Coronavirus Updates, March 23, 2020: Hospitals Expand Surge Capacity as Outbreak Spreads

Scroll from the bottom up to read in chronological order. And click here to catch up on the rest of our coronavirus coverage. 

5:42pm: New cases, more deaths.

Santa Clara County announced three more deaths from COVID-19 this evening. While health officials did not give the exact ages of the three latest fatalities, they did say they would begin releasing more detailed aggregate information from now on, including age range, gender and whether or not the deceased had pre-existing conditions.

Of the 13 people who have died from the virus in this county, eight had pre-existing conditions that made them vulnerable to the respiratory disease. One was between the ages of 41 and 50, two were between 51 and 60, four  between 61 to 70, two between 71 to 80 and four between ages 81 and 90.

Health officials also reported 19 new confirmed cases today, bringing the total number up to 321. As the time of this writing, 116 people remain hospitalized.

“Because of limited testing capacity, the number of confirmed cases almost certainly represents a small fraction of the total number of persons with COVID-19 in the county,” the news release noted.

—Grace Hase

5:23pm: Code blue.

A planning, building and code enforcement employee in San Jose’s permit center tested positive for COVID-19 on Sunday. The employee was last at work on March 19.

As of Monday, all development services employees who typically work on floors one through four were ordered to work from home until the “situation could be further evaluated.

—Grace Hase

5:16pm: Deputies fall ill.

Three Santa Clara County sheriff’s deputies have tested positive for COVID-19. One officers was assigned to patrol and the others to the jails. The Sheriff’s Office says it was made aware of two of the test results on Sunday and the other earlier today.

Two of the deputies are isolating at home and the other is in stable condition at a local hospital, authorities said.

“We are actively monitoring the situation by working closely with the Santa Clara County Public Health Department to mitigate further exposure,” reads a press release from agency spokesman Sgt. Michael Low. “We want to assure the public that our office remains dedicated to serving and protecting the community during these trying times. Furthermore, we are doing everything we can to protect our staff and other first responders battling this pandemic. We continue to ask everyone to comply with the county’s shelter in place order and do their part to keep our community safe.”

4pm: Eye on the Y.

While the shelter-in-place order prevents the YMCA of Silicon Valley from opening its facilities for after-school activities, the nonprofit will continue to help those who need it. Below are some of the emergency services offered during this health crisis.

Daycare. During the shutdown, the Y will offer childcare for families of essential workers, medical professionals and first responders. Starting today, the organization can watch up to 200 kids at two sites, the El Camino YMCA and at Morgan Hill Unified School District. Next week, the nonprofit will add a third site at Southwest YWCA.

Nutrition. With school out, many children lost access to health meals. To fill the gap, YMCA has teamed up with Second Harvest Silicon Valley and local school districts to distribute 6,000 daily meals through 20 drive-up-and-pick-up stations.

Blood drives. The Red Cross is grappling with a severe shortage of life-saving blood. YMCA will set up blood donation stations to help address that demand.

Hot, healthy meals for seniors. To ensure that older adults have steady access to nutritious food, YMCA will deploy staff to make home-cooked meals, package them and run them to cars of caretakers.

To find out how else the Y is helping out during this time of need, go to ymcasv.org.

2:35pm: Inmate tests positive.

The Main Jail confirmed its first COVID-19 case. (Photo by Jennifer Wadsworth)

Officers immediately masked the man and took him to an isolation cell in the booking area. After he was processed, they relocated him to the jail infirmary, where he underwent testing for the novel coronavirus. On Sunday, the test came back positive.

The inmate, whose name was not released, remains in quarantine. The SJPD officers who arrested him were notified about their possible exposure.

“As a precaution, custody medical staff has been screening new arrestees outside the jail in the sally port area,” according to a news release from the Sheriff”s Office about the inmate. “Healthcare staff is asking the individuals if they have a dry cough, shortness of breath, fever, or exposure to anyone with COVID-19.”

1:05pm: What a relief.

Local leaders set up an $11 million relief fund for people suffering an economic blow from the pandemic. Click here to read SJI reporter Grace Hase’s article about the effort.

12:58pm: Court adjourned.

