Sonoma County announces 2 new coronavirus cases as Mendocino, Lake and Napa counties plan shutdowns

Two more Sonoma County residents have contracted coronavirus, bringing the total known number of local cases to eight, as the scope of a strict Bay Area-wide shutdown expanded to cover Napa, Lake and Mendocino counties.

Mendocino County officials Wednesday confirmed the first case of COVID-19 had been detected there, triggering the public health officer to order residents to stay home and all but essential businesses to cease operations starting at 10 p.m. and lasting through April 7.

Similar community isolation orders go into effect in Lake County at 12:01 a.m. Thursday and 12:01 a.m. Friday in Napa County, directives made by public health officers in those counties, although officials said no local cases of the virus have been confirmed yet.

Public life and commerce came to a near halt for about a half a million residents of Sonoma County who woke up Wednesday to the new directive that left city centers and town plazas all but deserted. By the end of the week, nearly 800,000 residents in four North Coast counties will be under orders to stay home because of unprecedented public health policies designed to slow the spread of the coronavirus and avoid overwhelming hospitals.

'We want to tell the community to abide by the health officer's order to shelter in place and only leave their homes for essential activities to work in essential businesses,' Dr Sundari Mase, Sonoma County's interim public health officer, said in an interview Wednesday.

The newest cases in Sonoma County were detected through the county's surveillance program, set up last week to quickly determine whether the virus was spreading within the community by broadening the criteria for testing for the disease at four undisclosed hospitals, clinics and urgent care centers.

So far, the surveillance program has detected three cases out of 159 tests, according to Mase. Another three were detected through other testing.

The first two local residents to get sick had traveled on a Princess cruise ship to Mexico, where officials believe they contracted coronavirus.

At least three of the people who have tested positive are health care workers. They and one other patient were in isolation at home as of Monday. Beyond that, Sonoma County has refused to release even basic information about those who have tested positive, such as age, gender, the severity of any symptoms they may have or who may have come into contact with them. Mase and other government officials have cited privacy provisions of the federal Health Insurance Portability and Accountability Act, which requires the safeguarding of private health care information.

Mase said Sonoma County's public health lab has the capacity to run about 100 to 120 tests per day, which she believes is an adequate supply for the local population. A shortage of the type of swabs used to take samples from the noses and throats of people being tested has hampered testing at some facilities, a problem Mase said the county has been hard at work this week trying to address.

Kaiser Permanente said it would this week provide a shipment of swabs to some of the other health care facilities in Sonoma County that have run out of them, a temporary solution until the state fulfills the county's order for more swabs, Mase said.

'We need more swabs to test everyone we want to test,' Mase said.

The shortage of swabs could explain some of the anecdotal reports from people in the community who believe that testing should be more readily available. Shifting criteria for screening may also play a role.

The Centers for Disease Control and Prevention originally limited testing for people with certain flulike symptoms like a fever who had also either traveled internationally or been in contact with someone who had been abroad or people with confirmed cases of the disease.

March 4, as commercial testing became available, the CDC expanded the criteria and lifted health department approval, giving more agency to local doctors and clinicians to use their clinical judgment.

Still, some Sonoma County residents have been puzzled at what appears to be a reluctance of health care providers to test their patients for COVID-19, the disease caused by the novel coronavirus, including some of the 78 local cruise passengers on the Grand Princess who came home to learn an outbreak had been detected on the ship.

Others believe the virus has been spreading undetected for some time.

Rohnert Park resident Niko Aiello, 22, said he has been asking his primary care doctor at Kaiser to consider whether he contracted coronavirus after he succumbed to a respiratory illness about one week ago.

Aiello said he started feeling sick March 10 while he was on duty for his job at a local mental health care facility. It started with the onset of a fever and other symptoms including breathing difficulty he sought care at Kaiser Medical Center in Santa Rosa, Aiello said.

'They said it looks like you have an upper respiratory infection — take Mucinex and Tylenol as needed,' said Aiello, a political science student at Sonoma State University who is on hiatus this semester. 'Over the course of the week it progressively got worse.'

By Friday, Aiello was back at Kaiser's emergency department because his breathing problems had worsened. Medical staff evaluated him for pneumonia, took a chest X-ray and prescribed antibiotics to stave off infection.

Aiello said he believes his age and otherwise good health mean he will bounce back even if he does have the virus. But he would prefer to know. He said his employer tried to advocate for testing, but he has been denied.

'Every time I've been told that, practically, we don't have enough tests to test you because you haven't been in direct contact with someone who has already contracted the virus,' Aiello said.

Asked about situations like those described by Aiello, Mase said she couldn't comment on the specific case but added that doctors are no longer being asked to limit testing to vulnerable populations like the elderly or those with travel histories in order to allow doctors to make testing decisions based on each case.

'This has been our message all along; it's a disconnect with what we're telling people,' Mase said.

All told, 196 tests for coronavirus have been run by local, state or federal public health laboratories, including the 159 tests through the county's surveillance project. Those numbers don't include testing done at private labs including Quest Diagnostics and LabCorp, which are only required to report positive results.

In Mendocino County, Public Health Officer Dr. Noemi Doohan said the resident with a confirmed case of COVID-19 is in stable condition and 'is being placed in isolation.'

The individual, who was not identified, had come into contact with someone else with the virus, Doohan said in a statement.

The directives in Mendocino, Lake and Napa counties mirror those in Sonoma and other Bay Area counties and are aimed at strictly curbing all but basic errands for food, medicine and health care. Many businesses are being told to halt operations, though those considered essential to infrastructure, health and other mainstays of modern life are exempted.

Sonoma County was the seventh Bay Area county to initiate shelter-in-place orders this week. Traffic trickled in during the normal morning rush-hour commute, and downtown Santa Rosa was almost deserted — the only people near Old Courthouse Square were construction crew workers tearing down the two-story building next to the Hotel E.

Still, some businesses stayed open. Restaurants, including Café Mimosa on College Avenue, offered takeout or delivery service, though few customers lined up Wednesday. And even essential businesses struggled — SR Central Cleaners owner John Winter said business has been 'extremely slow' in March, particularly over the last week.

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

The Press Democrat wants to know what stories you see emerging and what you're experiencing locally during the shelter-in-place order. Reach out to us at coronavirus@pressdemocrat.com.