With the first confirmed cases of the new coronavirus in Santa Cruz County, residents are being asked to take steps to protect themselves and the community at large.
The virus is beyond containment at this point. What matters now, experts say, is community action to slow its spread. Even temporary interventions could have a significant impact, and the county is already rolling out recommendations effective through March 22 to limit community spread of the virus.
The new coronavirus, or COVID-19, first appeared in China in late 2019. The outbreak has since reached a growing number of places around the world, including the U.S. More than 30 states have reported cases, with nearly 800 cases in the country—roughly a fifth of them in California.
Several California counties, including Santa Cruz, have declared a state of emergency to prepare for dealing with the spread of the virus. The Santa Cruz City Council appeared poised Tuesday to declare its own local health emergency to help respond to the virus.
A key question will be how much disruption people are willing to accept as part of the effort to limit the spread of the virus, says Auston Marmaduke Kilpatrick, professor in the Department of Ecology and Evolutionary Biology at UCSC. “There’s going to be substantial transmission within the U.S.,” he says.
Just how much transmission happens will depend on “how much we’re willing to have our lives change and our behaviors change and for how long,” he explains.
Brief periods of working remotely, remote schooling and other changes can significantly cut an epidemic’s spread, if they’re done correctly and timed right, Kilpatrick says.
Beyond that, it is possible to bring an epidemic like this to a screeching halt altogether with large enough disruptions—such as restricting movement and contact between people—he notes, but such measures have other costs to a society. People still need groceries to eat, small businesses need patrons to stay afloat, and people need to access health services for any range of reasons, from giving birth to receiving cancer treatment. “Nothing is free,” Kilpatrick says.
That makes it even more important for people to do the “relatively simple, relatively nondisruptive things,” that can still help a lot, he adds. That includes hand-washing, rethinking cultural practices like shaking hands, and making moderations to physical space around other people.
It’s unclear how long disruptions might be needed, with a vaccine for the new coronavirus thought to be approximately one year away.
There are three major ways that experts think about human-to-human transmittable diseases and how to contain them, Kilpatrick says. The scientific community is working rapidly to understand those elements for COVID-19.
The first element, which looks at how much one infected person can spread the virus, appears to be around two additional cases per one person infected, depending on what control measures are in place, Kilpatrick says. The seasonal flu, by comparison, tends to lead to infections in around 1.3 other people per infected person. The goal for any epidemic is to get the transmission rate to less than one case per case, since the number of infected people will then dwindle over time.
The second element that experts are trying to assess is the chance of someone dying. It appears so far that the new coronavirus is deadlier than the seasonal flu, which has killed between 12,000 and 61,000 people in the U.S. annually since 2010.
The final element being assessed is the chance of someone transmitting the virus to someone else when they are not showing symptoms. The new coronavirus does appear to be able to spread from an infected person not showing symptoms, though it is unclear what that rate of transmission might be. That’s an important unknown to learn more about, as the efficacy of quarantining people “varies enormously with that fraction,” Kilpatrick says.
Following two confirmed coronavirus cases in Santa Cruz County, public health officials warned it is inevitable at this point that the coronavirus will spread through the community to some degree.
The county Health Services Agency released guidelines Monday for workplaces and “social distancing,” or ways to help slow the spread of the virus. The recommendations include minimizing or canceling meetings of 50 or more people, avoiding any events or gatherings if sick, and reducing nonessential work travel.
“It’s important for communities, families and individuals to prepare for the possibility of events being cancelled and schools being out,” said Santa Cruz County Department of Public Health Director Mimi Hall.
The “goal is to slow the disease trajectory,” she added. “We know that the disease needs people to spread. So if we lessen the amount of time that people spend amongst each other and the number of people together at one time, what we can do is slow the disease curve in our community.”
Santa Cruz County Health Officer Dr. Gail Newel declared a local health emergency on March 4, before there were any confirmed cases locally, and the county activated its emergency operations center to bolster response efforts. The county will reevaluate increasing its response efforts if warranted.
Both coronavirus cases in Santa Cruz County appear to be travel-related, according to health officials.
Newel stressed that the first patient did not contract the virus in the county. That patient was aboard the Grand Princess cruise ship that made a trip from San Francisco to Mexico before returning to the Bay Area in February. County officials could not say if the patient contracted the virus in Mexico or while they were on the ship but said it was not a case of community spread. The person is resting at home and does not require hospitalization.
Several other people from the cruise live in Santa Cruz County. Those people are under self-quarantine and are being monitored daily. None have symptoms of the virus, Newel said.
