Coronavirus: Q&A with Santa Clara County’s top health official

As the top health official in Santa Clara County, Dr. Sara Cody never imagined she’d be tasked with addressing a major pandemic that has taken root in the South Bay, killing 16 so far and infecting at least 375 as of Tuesday.

“This is absolutely unprecedented,” she said Tuesday during a virtual “town hall” call with more than 7,000 listeners.

But as the contagious virus has spread across the county, she’s led efforts to limit event sizes, close schools and issue a wide-reaching “shelter in place” order to slow the spread of the coronavirus, known as COVID-19. She’s worked with city officials, counties, mayors and fielded countless questions from reporters.

On Tuesday, she joined the call with Silicon Valley’s congressional delegation to answer questions directly from residents. The congressmembers on the call included Reps. Anna Eshoo, Jimmy Panetta and Ro Khanna and Zoe Lofgren, who also spoke about funding bills to respond to COVID-19, currently being fought over in Congress.

Cody started by laying out some of the facts about COVID-19 in Santa Clara County.

First, testing is still extremely limited in the county and the state, so the people who are confirmed to have the virus are only the “iceberg tips,” she said.

“We’re able to ascertain and identify the tips of iceberg, but they probably represent a large number of infections that are not detected, either because people have very mild symptoms or people have less mild symptoms but aren’t able to get tested because the testing capacity is still limited,” she said.

The main takeaway Cody stressed is that residents should follow the “stay-at-home” order.

“We absolutely have to slow down the spread of disease,” she said. “We know that everyone in the population by and large is susceptible — none of us have ever seen this infection before, so nobody has immunity.”

The questions below were asked during Tuesday’s call and have been shortened. The answers have been edited slightly for length and clarity. 

What should people do about vulnerable family members who need to go to the hospital for non-COVID-19 reasons — should people visit? 

What I would do in your situation is before you bring a family member in for care is call ahead. Many hospitals are adopting and changing their policies, and sometimes there’s a different entrance for different types of care. Some outpatient settings will see whether, for example, a visit could be conducted remotely, rather than in person, to reduce the risk.

Can you get the virus through a break in the skin, like a cut, psoriasis or eczema? 

It’s a respiratory virus, so it’s primarily spread by respiratory droplets when someone is speaking, coughing or sneezing, mostly by those larger droplets, but probably to some extent by smaller aerosols as well. I am not aware of any evidence that it could spread through a cut in the skin. The primary, what we call ‘portal of entry’ or the way it goes into your body, would be through breathing it in or through one of your mucus membranes, like your eyes, nose or mouth.

The president may, in a week or so, say it is time to go back to work and open the schools. What is our plan? 

I feel very strongly that we need to continue these broad mitigation measures and social distancing until such time as we either have other, more precise tools to slow down the spread or until such time as there’s enough of the population that is immune from natural infection. And we simply don’t have that information to say that we could start to peel back on what we’re doing.

We know from experience looking around the world, that what we’re doing now with these broad measures is necessary and it will save lives. We understand that it is an enormous, enormous hardship both for people personally, for the economy, for their businesses and we hope that there’s ways to somehow mitigate that, but these measures are necessary to save lives and they’re going to need to be in place for a bit of time.

I’ve seen posts relative to making masks out of fabric. Is this something people in the health industry can use?  

The honest answer is I have heard a bit about people making masks and I don’t think that they could be used in the health care sector, where there are particular standards for personal protective equipment. Whether they could be used elsewhere and provide some protection, the honest answer is I don’t know. I can see if I could get that question forwarded to the right person to help vet it and get information back to you.

What are the symptoms, and timeline of the virus. What should you do if you think you have the virus? 

The symptoms of this virus can range from having no symptoms at all, to having symptoms like a cough, fever or shortness of breath. The key thing to know is that anyone who’s having any type of respiratory symptoms — and it could be cold symptoms, flu-like symptoms that we all recognize — they should isolate at home and away from other people to keep from spreading it. That’s the number one important message: If you have any respiratory symptoms, stay at home.

If your symptoms progress, you should call your health care provider and arrange for care. It’s important to call in advance so that they know that you might be infectious.

Follow along with San José Spotlight’s real-time coronavirus coverage on our LIVE BLOG here.

Contact Janice Bitters at [email protected] or follow @JaniceBitters on Twitter.