The Santa Clara County Superior Court is taking steps to help stop the spread of COVID-19 by limiting access to visitors to the day of their hearing. The same goes for witnesses subpoenaed to testify and attorneys.

“The court is taking additional precautions to promote social distancing guidelines and the safety and well-being of the public, courtroom staff, sheriff’s deputies, judicial officers and those who have essential business at the courthouse,” Presiding Judge Ryan said in a Monday morning news release. “If you do not have a hearing taking place at the Court please do not come to the courthouse during this time.”

Those experiencing any kind of illness should not show up for in-person hearings and are encouraged to attend via CourtCall 888.88.COURT or other remote options.

Jurors, attorneys and other parties should direct questions to [email protected] or 408.882.2700. Jurors who received a notice to serve from now through March 30 are officially excused from jury duty.

—Grace Hase

12:10pm: The count must go on.

Virtual Press Conference on 2020 Census Efforts During COVID-19 Lockdown

County of Santa Clara leadership will discuss how their efforts to maximize the 2020 Census count are proceeding during the COVID-19 crisis.

Posted by Santa Clara County - Office of the Census on Monday, March 23, 2020

Last year, we were all rightfully worried about how adding a citizenship test on theU.S. Census form would prevent people from participating in the decennial count. Now, we face chilling effect we would have never imagined just weeks ago.

The coronavirus pandemic threatens to leave vast swaths of the nation undercounted, which would undermine our democracy for years to come.

Santa Clara County officials held a virtual press conference today to address this grave threat on a long-held custom that determines how much representation we get in our government and how much funding we receive down the line.

For more information about the census, go to my2020census.gov or call 844.330.2020 (for English, 844.468.2020 (for Spanish) and 844.461.2020 (for Vietnamese).

11:11am: Something in the air.

A fifth TSA worker at the Mineta San Jose International Airport has tested positive for COVID-19. The security employee last worked on the evening of March 11 at the passenger screening checkpoint of Terminal A. Meanwhile, city officials say a SJC employee who also tested positive may have had limited contact with airport tenants.

11:02am: Milpitas on alert.

Two Milpitas firefighters and one of their spouses have tested positive for COVID-19, according to a Monday morning news release. All three are quarantined at home.

The Milpitas Fire Department’s designated infection control officer was alerted over the weekend that the firefighters tested positive. Five others in the department were exposed to the first confirmed case, including the other infected colleague. Three have shown symptoms and the remaining firefighter has no apparent signs of illness.

A Milpitas fire recruit who participated in a recent fire academy training was also exposed to a separate case and is showing symptoms. All of the individuals exposed are under home isolation for the next two weeks.

“It is our belief that there is very little chance of infection to the public,” Milpitas Fire Chief Brian Sherrard said. “My priorities right now are the safety of the residents in our community and our first responders who serve them. Our firefighters take their oath very seriously, so it's difficult during an unprecedented time like this to quarantine to stay safe, but that's exactly what we are doing.”

On Sunday, Milpitas also announced that one of its crossing guards tested positive for the highly contagious virus. The person, who is not being identified, last worked on March 6 near Yellowstone Avenue and Sequoia Drive and have been hospitalized ever since.

—Grace Hase

10am: Perks for the clerks.

United Food and Commercial Workers Local 5 reached a deal with Safeway granting grocery workers stronger protections as they become frontline workers in a pandemic.

The agreement includes more scheduling flexibility to accommodate childcare and expanded use of paid sick leave. Workers will get up to two weeks of pay if they contract the coronavirus or have to self-quarantine because of exposure. The contract also calls for stricter sanitizing for employees and customers, assures that stores will hire temps only after offering existing workers additional hours and that all staffers will get a $2-an-hour bump for at least two weeks.

“Local 5 members are working around the clock to assure that families have the food and supplies they need,” union President John Nunes said. “Along with healthcare workers, they are truly first responders during this growing crisis.”

The UFCW is also asking the state to require grocers to give workers more paid leave, free COVID-19 testing and consistent access to hand washing, cleaners and protective gear.

9:16am: Hospitals get surge-ready.

This is how many hospital beds will be needed in San Jose if infections are spread out over six months, 12 months or 18 months. (Infographic via ProPublica)

As the outbreak continues apace, Santa Clara County is welcoming help from the federal government in setting up a temporary medical facility in a local event venue.

