Board of Supervisors — 2020-03-17

I'll call to order the 17th 2020 meeting of the Santa Barbara County Board of Supervisors. Will the clerk please call the roll?

Mr. Adam, Mr. Lavinino, Mr Williams, Mr Williams Can Santa Barbara hear us? Mr Williams

We are here

Thank You Miss Hartman And Chair Hart.

I am here as well.

Here, let the record reflect that Supervisor Adam is absent and Supervisors Hartman and Williams are participating in Santa Barbara.

Is approval of the minutes of March 10th, 2020 meeting. Is there any discussion? Can I please get a motion to approve? So moved. Motion's been made. Is there a second from Santa Barbara? Second. Thank you Supervisor Hartman. Any discussion? All those in favor please say aye. Aye. Aye Well we need to do a roll call excuse me I'm sorry Madam Clerk you want to read the roll?

Mr. Lavinino?

Aye

Mr. Williams?

Aye.

Ms. Hartman?

Aye.

Chair Hart?

Aye

Motion passes

We would normally have our CEO report right now, but we're going to trail that for a few minutes until we get everybody here Are there any announcements or changes to our agenda?

Yes, Chair Hart and members of the board. I have a couple quick announcements this morning. First on Friday we posted an addendum to our agenda amending administrative item number nine from the county executive office to approve budget revision requests and we added an additional budget revision request 0006819 In addition to that change, we also amended the administrative agenda to add administrative item number 14. This is from Public Health. It is to consider recommendations regarding the ratification of a declaration of local health emergency and ratification of the proclamation of local emergency regarding COVID-19.

I would also like to note for the record on Administrative Item No. 11 from General Services, this is to consider recommendations regarding renewable energy systems financing at Santa Barbara County Veterinary Campus in the 5th District. This is not a four-fifths vote required, this is just a majority vote. And yesterday we did receive a request from the department to continue departmental items number two and three. Departmental item number two is from the county executive office, it is a hearing to consider recommendations regarding an update on cannabis compliance enforcement and taxation second quarter fiscal year 1920 approval of the memorandum of understanding with the California Department of Food and Agriculture.

And departmental item number three is from the county executive office. It is a hearing to consider recommendations regarding storefront retail cannabis selection procedures within unincorporated areas of Santa Barbara County. And my last announcement this morning is that we are requesting to move administrative items number one and two, which are resolutions to be presented sponsored by Supervisor Lavinino. Administrative item number one adopt resolution accommodation honoring Joan Amate upon his retirement from the Behavioral Wellness Department After 25 years of faithful and distinguished service to the citizens of Santa Barbara County. And administrative item number two from Supervisor Labanino, to adopt a resolution of accommodation honoring Becky Padeno upon her retirement from the Santa Maria Cemetery District after 13 years of dedicated service.

And we are just requesting to move these from resolutions to be presented to honorary resolutions. And staff is available if you have any questions regarding those announcements.

Thank you Madam Clerk.

I'm just curious for the public if we do have, and I know our schedule is fluid. But on items two and well especially on item three, do we have a scheduled date for that or is that still in the mix?

Supervisor, we would like to bring that back in May. But we have scheduled community meetings right now in April. We can continue those community meetings because what we're asking you on item three is to approve a score sheet so we can go ahead and have the community meetings first, the score sheet. We wouldn't be scoring people until after that. So we're looking potentially if we can't do it in April to bring the item back in May

Thank you Madam Clerk?

Excuse me, Chair Hart and members of the board. I did have one final announcement and members of the public will see at the bottom of their screen we are allowing a call in for public comment today on any item on our agenda or general public comment and the phone number to call and give your name and number to be called when the item is up is area code 805-568-2240 again that's 5 6 8 2 2 4 0 so please give that number a call and give your name and number and the item you'd like to speak on. And we will try and incorporate that into our agenda today, thank you.

Thank you very much.

Chair Hart and members of the board, I have no request to speak on the admin agenda today.

Okay can I please get a motion to approve the balance of the administrative agenda? So moved. Motion's been made is there a second? Seconded. Any discussion? Roll call please.

Mr. Lavinino?

Aye.

Mr Williams?

Aye

Ms. Hartman? Aye. Chair Hart?

Aye.

Motion passes.

