Category Archives: No Vaccine

SMC FREE COVID-19 Testing sites expanded.

By Michael G. Stogner

Remember No Cure, No Treatment, No Vaccine

San Mateo County Expands COVID-19 Testing Sites to Include Daly City & East Palo Alto

The County of San Mateo is expanding the number of COVID-19 testing sites operated by Verily to include locations in East Palo Alto and Daly City on a rotating schedule. Verily will continue to operate its San Mateo County Event Center site on Mondays and Tuesdays, while adding the old Serramonte High School campus in Daly City on Wednesdays and Thursdays and the YMCA in East Palo Alto on Fridays and Saturdays. 

The new sites and schedule will begin operating on Monday, May 18. Testing is free and available without restriction to anyone, though an appointment is required in advance. 

To make an appointment, residents can visit Project Baseline’s website at https://bit.ly/2xk73OL. |
After being tested, residents will receive results and other information by email. San Mateo County Health will reach out to residents who test positive. The expanding of testing sites is part of the County’s strategy to bring more resources to more locations. The new sites, in the northern and southern parts of the county, will make it easier for residents to access free testing. 

The County is also planning to add a location on the Coastside. “We want everyone in San Mateo County who wants a COVID-19 test to be able to get one,” said County Manager Mike Callagy. “Testing is key to understanding the spread of the disease and to further opening our economy. We want to make sure that there are no barriers, including geography, that might prevent someone from seeking a test.” 

To meet State guidelines, San Mateo County needs to administer about 1,200 tests per day, through hospitals, private testing companies, and the free program available through Verily. 

The County can help residents who lack transportation to a test site. After being screened at the Project Baseline website and receiving an appointment time, individuals with no other means to reach the testing site can call (650) 779-9375 Monday through Friday, 9 AM to 4 PM to arrange free transportation. 

TESTING LOCATIONS & SCHEDULE 
Mondays & Tuesdays – San Mateo San Mateo County Event Center 1346 Saratoga Drive, San Mateo 9:00 AM – 4:00 PM 
Wednesdays & Thursdays – Daly City Serramonte High School 699 Serramonte Boulevard, Daly City 9:00 AM – 4:00 PM 
Fridays and Saturdays – East Palo Alto Lewis and Joan Platt East Palo Alto Family YMCA 550 Bell Street, East Palo Alto 9:00 AM – 4:00 PM Sundays Testing locations closed

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Governor Newsom: Don’t do it.

By. Michael G. Stogner

Governor Gavin Newsom, Now is not the time to grant this immunity to Businesses. What is more important is track down all the people who came into contact with the Prominent Doctor who flew from New York to California with his daughter to be admitted into Silverado Beverley Place where he made contact March 19, 2020 with Brittany Bruner-Ringo R.I.P. The 32-year-old nurse stopped breathing April 20, 2020 32 days later.

Stay the course Protect the Residents of California.

April 9, 2020

Governor Gavin Newsom State of California
State Capitol Sacramento, CA 95814

RE: Request for Executive Order Related to Liability Protection

Dear Governor Newsom:

California’s heath care workers and those serving in supporting roles are on the front lines of a crisis unlike any our state has ever faced. Every day, they are racing against time to prepare to treat and care for all in need. Sadly, in the coming days and weeks, they will face wrenching, life-threatening decisions in managing scarce resources amid arduous conditions.

The COVID-19 pandemic is projected to affect so many people that health care providers will be forced to allocate scarce medical resources among too many patients who need them.

Given this stark reality, we must have one goal: to save as many lives as possible. With that goal, we request the Governor issue an Executive Order including the following language, which will provide a level of liability protection adequate for care providers to save Californians’ lives:

During the current COVID-19 state of emergency, health care facilities, residential care facilities, senior living providers, health care service plans, physicians and other health care professionals, and all employees thereof, are hereby requested to render services to Californians. In recognition of these extraordinary and unprecedented circumstances, such facilities, plans, physicians, professionals, and employees shall be immune from any administrative sanction or criminal or civil liability or claim for any injury, death, or loss alleged to have resulted from any act, omission, or decision made related to providing or arranging services, including but not limited to acts, omissions, or decisions undertaken because of a lack of resources, absent proof by no less than clear and convincing evidence of willful misconduct as measured by a standard of care that incorporates all of the circumstances of the emergency. All state statutes and regulations are hereby waived to the extent necessary to achieve this immunity. The unenforceability or invalidity of any part of this paragraph shall not have an impact on the enforceability or validity of any other part of this paragraph.

