Exclusive Q&A: Dr. Sara Cody answers San José Spotlight readers

Santa Clara County Health Officer Dr. Sara Cody, who led the charge on the nation’s first shelter-in-place order, is a tough person to nail down these days, but on Friday she sat down to answer San José Spotlight readers’ questions.

The exclusive Q&A session was streamed online by San José Spotlight on Facebook and moderated by Senior Reporter Janice Bitters, who asked questions from readers concerned about the novel coronavirus, which were submitted before and during the broadcast.

San José Spotlight received questions from nearly 90 readers for Dr. Cody during the 15-minute webinar. We’ll work on getting answers to the questions that were not asked, and will post those in future stories.

Cody, the county’s top public health official, announced this week that Santa Clara County was likely home to the nation’s earliest known death from the virus on Feb. 6. Previously, the first recorded U.S. death from the virus — which causes a deadly respiratory illness known as COVID-19 — was Feb. 29 in Washington.

While the number of new cases in Santa Clara County has started to slow, Cody said her top goal remains maintaining the safety and health protocols in the shelter-in-place order, issued initially March 16 and made more restrictive on March 31.

On Friday, Santa Clara County reported 2,018 confirmed coronavirus cases and 98 deaths.

The questions below have been shortened. The answers have been edited slightly for length and clarity. 

What are you doing to protect the frail and elderly in skilled nursing facilities and nursing homes?

We do have an entire unit in our emergency operations center that’s dedicated to supporting skilled nursing facilities — actually two different units — and it’s anything from providing consultation on infection control practices to assisting with guidelines to even, in some cases, assisting with staff, because it’s important to have enough staff to care for patients when they’re there.

Another issue we’re thinking about is ensuring that we understand all the different ways in which COVID-19 might come into a facility and spread and then devising strategies to prevent that as much as possible.

Locally and nationally, Latinos are overrepresented in deaths due to COVID-19. How is Santa Clara County intervening to address this?

We’re addressing this in a few ways — one is we have now a outreach effort, wanting to ensure that communities understand the risks of COVID-19 — how it’s transmitted and how they can protect themselves.

But at the same time, we also understand that… there are structural reasons why it’s difficult to shelter in place. Even if you desire to shelter in place, if you live in a household that’s crowded or if you live in a household with other family members from multiple generations and if they’re the essential workforce, there’s more opportunities for COVID to come into a household.

We are hoping to protect all communities by having everyone shelter in place… and then by providing support as we can to help people isolate during that period so they’re less likely to infect others.

Is it OK for kids to run and play on the grass, as long as no one else is there? Does the virus stay active/transmittable on grass and trees?

We encourage everyone who can go outside and has a place where they can play, run and get fresh air, outside away from others, that’s a wonderful thing to do. Just keep in mind to stay with your household unit and not mix and mingle with others. If others are around, they have to keep at least a six foot distance — and more is always better. I’m not aware of any particular risks of COVID-19 on grass or trees.

If testing for the virus and antibodies are critical in the effort against the virus, then why is criteria for such testing so limited?

Testing has been a real sticking point in our response to COVID-19. As more testing has become available nationally and in our community, those criteria have expanded and the goal is for testing to be so widely available that everyone on our priority list can be tested. We need to get there as soon as we can.

That would mean anyone who has symptoms compatible with COVID-19 gets tested rapidly and then isolates as soon as they get their test results back. That would mean contacts of that person and health care workers would get tested frequently. As we get more testing, we work our way down the priority list.

I’ve seen people in grocery stores and restaurants not wearing a mask. Why not mandate masks when out in public?

Santa Clara County is 100% aligned with other counties and the state with recommending wearing a face covering. Our strategy here was to not make it a legally enforceable order — in other words, law enforcement can come and take action if you’re not complying with the order. Law enforcement has a lot of priorities for enforcement and I didn’t want to take enforcement resources away from other things towards people wearing face coverings.

When I issue a health officer order, I mean it and I want law enforcement to take action and I didn’t really see that law enforcement was going to be going around to the grocery store and citing people for not having face coverings. That’s the practical aspect of it.

People do what’s right to protect others. Again, I want to remind everyone: In case I have COVID-19 and am asymptomatic, when I cover my nose and mouth, I protect the people around me. So, if everyone is wearing a face covering when they’re out and about, then everyone has an extra layer of protection. The hope is that it becomes a social norm. I know we can get there.

Could you tell us what contact tracing efforts are underway and what the technology will be that will be involved?

One of the really important pieces of work that we need to get underway is thorough case investigation and contact tracing. We’re right in the middle of transitioning to a new platform. We have technology to assist us and we’re bringing on a lot of people. Now that our case counts are coming back down into the manageable area, we are well poised to investigate every case and identify every contact. That also is more manageable because with people sheltering in place, when someone does become a case, they’ve had fewer contacts.

The Santa Clara County shelter in place order is until May 3. Do you think it will extend to longer than May 3? 

Our population is not immune to this virus. A whole population — it’s like a tinderbox. If you think of every new case as an ember that drops in the tinderbox, a fire can certainly light and that’s what we want to avoid.

Since March 17, when the order went into place, we’ve made enormous progress and it’s been a collective action and sacrifice. It’s caused incredible economic and social disruption. Many families have made enormous sacrifice, and I do not want to squander the sacrifice everyone has made. I understand there are health impacts of the shelter in place. We’re endeavoring to understand those as best we can and navigate our way towards whatever it is that protects the most people — that’s the way we’re going to go. That means we are not going to return to our normal way for a very long time.

Watch the Q&A in full below.

Contact Nadia Lopez at [email protected] or follow @n_llopez on Twitter.