Health officer confident Sonoma County can care for sick

With large portions of California under new strict stay-home orders because of a worrisome rise in COVID-19 infections and hospitalizations, Sonoma County’s health officer Wednesday said she so far felt confident local hospitals could care for the rising number of people seriously sick with the coronavirus.

Health Officer Dr. Sundari Mase said she did not believe it was crucial to immediately shut down more business activity and order people to stay home, though those restrictions are highly likely to come from the state in the coming weeks. Mase said local hospital officials have reassured her they are not close to being overwhelmed by patients, unlike other regions where demand is outstripping the availability of hospital beds.

“What we’re most worried about is exceeding the health care system, the ability to take care of our community,” Mase said. “And we are not at this time seeing large, large increases in hospitalizations. We do have some increase in hospitalizations, but we’ve got a little bit of leeway yet.”

There were 43 patients with COVID-19 in local hospitals as of Tuesday, the most recent data available, including 14 people being cared for in intensive care units, according to Mase.

This month, the county has registered its two highest one-day totals of new COVID-19 cases since the first cases was detected in March, with 280 new positive tests Tuesday and 343 new cases on Dec. 1. So far, 162 people have died from complications of the disease since March, including the two latest fatalities the county reported late Wednesday. The victims were a man and a woman both over age 64. He died at a local hospital, while she died at an area residential care home.

Hospital capacity has become a key trigger in California for reinstating painful pandemic stay-home orders that have taken a dramatic economic toll. The state has ordered entire regions to restrict business activity, such as ending restaurant dining and limiting the number of people in stores, when ICU bed availability in those regions has dropped below 15%.

In the greater Sacramento region, 13 counties Wednesday were the latest to be warned by California health officials that they would soon be placed under the state’s most restrictive rules limiting business and public activity because ICU bed capacity for the area had dropped.

Sonoma County’s ICU bed capacity was at 11.6% Wednesday, but the Bay Area region was at 20.9%, making an immediate stay-home order voluntary.

Sonoma County didn’t join with five other Bay Area counties that preemptively adopted new restrictions just days after Gov. Gavin Newsom’s Dec. 3 rollout of the new plan to slow the spread of the virus, even before the region's collective ICU bed availability had dropped down to the state's 15% threshold.

Mase said that though the county’s ICU bed capacity was well below the state’s bench mark, it was just one metric she is tracking to determine how best to protect the public. She also is considering case rates, hospitalizations, what contact tracers have learned about local transmission trends and also the economic impact, “what it would mean in terms of the shutdown to our business community.”

Supervisor Lynda Hopkins said she wholly supported Mase’s decision to focus on a local analysis of what might be effective based on local data, noting that some of the state’s bench marks may not be the most effective indicators for all areas.

“One of the things I find compelling is the way she’s analyzed where the cases are occurring,” Hopkins said. “What we’re seeing in trends is an increase in home gatherings related to transmissions. So the shelter-in-place-order really doesn’t target that.”

Mase said she is evaluating whether to wait for the region to dip below the state’s bench mark or preemptively restrict business activity and public life.

The initial stay-home order in March was highly effective in slowing the spread of the coronavirus because "having that stay-at-home order limits the number of interactions people have, and that's why it's effective,” Mase said. She said it is an important tool and one she won’t hesitate to use should the data suggest it’s needed to initiate restrictions before the state does.

“I understand why the state thinks it could be very effective in really shutting down transmission of COVID-19,” Mase said. “We are simply tracking our numbers to see when it's appropriate for our own community in our county to go in that direction.”

Mase said she’s in contact with local hospital officials and has heard from officials saying they have the ability to expand the number of intensive care beds.

Dr. Chad Krilich, chief medical officer at Providence St. Joseph Health, which runs the county’s largest medical center Santa Rosa Memorial Hospital as well as Petaluma Valley Hospital, said he trusts Mase’s decision-making process.

So far, his hospitals have not been overwhelmed with patients and have been able to handle the challenges brought on by the pandemic.

Wednesday morning, three of the 22 patients being cared for in the Santa Rosa hospital’s ICU had been diagnosed with COVID-19 and one patient with COVID-19 was in the ICU in Petaluma.

Memorial Hospital has 26 licensed ICU beds, and that number could jump to as many as 39 ICU beds in the case of a surge, Krilich said. Petaluma Valley Hospital has nine ICU beds and could increase that number to 13.

“Today we’re in a place where we’re able to manage to our current capacity and our current volume,” Krilich said.

The hospitals served 49 patients with COVID-19 during the month of August, a peak number. The hospitals cared for 43 patients with COVID-19 throughout October and 41 in November, according to Krilich.

So far in December, the hospital has cared for 12 people with COVID-19, similar to what they had experienced in the last several months.

Krilich said that he cannot predict what the rest of the month will bring, and they are constantly reviewing conditions in order to determine whether they might need to increase capacity.

“I trust her decision-making process — I feel confident in Dr. Mase,” Krilich said.

Supervisor James Gore said he was aware that the blunt tool of a new stay-home order may be one of the last options left for the state as it faces a troubling rise in cases.

Gore said he believed Mase was striking the right balance when considering whether to preempt the state and restrict activities now. The stay-home order in March came with federal programs to assist businesses and the unemployed, whereas those programs by now are exhausted or expired.

Still, Gore said he did not believe Mase was being overly pressured by economic concerns. Gore said he and other board members have reaffirmed their trust that she will do what she must to protect the health of the community.

“The goal is public health and the right level of economic activity,” Gore said. “I still have confidence we’re doing the right thing in the right timeline.”

You can reach Staff Writer Julie Johnson at 707-521-5220 or julie.johnson@pressdemocrat.com. On Twitter @jjpressdem.