What’s Next for Eastern Sierra and COVID-19? An Interview With Mono County Public Health Officer Dr. Thomas Boo

By: 
Wendilyn Grasseschi
Times Reporter

 

The Mammoth Times sat down with Mono County Public Health Officer Dr. Thomas Boo on Wednesday, March 11 to ask him how the virus would be most likely to impact the Eastern Sierra and, what to do about it. There were no local cases confirmed at the time of the interview, but local cases are expected.

 

MT: What is the very most important thing we can do in Mono County right now? 

Dr. Boo: The most important thing I recommend is to think about how you can prepare for this while you continue personal hygiene practices, including staying home when you are sick, avoiding extra contact with sick people when you can, deciding whether you really have to take a trip or not. Can you work from home if the disease is spreading in the community, or you are sick but still up for working?

For employers, I think they should start thinking about what to do if it gets worse. For example, how will you make it easier for your employees to stay home if they get sick?  How will you continue to operate if people are out sick?

For businesses and public places, how can you protect your customers or clients? Signs about staying away if you’re sick? Conducting as much business by phone or computer?  Doubling down on cleaning and sanitizing of public surfaces (and letting people know that you are doing that!)?

 

MT: What is the second most important thing we can do, and when?

Dr. Boo: I think we are at the point where we should be limiting gatherings, voluntarily. The larger the gathering, the more important it is to consider cancelling it to protect communities, or to personally avoid such things. 

If there are gatherings considered essential, people can still try to distance themselves. Physical space does reduce the chance of the spread of infection, since this virus spreads best through close physical interactions. There are still some huge unknowns, but we do know it is spread by droplets, such as when you cough or sneeze, and possibly talk, as well as by contact with the surfaces of items that have been contaminated. But we honestly do not know the relative component of each; i.e. which is the greater risk – spread through the air over short distances (less than three to six feet) or by contact with hands and surfaces. There is still so much research that has to be done here. 

 

MT: What do you suggest people who have elderly parents, or people with underlying health issues, in their family do right now? Should they contact care centers and ask for tests, should they stop visiting their parents, should they take them home, etc.? 

Dr. Boo: So, right now, we should probably cut down on visitations to nursing homes. Nursing homes will likely all be coming up with their own policies and it would be good to call them and find out what those are. But most definitely, if you are sick, do not go to a nursing facility, and do not spend time with your vulnerable family members or friends, if you can possibly avoid it. Even if you’re well, it may be wise to limit your visits, since we think you could still be a carrier for the virus without knowing it.  

If you are vulnerable, or the caregiver for someone vulnerable, try to limit interactions with other people to the extent possible. Maybe stay home from the Senior Center (see if they can provide meal delivery if that is important?). If you have a routine doctor’s appointment, call to see if it can be deferred. Maybe you can have medications refilled without the visit?  

At home, if there are vulnerable people in the household, practice good hygiene, especially if other family members are sick. If the residence permits physical separation when someone is ill, stay away. If it’s not possible to avoid shared surfaces pay extra attention to cleaning and disinfecting the areas they use. Masks have a valuable role to play when people are sick, but unfortunately there are shortages of masks right now and we cannot rely on them.

 

MT: What should locals do if they suspect they might have the virus? 

Dr. Boo: Contact the nearest hospital by phone, or call your clinic or your health care provider. DO NOT GO TO THE HOSPITAL WITHOUT FIRST NOTIFYING THEM that you suspect you might have the virus. We do not want people who think they have it showing up at the clinic or ER without warning. If you are very sick, of course, go to the hospital but call them first. This will give them time to prepare and create a place for you to remain isolated from other health care providers and other patients. We are going to get some updated info on the hospitals this afternoon. They are working to create, isolate and centralize triage areas for patient evaluations, etc. Some of our hospitals right now are beginning to do some in-car screening; people are going out to check vital signs, other things like that, ask questions, and to start the evaluation process. We are trying to avoid our healthcare workers from getting sick, so they will still be there to take care of the sick. They are still working on this issue right now, creating a possible area for just possible COVID 19 cases, such as a triage tent or some kind of facility near the ER entrance. We are still trying to figure that out.

 

MT: At what point will you recommend ending gatherings in Mono County? What triggers that call?

Dr. Boo: The first thing to say is the minute we have a confirmed case in the Eastern Sierra, we will immediately go public with it and we will tell people what actions to take. Regarding your question, so, for example, the community forum in Mammoth on Wednesday night on the COVID19 situation, that will likely be the last time we organize a meeting like this. We will be thinking about other ways to get information out to people besides just news releases, such as videotaping meetings and posting them online, or other ways to get the information out. Every organization will have to do this; to consider whether the need for the meeting is outweighed by the downsides. The more human beings gather together, the more the virus can spread. I am not going to cancel things by an official health order until we have a demonstrated community spread. At that point, we will declare a local health emergency and a series of actions will follow from that. 

 

MT: How long can the virus live on surfaces, such as phones? Are restaurants etc., to be avoided, or just close contact with people? 

Dr. Boo: We do not know yet. It depends on the environmental conditions and many other factors. For example, the drier the air, the shorter the time the virus can live. It is at least many hours and it may be days. Part of the problem is the virus is not a living, breathing thing, and it is difficult to grow it in a culture, so even if you swab a surface and find virus genetic material you don’t know if it is viable and capable of causing infection. Other coronaviruses do seem able to persist on surfaces for some time. 

 

MT: If people do not feel sick but they unknowingly have the virus, can they pass it to others?

Dr. Boo: It looks like that is part of the problem with this virus. We think so. It is maybe a day or two before they even have symptoms, and it seems like they can pass it on. What if someone has the virus, but never has symptoms, can they pass it? That is less clear but probably, they can. We just do not know yet. 

 

MT: Do we have access to enough test kits and if not, how long will it take to get them, and, to get the results back? 

Dr. Boo: Currently there are about 16 public health labs in California that can perform the test; we will send local tests to a lab in Richmond. That said, as of last week, they could only process 40-50 tests per day, which is not enough to meet the needs of all the health care facilities that would like to test people. The good news is Lab Corp and Quest are now offering tests through the commercial sector.  That said, their capacity is also fairly limited. No matter where the testing is done It takes two to three days to get results back, after sending the test out. What we really need is locally available tests that can be performed the same day, but I do not know when we are going to have that. 

So, what health care providers are having to do now is decide on a case-by-case basis how to handle each client. We wish we could test everyone, but we have to go by who seems most likely to have it, or if they are at greater risk of dying from the virus due to age or the severity of their condition or underlying health issues.

 

For more information, go to monohealth.com. The Mono County Public Health Department is the lead agency for the COVID-19 response in Mono County and this website will be constantly updated. Also, call 760- 924-1830 or 760-932-5580 for more information. 

 

 

 

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