Governor Gavin Newsom
April 9, 2020 Page | 2

Effectively minimizing death and serious illness among the population as a whole entails distributing finite resources to those who have the greatest opportunity to benefit, thereby maximizing appropriate care for the greatest number of patients likely to benefit from these resources.

While the state is creating a framework to guide these difficult decisions, providers need assurance they will not later be judged or sued when abiding by this framework, or when making related care decisions based on their best judgment and determination at the time. In this time of crisis, care providers must be able to observe, evaluate, and respond to rapidly-changing conditions and events; the prospect of being subjected to future lawsuits would burden and slow these decisions, threatening greater loss of life throughout California. Basic ethical principles governing crisis triage decisions include accountability—not only for health care providers called upon to make such decisions, but also for the government in supporting the processes to make these decisions and protecting the providers who make them.

When providers approach their work in the coming weeks and months, we must give them the support they need to make the best possible decisions, including protections from future legal action, as long as that liability protection does not excuse willful misconduct. To help understand the magnitude of the situation, here are several examples of the kinds of situations our health care system will face:

  1. Thirty patients require ventilators, but a hospital has only 25 ventilators.
  2. A hospital has too few pulmonologists, so obstetricians agree to care for respiratory patients.
  3. A hospital postpones a patient’s elective surgery to accommodate a surge of COVID-19 patients,thus delaying care to the surgery patient.
  4. A patient no longer needs acute care, and is moved to a skilled nursing facility, although thepatient preferred to stay at the acute care facility and did not provide consent to be transferred.
  5. An assisted living facility resident contracts COVID-19 from an employee, even though thefacility used proper screening techniques when employees arrived at work.
  6. An assisted living facility suspends group dining and activities as well as restricting visitors, dueto social distancing requirements, and is sued for causing depression by isolating residents intheir rooms.
  7. A skilled nursing facility is sued for allegedly deficient care rendered by staff who had notreceived full training s a result of staffing shortages.
  8. A facility cannot access N-95 masks, and health care providers are asked to deliver care usingsurgical masks.
  9. A skilled nursing facility admits an asymptomatic patient in accordance with CaliforniaDepartment of Public Health and Centers for Disease Control and Prevention guidelines. The patient later is determined to be COVID-19-positive, and the facility must manage a potential outbreak without full staff and without sufficient personal protective equipment.

In addition to the executive order language requested above, when considering the issue of liability protection, provisions of Government Code Section 8659 should be explicitly invoked; however these provisions are too limited for the unprecedented pandemic we are facing, which is why even broader liability protections is needed. Government Code Section 8659 does not help skilled nursing or assisted living facilities or health plans, and omits many types of health care workers (such as physician assistants, mental health providers, custodial staff, and managers). In addition, this statute does not provide protection for a willful act or willful omission, such as considered decisions to ration ventilators,

Governor Gavin Newsom
April 9, 2020 Page | 3

stop elective procedures, transfer a patient to an alternate care center, or assign an obstetrician to care for a pulmonary patient which has been the advice of the state or the standard or care in a crisis.

As our care providers make these difficult decisions, they need to know they will not be prosecuted or persecuted. This request is made with the deep understanding that every care provider is doing all they can to protect all Californians during this unprecedented crisis.

Respectfully,

Carmela Coyle, President and CEO California Hospital Association

Craig Cornett, CEO/President
California Association of Health Facilities

Sally Michael, President & CEO California Assisted Living Association

Janus Norman, SVP, Government Relations California Medical Association

Charles Bacchi, President & CEO California Association of Health Plans

Jeannee Parker Martin, President & CEO LeadingAge Californa

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San Mateo County TESTING and Contact Tracing.