By placing between 250 and 290 beds in the Santa Clara Convention Center, health officials hope to ease the burden on the county’s nine-hospital system by taking in patients who need treatment for issues unrelated to coronavirus.

A U.S. Department of Health and Human Services affiliate would run the operation, according to a memo detailing the strategy. Valley Med Chief Medical Officer Paul Lorenz explained Sunday in a Facebook Live talk that the venue conversion is part of a broader “surge plan” to offload some patients to alternative sites.

The main driver behind the kinds of social-distancing mandates that brought the economy to a stop this past week is to slow the outbreak enough that U.S. hospitals don’t get bombarded with too many critically sick patients at the same time.

According to recently released data from a Harvard Global Health Institute study led by Dr. Ashish Jha, the South Bay has a total of 2,250 hospital beds, about 64 percent of which are usually occupied. That bed count includes 340 ICU spots, which are best prepared to handle acute coronavirus cases, per the American Hospital Association.

Of Santa Clara County’s 1.9 million residents, census data show that about 12 percent are 65 years or older—a demographic particularly susceptible to the respiratory failure seen in the most severe COVID-19 infections.

So, let’s say our lockdown initiatives “flatten the curve” just moderately, meaning 40 percent of adults contract COVID-19 in the coming year. Even then, the South Bay would need to expand surge capacity at its local hospitals based on estimates from the Harvard study showing that 8 percent of infected adults would require hospital care, which amounts to an estimated 120,000 patients with an average of 12-day inpatient stays.

In that scenario, Santa Clara County would require 3,990 beds over 12 months—about 4.4 times what’s available now.

Intensive care units would be hit the hardest, researchers found. Even without coronavirus patients, ICUs in this county typically have just 150 available beds, which is nearly six times less than what’s needed to care for the most severe coronavirus cases.

Again, that’s just in a moderate scenario.

The worst-case outcome projected by Dr. Jha and his team, in which 60 percent of the county gets infected in just six months, would force healthcare staff to basically choose who should live and who should die because of a lack of resources. That’s the situation unfolding in Italy now, and one that prompted Santa Clara County Public Health Officer Dr. Sara Cody to call for the sweeping lockdown that’s now going on week two.

Though hospitals in urban areas like ours stand to bear the brunt of the surge, researchers at Harvard say they’re also better prepared than their smaller counterparts to stretch resources in times of crisis. And that’s exactly what’s happening here now as the number of Santa Clara County COVID-19 cases surpassed 300 on Sunday and the death toll broke the double-digit mark for the first time.

I believe we’re in capable hands.

That said, I’d like to see more transparency from our county leaders. While the public health department has posted daily updates to the confirmed-case and fatality count online, it’s been silent about how much testing’s being done.

While I wrote about how Rachel Maddow lavished praise upon the Santa Clara County for its clear and effective public health communication, Trump’s CDC fielded criticism for dodging questions about testing. Now, I’m starting to wonder what’s taking our local authorities so long to tell us what they know about their own testing capacity—or, if they lack comprehensive data, to acknowledge as much to the public.

I raised the question over the weekend after eight days went by with the county ignoring our questions about local testing capacity. In a March 14 email to public health spokeswoman Joy Alexiou, I asked for, among other things, the total number of patients tested, total samples required to get an accurate reading for each person and a list of testing sites in the South Bay.

When I didn’t hear back, I forwarded the email to the county’s main emergency press address. When I still didn’t hear back, I called to find out what’s holding things up. In one of those calls, a spokesman named Roger (who wouldn’t share his last name with us) took down the questions and said he’d get back to me by late afternoon the next day.

He never did.

So when I wrote an update about the ongoing testing scarcity on Sunday, I made note of our futile attempts to learn about the extent of the county’s diagnostic efforts in an article and on Twitter, where many others shared our concern about the lack of transparency.

San Jose Councilman-elect Matt Mahan fired off a series of tweets at about the same time I did last night about the incomplete data.

“Local press ought to provide a big asterisk next to these official Santa Clara County case count numbers,” he wrote. “They are way too low and may lead people to think COVID-19 is less widespread than it is. To explain: The official data imply that 35 percent of known cases require hospitalization and just over 3 percent result in death. These ratios are too high. In fact, they are outside the range seen elsewhere, at least before a health system is overwhelmed. More realistic assumptions are that closer to 15 to 20 percent of cases require hospitalization and about 1 percent result in death.”

