Third case of COVID-19 in Stanislaus County; Emergency Services at highest activation
Stanislaus County confirmed Monday the third local case of COVID-19 and increased its response at the Office of Emergency to its highest level.
Stanislaus County Public Health received confirmation that an adult male resident of the county has tested positive for the novel coronavirus, authorities said in a news release issued Monday afternoon. He contracted the virus from a person with confirmed COVID-19 in another county, according to a press release. The county declined to release any further information about the man, citing medical privacy.
The first two cases of COVID-19 in Stanislaus County were reported last week, also among adult men. One of the men was a passenger on the Grand Princess cruise to Mexico. County health officials still have not reported if they’ve identified where the other man contracted the virus.
Along with the announcement of the additional case, the Stanislaus County Office of Emergency Services increased its response to Level 1, the highest alert with full-scale activation of the emergency response team and 24/7 monitoring and response to this threat.
Some of the biggest tasks for OES include ensuring that sufficient medical supplies are available, the public stays informed and that the county health care infrastructure is prepared to surge its capacity in case there is a large demand for medical care for coronavirus victims.
OES is closely monitoring medical supply reserves to be sure they have enough personal protective equipment (PPE) for health care workers and first responders.
PPE includes gowns, gloves and N-95 respirator masks, and eye protection, which are essential for defense against airborne pathogens, such as the SARS-CoV-2 coronavirus causing the COVID-19 pandemic.
“PPE is getting low in the county and all over California,” said Dr. Julie Vaishampayan, public health officer of Stanislaus County.
Medical personnel on the front lines, such as triage nurses, paramedics and physicians, are donning PPE for nearly all patient encounters to minimize their risk of exposure, to help ensure that they can continue to work throughout the pandemic.
Modesto Fire Department approach
Modesto Fire Battalion Chief Darin Jesberg said dispatchers taking medical calls are now asking additional questions of the patients.
“They have a series of checklists they go through to get the most appropriate level of response and there are certain trigger questions and signs of symptoms associated with the coronavirus,” he said.
When firefighters respond to homes of people who meet those criteria for potential coronavirus exposure, they are not entering as a crew anymore but sending one firefighter in with PPE and placing N95 masks on the patient as well.
“We have enough PPE for now” said Erik Klevmyr, the deputy director of emergency services and the deputy fire warden for Stanislaus County.
He said that the county and some of the partner organizations, including local fire agencies, have a cache of PPE, but with the expected increase in cases, more supplies will likely be needed.
At the operations Center Friday, logistic tech Twila Paul was packing “go bags” with PPEs for nurses who must visit homes to implement isolation orders.
Accounting for and distributing emergency supplies is one of the main responsibilities of the OES team staffing the emergency operations center.
“OES is a division of the county CEO’s office. They’re responsible for all of the planning and operational support for Stanislaus County,” said Jody Hayes, Stanislaus County CEO. He is also the county director of emergency services.
OES is part of a statewide, as well as nationwide, system positioned to respond to emergencies of any kind, including natural disasters, widespread blackouts and pandemics.
The emergency operations center is located on Oakdale Road, where Stanislaus Regional 911 dispatch operates. At this time, between five and 10 county agencies are embedded at that site.
The public wants information
One of the biggest commodities in demand — accurate and timely information. In response, the operations center has county personnel staffing phone banks to answer callers’ questions.
“We’re working really hard to make sure communications are getting out to the community and to the hospitals,” said Klevmyr.
He said they want to be sure that information is consistent and accurate, and currently everything is vetted by the public health team.
The operations center was raised to Level 3 on February 27, raised to Level 2 on March 2 and on Monday morning to Level 1.
Generally, Level 3 is a monitoring phase performed by the experts in the field of the specific emergency and their staff (in this case public health). With Level 2, there’s an increase in number of personnel in the lead team, as well as from other agencies needed to respond and the county is now at Level 1.
How is the decision made to activate OES?
CEO Hayes said when a county department sees something emerging, officials do a threat risk assessment and decide if OES activation is needed.
Hayes said since the coronavirus is an infectious threat, public health was the first to activate their department.
The decision to activate is made by the county’s assistant director of emergency services, Richard Murdoch, which was in coordination with Dr. Vaishampayan.
In addition to public health, the other agencies currently on alert include the CEO office, community services agency and the sheriff and fire departments, among others.
However, any county agency may be called upon to assist in the emergency response.
Partner agencies include the City of Modesto and other local governments, Turlock Irrigation District, local fire agencies and Mountain Valley Emergency Medical Services, to name a few.
MVEMS is functioning as the area coordinator for health care services, including managing dispatch calls and communicating with hospitals and first responder agencies.
They are responsible for monitoring supply and gathering PPE, swabs for viral testing and other medical supplies, and distributing them to sites where they’re needed.
MVEMS is also responsible for determining if and when there is a need to call for a surge of the health care system.
What constitutes a medical surge?
In a press conference on Sunday, Gov. Newsom discussed some of the state resources in place if there’s a need to surge health care personnel, hospital beds and medical equipment such as ventilators.
The U.S Department of Health and Human services defines “medical surge” as the ability of a health care system to provide medical care during major events that exceed the limits of the normal medical infrastructure of an affected community.
Calling for a surge could mean canceling all elective in-hospital procedures, smaller community hospitals would increase staff to care for patients who are mildly ill (inpatient and outpatient) and the acute care hospitals would be designated to care for the critically ill, including those needing intensive care or ventilator support for breathing.
Newsom said there are 416 acute care hospitals, with 74,000 beds at baseline and the capacity to add nearly 9,000 if surge is needed. He also said there are 11,500 adult and pediatric intensive care beds and at least 7,500 ventilators, with the capacity to add almost another 1,000 with a surge.
County capacity data was not immediately available.
In California, all health care organizations are part of the emergency preparedness services, and are required to participate in drills at least annually.
In 2017, Gov. Jerry Brown described the preparedness plan as, “the collective effort of emergency services professionals to protect our people, our infrastructure, and our environment against all threats.”
“This process is very dynamic. It’s not designed, nor will it ever be resourced, to answer all questions at all times in real time,” said Hayes.
For the latest updates form OES, follow them on Twitter @StanEmergency and on Facebook at facebook.com/StanEmergency/. You can call the public line at 209-558-7535.
This story was produced with financial support from The Stanislaus County Office of Education and the Stanislaus Community Foundation, along with the GroundTruth Project’s Report for America initiative. The Modesto Bee maintains full editorial control of this work.
This story was originally published March 16, 2020 at 1:44 PM with the headline "Third case of COVID-19 in Stanislaus County; Emergency Services at highest activation."
