cases was 8,081, an increase of 49 from the day before. Deaths from COVID were 118; 51 were females and 67 were males. Men seem more prone to get more severe disease which is not surprising because for all lung diseases, men are more likely to have severe disease and die.
“Currently, there are 26 COVID patients in the hospital in Merced, and 71 hospitalized out of county, so the total number of residents hospitalized within the county or elsewhere is 97.
“Currently, 16.7 percent of our ICU beds are available; the state wants to see at least 20 percent of the ICU available.
“The percentage of ventilators we have available is 40 percent. The state wants to see more than 50 percent of routine ventilators available. We’ve received some ventilator replacements through grants.”
Foster Farms outbreak
The Foster Farms poultry operation in Livingston experienced an alarming spread of COVID-19 among its workers during the past two months.
Dr. Sullivan told the Times, “On June 29, the Foster Farms outbreak was declared officially. There have been eight fatalities, and 392 employees tested positive. A lot of other plants have also experienced outbreaks because when people are close together inside, that can increase risk.
“Dr. Sandoval of the Merced County Public Health Department ordered the closure of Foster Farms to help mitigate the outbreak. It was closed on Sept. 1 at the end of the day shift, between 8 p.m. and midnight.
“Foster Farms will be closed to do testing of all the employees and clean the facilities. They will be doing two rounds of testing on all their employees and it will take time to get the results back, so the facility will be closed for six days.”
Recently, the county was behind on determining exposure type because of the number of cases it was getting. It was taking longer and longer to contact everyone and perform the first case interview, which is where the contact tracer asks the questions that determine who has been exposed through community spread.
Dr. Sullivan reported, “Now, contact tracing is going really well. We’ve been working through our backlog. We had over 2,000 individuals that we hadn’t been able to reach out to yet to do contact tracing, and we’ve gotten that number down to 766.
“We have more contact tracers. At the height of our backlog, we were in the middle of training people. We’ve been able to get eight case investigators from the state to help us, and then we’ve trained six additional part-time investigators through the grant, and they are working already, and we’re in the process of training one more.
“We also have our own 25 contact tracers that are made up of Public Health Department staff as well as others from county departments reassigned to Public Health.
“We should be getting two more from the state so there will be a total of 42 contact tracers.
“We are talking to other agencies about contact tracing and exploring different options.”
The Merced County Department of Public Health led a series of meetings with the State’s COVID-19 Response Unified Support Team on Aug. 10 and 11. Public Health was joined by other County agencies, partnering agencies, and community partners.
Dr. Sullivan explained, “As a result of the site visit, there was discussion about long-term COVID disease management. It looks like it’s here to stay. The hope is that the vaccine will be the kind that you only need once and then you’re protected, but it might be like the flu vaccine that you need to get once a year.
“We requested support from the state on enforcement as to compliance issues when people or businesses aren’t following the rules. What can be done depends on the sector and whether they have licensing.
“In terms of gatherings, there is less enforcement ability so we have to rely on social and community responsibility to do the right thing and not have big parties.
“We also talked about the partnerships with health care providers, schools and others, and we talked about developing strategies and keeping everyone on the same page. The state was happy about the partnerships we have.
“Rapid testing was also discussed. We hope to increase the availability of point of care testing which is when you get tested and get the results within 45 minutes. It exists, but those tests are limited. They’re only in a handful of places. The hope of those tests coming to Merced County is what the state was discussing.
“There was guidance on alternative safe spaces for children — learning pods — which allow small groups of children that are kept together and not mixed.
“We are exploring learning pods at facilities in the county, such as schools and churches, and the idea is to be able to bring in vulnerable children who may not have supervision, reliable Internet, reliable food, or anyone to help them with use of the Internet. People for whom Distance Learning is not possible, like younger children whose parents are Essential Workers, could come into these spaces.”
“Currently, 71 percent of Merced County COVID cases are among Hispanics,” Dr. Sullivan said. “That percentage is so high because a lot of our essential workers, particularly in ag settings, are Hispanic, and the disease spreads where people are close together in farm and plant settings, and where families have multi-generational housing. With a large family group living together, a younger family member may bring COVID home and the rest of the family gets it. The size of the home impacts the spread of COVID, as does the poverty level because of the inability of the extended family to have separate homes.”