By Michael G, Stogner

Testing and Contact Tracing should be and should have been the Number One Priority of San Mateo County Supervisors.

When will San Mateo County have Testing for All Residents like L.A. County just announced?

Saving Lives, Shelter in Place, No Cure, No Treatment, No Vaccine, Critical Shortages of all PPE, are all important topics, none are more important than Testing and Contact Tracing.

San Mateo County has 771,000 residents, Since January 1, 2020 when BlueDot Inc. first warned of the Virus a total of 13,004 Residents have been tested. That’s 4 months to test 13,004. SMC has No Idea how many residents are infected as of today, How could they?

State officials said they are testing more than 20,000 people a day — a third of the minimal daily tests needed to reopen. The State of California has 40,000,000 residents. You do the math

Los Angeles Mayor Eric Garcetti announced Wednesday that all county residents can now get free coronavirus testing at city-run sites. Until now, only residents with symptoms, as well as essential workers and those in institutional settings such as nursing homes, could be tested.

Stay at Home, Save Lives until Testing and Contact Tracing comes to San Mateo County.

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San Mateo County Parks Open Again, Why?

By Michael G. Stogner

Remember these Parks must be within 10 miles from your residence. Only 13,004 San Mateo County Residents have been tested for COVID-19 out of approximately 771,000. The State of California is testing 20, 000 residents per day out of 40,000,000. You do the Math.

Parks director Nicholas Calderon said the county — which closed 23 of its parks on March 27 in a bid to slow the spread of COVID-19 — is “eager to welcome visitors back” so they can “experience the physical and mental health benefits of being outdoors and on the trails.”

Why doesn’t San Mateo County focus on TESTING & Contact Tracing first?

Trails will reopen in 13 parks Monday, according to the San Mateo County Parks Department.

Certain restrictions, however, will still be in effect. Visitors will have to carry face coverings, maintain a buffer of six feet, avoid mingling with people they don’t live with, and hike single file on narrow paths.

“During this time, it’s critical that park users follow the new rules developed to prevent overcrowding, discourage gatherings and that support social distancing,” he said in a statement Tuesday. “Let’s work together to ensure that parks are safe environments for everyone.”

The announcement applies to the following trails and parks:

Edgewood Park, Huddart Park, Junipero Serra Park, Memorial Park, Mirada Surf West, Pescadero Creek Park, Pillar Point Bluff, Quarry Park, Ralston Bike Trail, Sam McDonald Park, San Bruno Mountain Park, San Pedro Valley Park, Wunderlich Park, The Crystal Springs Regional Trail also will reopen to foot traffic, and the Bay Trail will be accessible through the Coyote Point Recreation Area, though the surrounding park will remain off-limits.

All those areas will be open from 8 a.m. to 7 p.m. daily.

Visitors, however, shouldn’t expect business as usual. Common areas such as campgrounds, playgrounds and picnic areas will remain closed — as will some parking lots and restrooms. More detailed information on what is open at each particular park is available at the Parks Department website.

Conditions are a little different in San Mateo County, where coronavirus restrictions state residents are not allowed to travel more than 10 miles from their homes for outdoor recreation.

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SMC Health Officer Dr. Scott Morrow COVID-19 Update.

By Michael G. Stogner

Message from April 13, 2020

Please read or reread my statements below from 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.  

We continue to be in a very challenging situation.  This situation has impacted every aspect of our lives and will continue to do so for a long time.  There are several bits of good news.  By many accounts, there has been extraordinary adherence to the Shelter-in-Place (SIP) orders which were put into place here earlier than in other places in the country.  There is no perfect adherence, by any means, but it seems to be the major reason for lowering the rate of new infections to a stable level.  The adherence has been so good, in fact, the models we’re using to predict our future state don’t seem to be able to account for this fact.  It appears that we have flattened the curve, at least this first curve, for now.  I am hopeful we have avoided the catastrophe that New York and Italy experienced, for the time being.  Everyone who is cooperating with the orders and law enforcement and others who are enforcing the orders should be commended in the highest possible way.  Although it may not seem like it, you are doing your part, you are serving your community by limiting your contact with others.  Thank you.  And, as always, special thanks to our first responders, healthcare workers, and other essential workers who are keeping us safe and fed during this crisis.