The person with the second case of COVID-19 in the county had traveled to Seattle, where public health officials believe they contracted the virus before returning home on a commercial flight in late February. That patient is recovering while in isolation. The county is tracking down all of the contacts that person may have had so they can be monitored or report to the health department.
The second case “confirms that COVID-19 is present in our community and is not an isolated case,” Newel said in a statement, urging everyone in the county to “take steps to protect themselves and their families.”
The county’s recommendations will lead to some disruptions in people’s daily lives, and officials are advising people to prepare accordingly. They suggest making sure emergency preparedness kits are up to date, having two to three months’ worth of critical prescriptions, preparing to work from home, and making plans to manage a school dismissal of at least two weeks. People can also check in with family, friends and neighbors about preparedness plans and sign up with local volunteer groups in case the community needs volunteer support as part of the response.
Government and school officials, employers, and health care leaders across Santa Cruz County are in a mode of continual communication and assessment of the evolving situation locally.
The Santa Cruz Police Department cancelled a series of three meetings this week due to concerns about spread of the virus.
No school closures have been announced, though officials asked the community to be prepared for the possibility. The county health department is working closely with the County Office of Education and local school districts to monitor the situation.
The Santa Cruz County Office of Education issued a memo on March 8 outlining its efforts to help address the outbreak. Steps have included updating the cleaning, disinfecting and sanitizing protocols, cancelling all field trips to destinations outside of Santa Cruz County, and handling travel restrictions for athletic and music competitions on a case-by-case basis.
The county is looking at what it would do to continue education if a confirmed case among students, teachers or staff leads to a school closure. Learning could be livestreamed to students during the closure period, says Faris Sabbah, the Santa Cruz County superintendent of schools. Local school districts are assessing the number of devices they have available to give to students if remote or distance learning is needed. But internet connectivity may be a hurdle for some students, even if they are provided with devices to access courses. An estimated 30% of families in Santa Cruz County do not have access to the internet at home, Sabbah says. The county is reaching out to internet service providers to see if they would be able and willing to provide free or low-cost solutions to help.
At UCSC, campus leaders said Tuesday they are suspending most in-person classes through at least April 3, and classes will shift online to reduce in-person interactions. All campus-sponsored events with 50 or more attendees will be cancelled or postponed.
There is a heightened concern among the business community, says Casey Beyer, CEO of the Santa Cruz County Chamber of Commerce. Beyond following basic protocols issued by federal health agencies, precautions that businesses are taking at this point appear to vary depending on their assessments of the health risks for their employees and their customers, along with how their business could adapt to changes like remote work or reducing business travel.
The Chamber has postponed its Santa Cruz County Business Expo, which was scheduled for March 11.
Robert Singleton, executive director of the Santa Cruz County Business Council, says he is already hearing from some local businesses in the hospitality industry that travel to the area appears to be down significantly from last year. There’s no discernible difference that would cause the drop aside from the fact that people have a bit more trepidation about traveling due to the coronavirus, he says.
While it remains to be seen how the coronavirus unfolds locally, officials and leaders across the county emphasize the importance of staying informed.
“The take-home message to the community is be prepared,” Hall said.
COVID-19 presents a serious risk for some groups, particularly people over 60 years old and people with certain pre-existing medical conditions such as cardiovascular disease, diabetes, cancer and lung diseases.
Symptoms of COVID-19 can be similar to the flu, including fever, cough, and shortness of breath. The symptoms can take two to 14 days to appear after exposure. People showing symptoms of COVID-19 are encouraged to contact their health care provider, especially if they have traveled to areas with an outbreak of the disease or had contact with a person known to have COVID-19.
The coronavirus does seem to be able to live on surfaces, though it is unclear for how long and doesn’t seem to be the main way the virus spreads.
Santa Cruz County public health officials urge community members to take precautions to help prevent the spread of the coronavirus. Their recommendations include:
- Wash hands frequently with soap and water, rubbing for at least 20 seconds
- Use at least 60% alcohol-based sanitizer if soap and water are unavailable
- Cough or sneeze into your elbow, not your hand, or use a tissue and discard
- Avoid shaking hands
- Don’t touch your face with unwashed hands
- Regularly clean surfaces touched by many people using normal household cleaners
- Stay home from work or school if you are sick
- Get a flu shot to protect yourself and others from flu, which has similar symptoms to COVID-19
- Call your health care provider if you experience symptoms of COVID-19
Todd Guild and Jacob Pierce contributed to this report.