COVID-19 Sansum Reports

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Coronavirus has brought unanticipated and signifi cant challenges to our families and our communities. How we respond to this pandemic may be the biggest story of our lives.

At VOICE Magazine we feel a responsibility to ensure we share the full picture with you. Our news team has published dozens of stories during March, April, May, and June. Much of this reporting goes beyond breaking news and refl ects the enterprising journalism we have consistently produced, going back 27 years. We dive deep in our reporting, delivering answers to questions both asked and anticipated.

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“Wearing masks in particular decreases the chance of transmission.” — Kurt N. Ransohoff

Dear Sansum Patients,

As the situation with COVID-19 continues to evolve, we are committed to keeping you and our community as informed as possible. Th e more we know about this disease, the safer we will be during this pandemic.

I thought I would share with you data from the COVID-19 testing we do of our patients. I know that you have seen national, statewide and county-level data. I thought sharing data from our own testing may make what is happening locally more real and meaningful. We have been testing since early March. We have been consistent in the group of patients we test: ambulatory patients in southern Santa Barbara County. When we say “ambulatory patients” we mean patients out in the community and not those who are hospitalized. Labs have larger data sets, but they tend to have some confounding populations, for instance one week they may test nursing home patients and the next week only test ambulatory patients. So, though our data set is not huge, it is large enough to see trends and the

COVID-19 Update from Cottage Health – June 25, 2020 Below is a status update as of June 25, 2020.

• Cottage Health is caring for a total of 283 patients across all campuses. • 226 are acute care patients; 147 acute care beds remain available. • In surge planning, capacity is identifi ed for adding 270 acute care beds. • Of the 226 acute care patients, 11 patients are on ventilators. 73 ventilators remain available (adult, pediatric and neonatal ventilators). • Of the 226 acute care patients, 14 are in isolation with COVID19 symptoms; 13 are confi rmed

COVID-19 positive. • Of the 14 patients in isolation, 7 patients are in critical care.

• From June 8-14:

2,274 COVID-19 laboratory tests were collected by Cottage Health. Results: 66 positive, 2,208 negative

• From June 15-21:

2,673 COVID-19 laboratory tests were collected by Cottage Health. Results: 80 positive, 2,037 negative, 556 pending consistency of the tested population is helpful to see trouble fading or coming.

Th e following chart shows all of the COVID-19 tests performed at Sansum Clinic week by week. Th e number that were positive is indicated in red at the top of the blue bars, and the percentage of positive tests is shown with the orange line. You can see the high percentage of positive cases early, when we only had capacity to test very ill people. Th en you can see the fall-off in the percentage of positive cases, despite testing more people during the “lockdown,” and now the increase in the percent of positive cases with the return to more normal levels of activity. You can see in the last two weeks, the number tested is fairly constant, but the rate of positives has doubled in a week and gone up by multiples of that in the last 3 weeks. Hospitalizations locally have increased as well, though typically with this illness the hospitalizations come aft er people have been infected for a week or more – put another way, hospitalizations lag the positive tests on ambulatory patients. Th e recent trend is very concerning for all of us, as these results are refl ective of people just walking around in our community, just like most of us reading this. Half way through this current week, we can see that next week’s report will likely look worse than that shown here. So, it is not likely a self-correcting blip. It is a trend and we need to acknowledge that shutting down again is seemingly not in the cards, and instead we need to do what we can to reverse this trend. We need to do things diff erently about mask wearing and social distancing.

Before the uptick, we thought the prevalence of active infections was about 1% of the population. It is likely higher than that now. Another way of illustrating this: if you were to attend an event with 100 people several weeks ago, when rate of infections was 1%, it was likely that 1 of the 100 people was infected. If you were to attend the same event now, it is likely more than 1 would have the illness.

From what we see in the news, at our parks and beaches, or downtown, it doesn’t appear that the public is ready to be on lockdown like we were before the reopening began. As we begin slowly returning to everyday activities like going to local restaurants or returning to the gym, many people seem to have thought that a loosening of restrictions meant there was no need to do the things that decrease transmission; some relaxed on wearing masks, social distancing and hand washing. All are important in stopping or slowing transmission.

Wearing masks in particular decreases the chance of transmission.

We know the histories of the people testing positive and in many instances they were exposed while out in the community not wearing masks and being around others not wearing masks, and then rapid spread occurred when they returned to their family environment, impacting people of all ages. To further reinforce the importance of mask wearing, we also know of instances in which people were exposed to COVID-19, but since all parties were wearing a mask, the infection did not spread. Since mask-wearing protects the people with whom you interact, if everyone adheres to the mask-wearing ordinance, we can all enjoy a little bit more freedom. I have heard mask-wearing referred to as the ultimate act of kindness and compassion for others.

I thought I’d share the age and gender breakdown for those who tested positive through our testing site. Th is data comes very close to the overall California data. Since this is a relatively small sample we don’t want to draw too many conclusions, but it is interesting to see that about one-third of the cases are under the age of 30.

According to a June 8 New York Times article, many epidemiologists are already comfortable going to the doctor or socializing with small groups outside, despite the coronavirus. But unless there’s an eff ective vaccine or treatment fi rst, it will be more than a year before many of these scientists say they will be willing to go to concerts, sporting events or other large gatherings. Th e following chart shows, by percent, when 511 epidemiologists expect to do some everyday activities again. As a group, they may be more strict than most of us, but it is interesting to consider these choices that we all will have to make until there is an eff ective vaccine.

While we are seeing an uptick in cases, we are also gaining a better understanding of this coronavirus and how to protect our

communities until there is a vaccine widely available. If there is one thing we hope people will acknowledge, it is that COVID-19 is in our community and if we are out and about, it is up to all of us to do our part to protect ourselves and each other. Wearing masks and social distancing are the most eff ective ways we can prevent the spread of infection as we go about our daily lives.

I want to be clear that we think people should not defer their healthcare out of fear of coming to Sansum Clinic or our local hospitals or to the other healthcare providers following the rules set up to protect all of us. Similarly, there are businesses doing a good job of protecting their workers and their customers. We just need to be sure we all do our part to change the trend we are seeing in the data above so that it does not continue.

Your health matters to us. Please stay safe. We are here for you – and we are smiling under our masks.

Sincerely,

Kurt N. Ransohoff , MD, FACP CEO and Chief Medical Offi cer