Thank you, now's the time for members of the public to speak on items that are not on our agenda. Madam Clerk, are there any requests to speak on items not in today's agenda?

Chair Hart and members of the board, yes we have four requests to speak on our administrative agenda today. We are going to begin in Santa Barbara with Ed Kalaski and then we're going to return to Santa Maria with Andy Caldwell. Ed?

Thank you. Good morning and there was snow on the mountains. Okay I call my talk today What is the requirement to simply remodel your house? One would think it'd be simple. But must one contribute to the Alex Peugeot Fund in order to get the right to remodel your house? It would seem so, sadly. And how long is this going to persist? You know, we had our corrupt supervisor Janet Wolfe here and Anne Olney both of which retired.

But we now have Alex Peugeot still here. I didn't sign up for this kind of treatment. It's been over six years since I started this project. I didn't ask to get ripped off. This was not my idea. I just wanted the remodel in my house. Something that's done everywhere, very simply. I have friends out of state that do it instantly without hesitation. Why is Alex Peugeot still at the Board of Architectural Review?

Is he there simply to collect a little extra money on the side from contractors? You know, I thought it would be very simple. All you had to do was follow the rules, do what the board requested and we did that. My architect did that. He thought that after four meetings, by the fifth meeting we were a shoo-in. We would have complied with everything they had requested.

But no, Alex kicked us out of the meeting! Wouldn't even let us show our drawings to the other six members. This is the way you run your business? One guy down there decides what he wants and that's a contribution? Why couldn't we even show our drawings to the other six members? We had a for sure show in. It would have been simple, it would have been easy. I wouldn't be here for six years complaining about the corruption downstairs.

Somebody needs to do something about it. He needs to be removed. He couldn't even come up with a legitimate idea to reject us. I don't know if my drawing is showing or not. He ruled that it's solely over the garage. Clearly, it's not solely over the garage. He couldn't even think up something that would make sense. It's nonsense. When we appealed to the PC, they couldn't make sense of it. Nobody could make sense of it This is liberty and justice for all.

This is why we pay our taxes to the Board of Supervisors, to the County of Santa Barbara To be run efficiently and corrupt, is that it? My neighbor got approved in two weeks. He didn't know why. He thought he had a hard time getting it passed. His contractor told him, yeah, it took forever to get past the Board of Architectural Review. No, he must have made a generous contribution. Of course, he didn't know he made a generous contribution. But that's the way life is here in Santa

Barbara. Thank you for your time. Appreciate that. Your time is up. Thank you.

Chair Hart and members of the board now we will return to Santa Maria for Andy Caldwell. Andy?

Before you start that talk, are you still doing the medical one later? Yes. After public comment we're going

to

go back to the

CEO's report.

I'm Andy Caldwell and I'm representing CoLab. We're really concerned, not so much with some of the normal protocols people should be doing every year about handshakes and sneezing into your sleeve and things like that. But what the San Francisco counties have done is absolutely unprecedented. It's almost a form of martial law where they've told You can only even go to work if you are working in some quote unquote essential industry.

Now I know the Bay Area's got more money than most other parts of the state, but we all know that most people are one paycheck away from being homeless. And even though the governor has said, well we're going to not let anybody be evicted or we're not going to let anybody. We're even going to put the homeless in motels and hotels. All of this stuff's going to cost somebody money. If they have no employees those businesses are shut down and most small businesses have a 3-5% profit margin.

And so I'm sure as heck hoping the rest of the state of California doesn't follow the Bay Area's issue. And I've listened to the presentations here, I have also listened to presentations that were one that was done to Cottage Hospital and the bottom line is this disease is extremely fatal to older people with underlying conditions. But there's a lot of research out there, even some of the research I've heard presented to your board that indicates for the vast majority of people at least 80%. Some people say up to 90%, you're going to have a mild flu like condition or no symptoms at all.

And the question is, to what degree did this flu outbreak? And that's ultimately what it is. It's a viral flu that's respiratory in nature or at least with respiratory complications. Is it worth crashing our economy? All I've heard is panic and induced hysteria versus telling people the vast majority of you this presents no serious health threat. And one of the things I've not heard your board talk about is what does this stock market crash do into your pension?

