Miller Report for the Week of May 25, 2020; by William Miller, MD.
A small outbreak of COVID-19 has occurred in Redwood Valley which is located in Mendocino County north of Ukiah along Highway 101. Nine new cases have now been traced to an event at a local church that involved singing on Mother’s Day. Three of those are hospitalized currently at Adventist Health – Ukiah Valley Medical Center. Over 300 other people have tested negative as part of the contact tracing effort according to the Mendocino County Health Department’s news release of May 24th. Contact tracing and testing continues.
This outbreak underscores the importance of several factors that increase the likelihood for spread of COVID-19: close proximity for a prolonged period (in other words, more than just passing by someone in a hallway), crowded indoor conditions and forced respiratory exhalation, such as coughing, sneezing and singing, which generates a lot of virus particles and carries very high risk. We have seen many church related outbreaks around the US associated with singing.
Several scientific articles have come out which reinforce the above mentioned factors as being of high risk. It is also clear that it is very difficult to catch this through exposure in the out-of-doors. Also, transmission through contact with contaminated surfaces, such as door nobs, while still a concern accounts for a low number of cases. Since this is not a blood borne pathogen, transmission from mosquitoes does not occur. So, social distancing (avoiding indoor crowds), face masks and handwashing remain your best protection.
From a population perspective, the key to controlling this epidemic is wide spread testing and good contact tracing leading to quarantine of people infected. Unfortunately, such testing remains limited in many rural areas including here on the Northern California Coast. A testing center has opened in Ukiah, the OptumServe testing site is open to the public Tuesday – Saturday from 12:30 pm – 7:00 pm at the Redwood Empire Fairgrounds, 1055 N. State St., Ukiah CA 95482 in Carl Purdy Hall. Appointments can be made by calling 888-634-1123 or by visiting https://lhi.care/covidtesting .
Local leaders, including Mayor Will Lee, City Manager Tabatha Miller and Mendocino Coast Clinic (MCC) CEO Lucresha Renteria and myself are working to find a way to get such testing done here. MCC, in collaboration with the City of Fort Bragg, has done about 323 tests. MCDH has done an additional 199 tests. All of which have been negative. However, we need to do more local surveillance testing. This will help guide decisions on when to start rolling back on shelter-in-place and how to best do so. The Miller Report will strive to keep you informed on such important progress.