Riverside County officials talk hospitalization numbers, contact tracing

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Containers for coronavirus nose swab tests are arranged for use before sending off for results. Valley News/Shane Gibson photo

While Riverside County’s testing numbers continue to rise, the number of positive COVID-19 cases also climb higher.

Riverside County public health officials reported 546 new cases of COVID-19 along with 20 new deaths associated with the virus, Tuesday, July 7, during the Riverside County Board of Supervisors meeting. Health officials updated the board members on how the county was dealing with the pandemic that has killed more than 500 county residents.

One of the more widespread theories talked about on social media places the blame for the county’s increase in positive cases on patients from Imperial County being transported to Riverside County hospitals.

In early June, Bruce Barton, director of the Riverside County Emergency Management Department, confirmed to Valley News that Riverside County had recently taken in 51 patients stricken with the coronavirus from Imperial County hospitals. He said at the time that another 12 patients originating from Imperial County had walked into county hospitals as well.

As the two Imperial County hospitals continue to deal with an influx of COVID-19 patients, patients have continued to be transported to nearby counties such as San Diego and Orange County to help lessen the impact.

On Tuesday, during a discussion with supervisors about how the surge was impacting county hospitals, Barton confirmed that four patients were currently hospitalized.

“Over the weekend, we went from 429 hospitalizations on Thursday to 495 were reported yesterday,” Barton said. “That is a significant jump countywide. Hospital bed utilization is at 68.1% of licensed capacity and of the 495 COVID-19 patients hospitalized across the county, 130 are in ICU.

“Once again, 495 COVID-19 positive patients and 130 of those being in intensive care represent the single highest day total so far, which seems to (become) a daily story,” he said.

Barton said the utilization of countywide licensed ICU beds is at 94%, which means that 362 of the 385 ICU beds are occupied.

“Six of the 17 acute care hospitals are over their licensed ICU capacity and are utilizing additional ICU beds according to their surge plan,” Barton said. “Out of the 495 COVID-19 positive individuals that were hospitalized and Riverside County’s 17 acute care hospitals, 10 of them are from the state prisons as of yesterday and four are patients that were transferred from Imperial County.”

Kim Saruwatari, director of public health for Riverside County Department of Public Health, told the board that testing is increasing countywide.

“We also are very closely monitoring our testing,” she said. “We have seen our testing numbers increase, which is great. It allows us to better characterize where the disease is in the community.

“Our positivity rate, however, is around 15.9% now. We are almost double what the state’s threshold of 8% is. Just to make everybody aware, uh, we are continuing to monitor that and work closely with our testing group and our case investigators and contact tracers.”

Saruwatari said the county is adding roughly 60 contact tracers each week, and they currently have almost 300 on the job.

Chuck Washington, District 3 supervisor, had questions for the department about contact tracing and the controversy around what the data collected would be used for.

“I have a number of folks who are concerned about participating in contact tracing,” he said. “They fear that is something that perhaps the government’s trying to do to them. And in some cases, they’re actually steering clear of any kind of health help procedures or other interaction with health, for fear that it may cause them to need to be contact traced.”

Washington said he’s explained to those who are skeptical about the contact tracing process that it’s been around for years.

“Before COVID-19, it was certainly a significant component of trying to control the spread of (sexually transmitted diseases),” he said. “I can imagine that that would be a very uncomfortable conversation for someone to have if they tested positive for an STD, and then you would have to go and ask them who else they may have been interacting with, I should say.

“Can you just briefly explain the basis of contact tracing, why you do it, and why it’s so important right now for our containment of the coronavirus?” Washington said.

Saruwatari explained.

“We actually are seeing this with our own communities and our contact tracers,” she said. “They are having some difficulty in some cases getting information about where people have been so that we can effectively contact trace.

“Contact tracing, as you mentioned, is something that we’ve been using in public health for decades. We use it for tuberculosis, sexually transmitted diseases, HIV, any communicable disease that we investigate. Contact tracing is a very important tool in our toolbox,” she said.

Saruwatari said the goal of contact tracing is to disrupt disease transmission. She said that when someone is diagnosed, a public health nurse or communicable disease specialist, will call the person and talk about their symptoms, where they may have been infected, who else lives in their home and whether someone in their home may be at higher risk if they catch the virus.

“We talk about their environment and who else might need to be tested,” Saruwatari said. “We talk about who needs to be quarantined. Then we ask about where the case has been outside of the home. The reason that we do this is because we want to stop the spread of transmission. So if that person was eating in a restaurant and then went to a dentist and then was shopping in a retail store, we want to look at those environments and see if it was possible for transmission to occur there.”

Saruwatari said if the contact tracers can’t nail down that information, all of the people who came in contact with the patient may go on to test positive for the disease themselves and pass it on again.

“The way that we are going to get our arms around this pandemic is from our cases, identify contacts and contact, reach out to those contacts and put them on quarantine so that they are not potentially spreading the disease any further,” she said. “We are not passing judgment on where people have been, what they’ve been doing. We don’t share that information with law enforcement or anybody else. It is purely for public health to stop disease transmission.”

Karen Spiegel, District 2 supervisor, shared a conversation she had with a constituent.

“It was an interesting conversation I had with somebody who told me, they refuse to talk to anybody with the contact tracing,” she said. “They said if they infected someone, they were afraid it was going to track down and they’ll be sued because they gave that person COVID-19.

“I want to verify that you said that information is not passed on. There’s no way to sue somebody if you’re out and it spreads. I’m just concerned because if that’s the word that’s being spread about, not talking to contact tracing, it’s going be a little more challenging to get some information so that we can help squash it,” Spiegel said.

“When our contact tracers reach out to contacts of a case, they never disclose who the case is,” Saruwatari said. “They are very careful that they are not giving enough information so that the person can say, ‘Oh, you’re talking about where I was in this meeting on this day, at this time sitting next to this person.’ They don’t get into that detail. Our whole point is just to notify that person and say, ‘You may have been exposed, and it’s important that we talk about your symptoms. Get you in for testing,’ and not focus on where that exposure occurred, because we don’t want to violate anybody’s right to confidentiality.

“We’re not going to tell the person that this person was positive, and you were around them. We’re very, very careful, and our contact tracers are very skilled at having conversations without disclosing that sensitive information.”

V. Manuel Perez, District 4 supervisor, asked if hospitals were ready for the surge.

“There are particular hospitals that are surging as we speak right now and so there is definitely a reason to be concerned,” he said. “The other reason to be concerned is we can’t pin down any one reason (for the surge). There’s a number of reasons: people going out, people not observing the guidelines of social distancing, not wearing masks, protests, other congregate settings. It’s not any one thing. It’s a combination of all of the above.

“We certainly believe there’s expert opinion that supports the fact that after we have holiday weekends, it’s followed up by surges. We just had one, the effects of that we will start to feel in a week, two weeks, three weeks. It’s hard to have a crystal ball on that, but that bullet, so to speak, has left the gun,” Perez said.

Jeff Pack can be reached by email at jpack@reedermedia.com.