I'm wondering if you should have an immediate meeting as to whether or not you need to start laying off staff. Because you were barely making it in the booming economy that we've had in the last three to four years. Again, they're crashing our economy people are hoarding there's nothing wrong with our supply chains. There's a lot of reason that leaders should be asking for calm and also be looking at the trends in China.

China's new cases have flatlined, how did that

happen? Thank you. I'm quick we have additional public comment.

Yes, Chair Hart and members of the board. I just wanted to announce that during this time when we understand that participation in the Board of Supervisors meetings in person is difficult. We are accepting public comment via email to be read into the record and our next public comment is from Teresa Stevens PhD. Dear board members, I am speaking for my family today. We live in Ventura. My husband has worked in the planning and development department and spends most mornings and sometimes whole days at the public counter on the second floor. He's been doing this job for many years because of exposure to the public and sick co-workers he brings illness home and then I get sick. He is over 60 and we both have underlying health conditions from prior bouts with swine flu H1N1 influenza which have had lasting respiratory effects and familiar heart disease.

As you know, none of the staff who work at the second floor planning development or building and safety counters work behind a screen of any kind. These staff are breathed on, sneezed and coughed on, share ballpoint pens and pencils and touch all sorts of things when the public comes in to submit plans and write those big checks to the county for their permits. Moreover, the droplets go the other way when staff are sick. In my opinion there is an appalling lack of management support for staff when staff are sick and they have to stay home. I've also recently learned that only five or so laptop computers exist for the entire P&D staff, but the managers all have one. My husband has also mentioned that county management would not accept staff wearing masks at the public counter.

Is this true? By the way if someone is coughing on me a mask will protect me unless a drop of lands in my eyes. Please avoid a repeat of the Thomas fire and mudslides, wherein county management insisted all staff come to work even through all roads from Ventura were closed. And those staff couldn't get there. The Thomas fire mud slide demands placed on staff force most if not all Ventura based staff to use vacation time or sick time while not sick or vacation time. While managers are staying home in more than comfort with their laptops and paid full salary or given administrative time, including those managers who live in Ventura. Therefore, in light of this current pandemic and to protect the staff and the public I request you take immediate action as follows.

One draft and bid out immediate construction contract install barriers Like those at the banks, at the P&D and B&S and other public counters to prevent spewed droplets from covering the staff and our public. A good contractor should be able to install such a thing in a week or less. To provide ample supplies of non-latex gloves N95 masks protective eyewear alcohol based hand sanitizer tissues and soap and water At the public counters throughout all county buildings and encourage staff to wear use everything staff should also be given Wide latitude to break from public counter duties to hand wash anytime they feel it necessary. Three, provide alcohol-based spritzer or bleached wipes for staff to use on keyboards, computer monitors, computers, computer mice, phones, counters, or surfaces.

Can be cleaned immediately if a sick staff member or member of the public contaminates the area. Four, install cleaning checklists at the front door 5. Require all sick staff to go home immediately and advance them sick time leave immediately, clean with bleach or alcohol after they go. Better yet, give six staff administrations paid time off until they are well enough to return. Six, pass an immediate ordinance to promise to pay for coronavirus testing that may be required of staff who become infected or their family members. Seven, strike a deal with the county's health insurance providers to eliminate cost-sharing COVID-19 treatment for affected staff and their families if under the same health plan to eliminate financial burden. Eight, purchase and make available laptop computers in case staff need to work from home.

Better yet, enter the 21st century and swap out box computers for laptops for all staff this fiscal year and ramp up VPN connections. Nine, finally if you refuse to do one through eight close all public counters until peak transmission subsides.

Thank you Ms. Stevens if you're watching. Thank you Jacqueline for- Mr Chair? Yes, Supervisor Williams.

I just thought it would be, this would be a good time to announce that the public counter planning and development is closed as of 8 AM this morning. The P&D director sent out notice yesterday afternoon. They've established a drop box at reception so that they can keep on accepting paper materials and applications. And they can also receive plans via email and via the county's box account And provide comments and corrections electronically on building and safety submittals.

And in a more limited manner on planning submittals, so they can do appointments via telephone go to meeting or Skype. So the employee's spouse that made public comment obviously this is a concern of the department since Closing the public counter for two weeks.

Thank you, Supervisor Williams. We have some additional public comment here?