With a more realistic death rate of about 1 percent, he went on to say, we should expect that about 1,000 people in the county have COVID-19—not 302. That implies that three-and-a-half times more people have the disease than the official case count tells us.

“Essentially,” Mahan continued. “the case count is meaningless without significantly more testing. As a matter of transparency, @HealthySCC ought to be reporting the number of daily tests completed and press should make clear that the case count represents a significant undercount at this stage.

Other counties have provided constituents with data about testing—even the lack thereof. In Orange County, where officials reported 95 confirmed cases on Sunday, they also noted the total number of people tested by public and commercial labs: 1,585.

When we spoke to Santa Clara County Executive Jeff Smith last night about his agency’s lack of comparable data, he chalked it up to employees being overwhelmed.

Our communications team has been confused and befuddled, he told me. I don’t know exactly the situation with your particular questions, but there’s been a lot of challenges with the EOC [Emergency Operations Center]. The workload’s been pretty immense.

Meanwhile, he added, there simply aren’t enough people to conduct the level of “community surveillance”—public health parlance for finding out who passed the virus on to whom. “All of this is rough stuff,” he said, “as you can imagine.”

It’s safe to assume that anywhere from 4,000 to 5,000 people in Santa Clara County actually have the virus but don’t know because it’s mild or asymptomatic.

“And if each of them infect a few people a week, it just gets harder to trace,” he said.

On Sunday night, Smith said he didn’t have an answer about the total number of tests conducted, but that he’d get me more info on that today. In the meantime, here’s what he does know. The county’s public health lab can only use CDC kits, each of which has supplies for roughly 500 tests. The county lab tests 45 to 50 patients a day. Private labs can do more because they make their own tests.

However, it’s unclear how many tests private labs are conducting because the law only requires them to disclose positives. Smith said the county’s in the process of revising its public health order to get those private labs—including Quest, Stanford and Sunnyvale’s Cepheid—to disclose data about all tests.

I asked him whether the lack of exhaustive data hampers the county’s efforts.

“I guess I would say yes,” he replied. “And the efforts have been changing pretty dramatically. Initially, the focus was on trying to identify and mitigate the disease, then we switched rapidly to community distancing and now the real issue is trying to prevent the health system from getting overwhelmed. So that’s the big focus, and yes, it would be much more effective from an epidemiological perspective to have an idea of what the testing capacity looks like, to know more about the transmission. But at this point, at a l0cal level, we’re in much more of a reactive mode than a planning mode.

Smith and countless others under his purview have had an exhausting few weeks, so we thanked him for taking the time to help us get to the bottom of all this. Seeing so many people go through so much at the same time is a tremendous burden, he acknowledged.

“This is a disaster to begin with, but on top of that we have all these individuals who can’t go to work,” he said. “And here at the county we have a lot of duties and responsibilities and—basically everything’s being knocked off kilter and we’re doing the best we can.

Jennifer Wadsworth is the news editor for San Jose Inside and Metro Silicon Valley. Email tips to [email protected]. Follow her on Twitter at @jennwadsworth. Or, click here to sign up for text updates about what she’s working on.

4 Comments

  1. As the outbreak to continues apace, Santa Clara County has welcomed help from the federal government in setting up a temporary medical facility in a local event venue…

    Trump’s America

    Wait, what !?!

  2. Thank you for asking the right questions. Great reporting Jennifer Wadsworth! I don’t understand how these numbers are not handy and easy to access? Santa Clara County is not immune from public transparency. So much need for honest, no dirty politics media during this crisis times. Thank You!

  3. Jenn, great work, stay on it! If information is hidden or if the public is being lied to how is the public supposed to make the right decisions for them and their families? How does SCC get away with not reporting critical information? What are they hiding?

  4. Jennifer says:

    > I believe we’re in capable hands.

    We’re so blessed to have such capable and competent officials. Not to mention, an astute, skeptical, and energetic press.

    I’m confident that we’ll finally get the homeless crisis resolved, reduce the crime rate, fix the potholes, pave the streets, and have honest elections.

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