TRADE OFFS. Without doubt, we will get through this.  But we need to be very deliberate about our next steps.  If we don’t take our next steps carefully, we will experience the worst of what this virus has to offer.  What we’re being faced with, in our immediate future, are trade-offs of the most significant kind.  We have to find a way to increase the immunity of the population (in public health terms, this is called “herd immunity”) slowly and methodically, while minimizing death, with equity in mind, while not overloading the healthcare system, and minimizing economic damage.  Many of these considerations work in opposite directions.  An effective vaccine or effective medical treatments would certainly make our path forward much easier, but neither of these seem to be available to us in the short or medium term.  There is no playbook for the decisions we face or the balance we should attempt to maintain between these competing interests.  Some very smart people have put forth some criteria that should be considered regarding how to slowly unwind the SIP orders and we are considering all of them now.  Most of these decisions have very limited underlying supporting data.  One thing I do know is that releasing the restrictions on movement and gatherings too soon, or in not an incremental enough way, will diminish the gains we’ve made and will unleash the very thing we are attempting to avoid.  Herd immunity is typically 70-80+/-% based on the characteristics of the disease.  So we have a long way to go.  There are no quick fixes.

DATA. There has been some concern expressed that we’re not being transparent enough with the data.  Everyone would like more data.  Well, I too would like more data.  There simply is not a lot of data either about the virus itself, how and why it spreads so easily, how and why it causes such devastating disease in some folks, or how it’s spreading here.  For those who are deeply steeped in working with data, as I and my staff are, you know that datasets have their own personalities, their own strengths and their own weaknesses.  You know that data can either lead you to an approximation of the truth, or data can mislead you and cause you to make incorrect conclusions and, therefore, take wrong actions.  The data we have is, simply, very limited.  This is based on the facts that many characteristics of the virus are unknown and that testing remains very constrained here.  This requires us to synthesize estimates from very different sources of data that may be more qualitative in nature.  For the data that is put up on our website, except for the hospital level data, which is mostly accurate, I tend to look at it skeptically, specifically the cases and the deaths, not because those aren’t accurate from what we know, but because they don’t reflect what’s actually going on very well.  People generally want data to be able to make informed decisions about lowering their risk.  The data we have, if it were to be presented to you on a more granular level, would be misleading, and I believe, downright deceptive.  This is what I think you need to know.  This virus appears to be wildly transmissible especially within households or congregate settings.  Your risk from contracting the infection from any human you encounter in San Mateo County and outside your immediate household continues to be substantial unless you take all the recommended actions to protect yourself.  I hesitate to give you the following numbers, because first of all they are a guess, and secondly because some will think they are too low to take action.  My best guess is that approximately 2-3% of the SMC population are currently infected or have recovered from the infection.  That’s around 15-25,000 people and they are all over the county and in every community.  I don’t believe this number is off by a factor of 10, but it could be off by a factor of 2 to 3.  Without the SIP, it could have well been over 50-75,000 by now, and that would have overwhelmed our healthcare system.  So if you want to get a sense of how many infected or recovered cases are around you, just multiply your city population by 2 or 3%.  My best guess on the number of people who are capable of transmitting the virus now is just under 1%, or approximately 5-7,000 people.  These numbers are likely to be more accurate than the numbers we are sharing on our website.  I know that sounds ridiculous, but these estimates are better than the direct counts that I can currently provide you.  That’s the status of our testing data at the moment.  I anticipate, and am hopeful, that our estimates will improve remarkably over time.

Scott Morrow, MD, MPH
San Mateo County Health Officer
April 13, 2020

Dr. Scott Morrow March 16, 2020 SIP Order

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