Yes, Chair Hart and members of the board I did just receive an additional public comment for general public comment from Lee Heller and I will read that now. Chair Hart and members of the board, I urge the Board to direct the Public Health Officer to mandate the closure of all restaurants other than for delivery or takeout in addition to mandatory closures of all bars, wineries and other gathering places. There seems to be a notion that we should wait until the number of identified cases is high enough to justify such closures.

But we have had so little access to testing that there is certainty that we have many more cases that have been identified. By the time those cases are confirmed, the spread of disease will be even greater. The whole point is to prevent greater spread, to protect our vulnerable community members and flatten the curve so that our healthcare system can manage the load when it does arrive. We owe this to our health care providers and first responders. We can do better than Governor Newsom's guidance by making this mandatory, but we need the Public Health Department to make this finding so that the cities can take action. Mr. Colwell is misrepresenting the health impacts of this virus. He clearly is not licensed to the Cottage Health presentation on COVID-19 from March 12th Even mild infection may involve serious symptoms and it's not just the elderly that are at risk.

As Italy's experience makes clear, people in their 40s and 50s have been seriously affected as well. The state and federal government are providing financial support to workers affected by closures. This morning's presidential press conference confirmed this. The economic costs will come one way or another. Thank you

Thank you. Thank you, Ms. Hiller. Now we'll go back to the CEO's report. Ms. Miyasato could you begin the

presentation? Thank you Chair Hart and Supervisors. So in Santa Barbara today we have Dr. DiRenoso here with her team to give an update but here in Santa Maria we also have the CEO of Cottage, I'm sorry, of Marion or Dignity Hospital Sue Anderson And I'm not sure, Dr. DeRinosa how you'd like to handle this? Maybe you can go first and then Ms. Anderson can give an update as to what her organization is doing.

Great. I'd like to give the board a few updates. First of all, I know that you had a preview of the website and I want to give you an update that it is fully launched and is containing key information and updated on a regular basis providing information such as the number of tests The number of and links to all the latest guidance from the federal government as well as the state government.

So specifically, if you were to go to publichealthsbc.org under the Santa Barbara County Public Health Department daily status, you will see that as of yesterday March 16th we have 128 tests collectively done in our county with 31 negatives and 96 pending, and one positive. And I'd like to also give a current status report late last night around in the evening 1030 ish we received notice that we have a second confirmed case Staff at that late hour went out and began their investigations. So around 6 o'clock this morning, we have some brief details. It is a person in the 50 age range and it is not a From our first blush, it does not look like a community transmission but a close contact transmission with unknown case in San Luis Obispo.

I shared yesterday at the press conference that we as a community have convened a work group to really look at with the limited available of testing, how can all, we all, the healthcare providers be on the same page in terms of criteria for testing. And with that, I'd like to invite Paige Batson our Deputy Director of Community Health to talk about that joint document.

Good

morning, thank you for having us here today. So in an effort to meet the demand of the community for testing we collaborated with our health care partners with public health department over the weekend with Cottage Health, Lompoc Valley Medical Center, Sansum Clinic, Santa Barbara Neighborhood Clinics and Dignity Health To come up with a strategy on how do we prioritize or triage for testing.

Because the goal here is to try to identify those that are truly candidates for testing, so do they have symptoms? Are they in a high risk category? So that was our attempt to make that happen. And so the end result of that is we arrived at a triage tool that will be used by our healthcare community to screen individuals, to determine if they need testing and this test will be administered by a licensed healthcare provider.

In addition, Collectively determined what we would do when we have all of these individuals that do require testing, but how we would prioritize their testing. So the group came up with a tiered approach and that tiered approach really would allow for individuals who are hospitalized or severely ill or healthcare workers or individuals living in congregate settings.

Health care partners would look work with the public health department to find a mechanism to prioritize that testing. I need to say that there is sufficient testing available in Santa Barbara County, we have sufficient testing kits. We have multiple labs coming on board, commercial labs including the public health labs, Ventura and San Luis Obispo as well as the state lab to help us prioritize and process testing. So we're happy for that but there is still a need for us to continue to prioritize our testing resources.

Additionally, I just want to emphasize that on March 5th the Department of Managed Healthcare directed full service commercial and Medi-Cal plans to waive cost sharing. So what that means again is that individuals who have insurance or Medi-Cal they should not endure any cost sharing in order to have COVID 19 testing services provided to them. So with that, I'll pass it

back to Pond. So we acknowledge that with stories in the media that our community is worried and wants to know about the availability of testing so you have a preview what I'm about to share So this morning we plan to disseminate information to our community about testing and home care information. And so I'll briefly gloss over or highlight what's in that document that will be widely distributed to our community. So essentially, this is again a recap but in more daily language for our public.

And this document was created jointly by the same group of people that Paige just shared. So even though we anticipate more availability of tests in the coming week to assure vulnerable patients and those most at risk will receive testing, we are asking the public to assist us with thinking through some questions so asking do you have a fever I'm And should not go to any healthcare facility to ask for testing at this time. We're asking that all community members follow these instructions so that again, we can reserve the most, we can protect the most vulnerable residents in our communities so that they can be tested, so that they can get the care that they need.

We also included in our guidance that information about Technology, my computer just froze and this is why you need hard copy when you have something. So with those questions, we also are building the capacity of our residents to further think through the questions. So if any of the above questions are yes, we want to alert our community members that contact your health care provider and let them know that you may be a candidate for testing and give the community a heads up that the provider will further triage by asking questions such as Are you 60 years or older? Have you traveled to one of the affected areas? Have you come close contact with someone who has COVID-19? Do you have lung disease? Do you have medical condition like diabetes, heart disease, or cancer?

Do you have a condition that lowers your immunity? Do work with healthcare or residential care facility? So these are all the questions that dialogue. That will go on between the patient and the provider so that there could be a ruling out for other sources of illness prior to testing. In our document to the community, we also cover testing what to anticipate and a really detailed list of home care while the community member is homesick or recovering.

So with that, that concludes our update and we are open for any questions.

We also have additional, we have Ms. Anderson from Marion Hospital here in Santa Maria. Welcome Ms. Anderson, thank you for being here.

Thank you, hi. Yes, Sue Anderson, President at Marion Regional Medical Center. I also brought with me Dr. Kevin Ferguson. He's a pathologist and the head of our lab services at the hospital and works throughout both counties, San Luis Obispo and Santa Barbara. And he's been on the task force that was set up quickly over the weekend with the county to Get lab testing criteria set up. One of the things I just a comment, I ran into one of my nurses the other day and I said hey how's it going? And she said one of our directors and she said you know what this is what we were trained for. We're ready and another nurse up on the floor.

Said to me a day ago said, you know I everything in the world around me my kids are home. Everything seems so out of source but I come to the hospital and it's business as usual we're taking care of people like we always have and always will. You know, I mean it's not we take care of people with infectious diseases all the time. Some of the questions I thought people might have, our supply chain is good right now. We have what we need. We have enough masks. We have enough equipment and supplies.

Corporate structure, and we've been in close contact with them on a daily basis. And they've assured us that we have supply chain to get us the masks we need, the scrubs we need, everything else that we need. We have limited visitor access to the hospital. We put in, and that's a daily kind of updated type of thing but we are limiting patient visitors. We are preparing for a surge in census if that were to happen. We have adequate number of beds. And as I said, in supplies right now so we're in good shape. We're also though CDPH is coming out the Department of Public Health.

We're working with them today actually to do it over WebEx I think where they will sign off on a couple of expanded areas we have where we plan to do additional testing so that it doesn't clog up our emergency department. One of the biggest issues we've had is the lab testing. It's taking considerable amount of hours to get any results back and days to get results back. In the meantime, people don't know what their situation is and for that I'd like to turn it over to Dr. Ferguson because he can talk a lot better about the testing.

Again, my name is Kevin Ferguson. I'm the medical director at Marion Regional Medical Center and also Royal Grande Community Hospital and French Hospital Medical Center. So I would echo what my colleagues had said but I would amplify or really clarify the testing situation There is no local testing for COVID-19 in Santa Barbara County. We are relying on the Public Health Department in San Luis Obispo County and the Public Health Department in Ventura County to test our most vulnerable patients and our most at risk patients, and they've been gracious to do so. But their ability to test Santa Barbara County patients is limited. And we've been told that we have to go to the private sector to get the bulk of our testing done. The big commercial labs that are doing this testing that you've heard about in the news, Quest and LabCorp are the two biggest.

They appear to have a turnaround time of three to five days depending on the case. Our other reference laboratory Arup in Utah stopped accepting cases because they were overloaded with the number of cases. So we're in a very tricky time period now for the next, I would say two to three weeks as the commercial labs ramp up capacity. And as the local labs start to get the release of what were called FDA emergency release kits that we can run on our local platforms. We're hoping to get those in the next two to three weeks but it's really a day by day situation as those tests are manufactured that could be run locally. So right now, we really are relying heavily on large contract labs that are outside of our area. And so the testing is therefore not completely in our control.

The other rate limiting resource that we have is a number of actual nasal pharyngeal swabs that we use, we use those to collect the specimens. Those are in somewhat short supply. We do have enough to take care of our hospitalized patients and we have algorithms in place I know my colleagues in Santa Barbara talked about. The scoring tiering system, which is in use and it's very good. We have an additional step at Marion Regional Medical Centers where we make sure that the testing that is referred to our local public health departments in Slough and Ventura County are the highest priority cases. So we are judiciously guarding that resource. We would like to open up more testing for the community but right now we don't have a capacity so I do think that we should at some point report back to this group.

I don't know if there's going to be a task force set up or anything like that, so we can talk about how we can generate a larger sort of coordinated effort along with our colleagues down in Santa Barbara City for more widespread testing when that becomes available. But right now, we're asking that if you don't have a fever and respiratory symptoms, that you don't seek testing.

Encourage to talk to your healthcare provider if you have anything else going on. But really, we are most interested in testing our most vulnerable populations people over 60 that are symptomatic that have fever over 100.4 and respiratory symptoms. That's our target population right now.

So as you can see, testing that's our biggest concern right now. And the turnaround time is like we said days so it's really not a good situation on the testing side.

Thank you Ms. Anderson and Dr. Ferguson. We appreciate you both being here and helping us understand the situation particularly here in Santa Maria. Supervisor

Lavenito. Thank you, Mr Chair. I'm just curious what direction you would give to somebody? What's the protocol? Do they just go to the ER or should they give advance notice so that they don't come in and expose everybody in the emergency room? How should somebody present themselves for a test?

So in this, and particularly in this situation, communication is key. So advanced notice is great. A lot of providers have been very good about doing telephone consultations. It's nice if we can get some information over the phone. And then sometimes we have directed patients who are symptomatic or vulnerable or at risk to our emergency rooms in the area. We have done that. Sometimes we're able to swab patients in our outpatient settings In our urgent care centers, that's been one thing that we've done. We've even swapped patients in their car like you see and that is to protect our healthcare providers and make sure they have the proper protective gear can collect the sample get the information that we need in expedite testing. So communication is key I will call first.

Right? And also just so you know we are screening people as they come into the emergency department lobby and masking them if they're exhibiting symptoms and all to protect our providers and our caregivers.

Are there questions in Santa Barbara? Supervisor Williams.

I'll let our public health director first, she had a comment first.

Hi, I just want to clarify the comment that Dr. Ferguson just made. So yes we send our tests to Ventura and to Sloan but that has not slowed the turnaround time for critical cases in addition to that we are In a partnership with a private lab, and we anticipate that within two weeks the public health department can also run our local tests for critical cases.

And Ms. Batson has some additional information.

Another key player for us in the testing arena is the viral and rickettsial disease lab, which is at the California Department of Public Health. They are ramped up to test seven days a week and we have the ability and have had the ability to prioritize testing seven days a week to get it to them. And they have a much quicker turnaround time and that's at least a day sometimes You may go into day two, but overall we have at this time the capacity to prioritize testing and submit to them. So this situation as we've all said is rapidly evolving and we anticipate that expanded testing will occur by also including our lab in the mix. Thank you.

Thank you Dr. Dorenoso and Ms. Batson, Supervisor Williams?

So I had a couple questions. One is, my understanding is that you formulated this new protocol on testing to make it more clear for doctors whether they should test or not and if You know, I looked at it as a very clear point system. You either meet the criteria or you don't and so I think that is a reason that the public should be more reassured that we will be number one testing more people but still conserving resources for the ones that need to test the most. That is the object of the protocol correct?

And then I think the other question is, are we doing enough to force social distancing in places where people gather? Meaning if advice from the state and federal government is that we shouldn't be having In general, more than 10 people. Thankfully even in this big room we're only about 10 people so I guess we're meeting that criteria. Is there a way to make that happen in a more uniform and accountable manner?

Closing down some types of businesses or should we be, I was trying to think of what else besides closing down certain types of businesses could be productive in this manner. Should we be enforcing a dramatically reduced capacity for people in a given building or room? Every room and building has a capacity and We were putting that into a fifth or a fourth of the capacity if that would be better to reduce the amount of contacts that people have. And then I just wanted to ask Paige to repeat the information that you did last night at the press conference about how the disease is actually transferred because I think people don't understand that well, that it's transferred by droplets.

So I'll let Ron speak to the first part of your question and then.

Okay, Supervisor Williams through the chair. Those are great questions that you pose with the governor's recent guidance for seniors or older adults age 65 and older to be self-isolation and the closure of bars and reduction of restaurants by 50%, but as of last night is total So those are guidances that we as a public health department are grappling with and so it's top of our agenda today for our policy group of experts. We will be weighing We will be looking at what the Bay Area counties are doing in terms of enhanced community quarantine is the term, and what LA County is doing in terms of reduction of enforcing social distancing I believe for less than 50 folks in one room. So those are all The local jurisdictions are doing that we will be reviewing and debating today.

And we will definitely come back to the board for guidance once we land on several recommendations,

Paige? Just as a follow up I would just urge you to take some additional mandatory measures whether that's certain businesses or whether that's a ratio And I know you need to balance it with the fact that if you purposely tank the economy, people will suffer and some people will perish from that as well. So I'm not urging a total shutdown of the economy but I am urging stronger mandatory steps.

Supervisor Williams, in answer to your second question on how the virus is transmitted. So if we think back to the principles of social distancing, we want to slow the progression of the virus getting transmitted to other people. We need to consider that Why social distancing would work in this case is because the coronavirus is spread via droplet. And what that means is that the drop, the virus, the particles are much more they're heavier than those particles of measles or tuberculosis and so what that means is that it would only when someone coughs sneezes It would not travel any more than three feet So it would fall on the surface if somebody coughed and sneezed. And so if somebody is six feet away, they would not be able to inhale the virus or of the particle, the droplet in essence, if someone coughed.

That doesn't mean so that's why social distancing works but in concert with social distancing we also have to emphasize environmental cleaning and sanitation because as I mentioned, And the droplet falls on a table in the right condition. That virus can remain on a surface anywhere from a few hours to a few days, hence why it's so important to wipe down surfaces and also hand washing. Handwashing cannot be overstated enough because as individuals touch those infected surfaces or contaminated surfaces then they proceed to touch their eyes nose and mouth and this virus lives in mucous membranes and that's how persons become infected.

Supervisor Hart,

may I? Thank you. I just wanted to second what Supervisor Williams has said about considering additional measures and ask you to look at San Diego County as

well. Supervisor Lavinia, do you have a question?

Not so much a question as just an observation. First of all, I think it's probably a good time for us to thank all the healthcare workers and especially our county employee. All of our, everybody in healthcare but yeah I will say especially our county employees. I mean, I guess that's who I'm representing so and I just, I know that there have been long hours not just folks in public health but others in our CEO's office, County Council's office.

Put in many hours on this, and so I want to say thank you. And I think the other part of this that I want to stress also is I know elected officials have been asked many times on social media about what my direction is or what my opinion is. This is a really good time for us to make sure that all decisions are made by those that are qualified to do so. And so when we might have individual concerns, we might have individual biases or preferences.

I think the wise decision at a time like this is to make sure Folks that are qualified public health officials, those who are in the public health arena to be making the decisions that affect us. And so I for one will be lining up behind those folks with those qualifications and urge calm and just a level head while we continue to follow the path that our public health professionals lay out for us. So that's my comment.

Thank you, Supervisor Lavinino. I had a couple questions for Dr. Del Rinoso. I want to congratulate you on the collaboration that you have developed with all the medical partners in creating the testing protocol and I know that's been significant work bringing everybody together and getting everyone on the same page. And I am curious about the expert policy group that you mentioned, that's helping the public health department make decisions about additional interventions. Is that the same group as the collaboration or is that a different group of people? Could you tell me more about that?