San Diego County Approaches 24,000 COVID-19 Cases After More Than 1,000 Reported Over Weekend

Speaker 1: 00:00 We start this week with a sense of uncertainty as the number of coronavirus cases around the country, the state, and here in San Diego continues to increase governor Gavin Newsome said this morning that the rate of people testing positive in California is holding steady at 7.4%. Over the last 14 days, he said, hospitalizations are still rising at 16% though, the rate is slowing new. Some said the state has put out new guidelines for personal care businesses to do business outdoors. He said the future course of the pandemic is up to us. Speaker 2: 00:33 We have to minimize the transmission of this disease. We have to minimize that by practicing physical distancing, wearing the face coverings and doing the kinds of things that, uh, I think are well described. And obviously now need to be, uh, more vigilantly followed. If we're going to move past this, uh, more expeditiously Speaker 1: 00:55 Here to help us put the latest news into perspective and talk about our prospects for getting a handle on the spread of COVID-19 is dr. Mark Sawyer and infectious disease specialist at radios children's hospital. He's also chair of the UC San Diego immunization project. Dr. Sawyer, thanks for being with us. Great to join you. So now in San Diego County, more than a thousand people tested positive for COVID-19 over the weekend, the rate of people tested who tested positive over the last 14 days in San Diego is now 6%. And we just heard the governor say that the state's positivity rate is holding steady at 7.4%. What actually does this tell you? Speaker 2: 01:37 Well, the percent of tests that are positive is a good way to get a measure of the burden of disease in our community. It's, it's better than just counting total cases because total cases is impacted by how much testing you're doing. So this is a metric that the CDC and the state and the County are all using to decide how we're doing. And although we're at 6%, which is not terrible, you know, we were at two or 3%, a few months ago. So we're definitely on the increase compared to that. Speaker 1: 02:07 What is the statistic that you personally pay particularly close attention to when assessing how we're doing Speaker 2: 02:14 Well? That's one, the other is the hospitalization rate because people recall the whole purpose of the initial social distancing was to quote flatten the curve that is not overwhelm our health system. So we're watching the number of people put in the hospital, which is both a measure of how active the disease is, but also a measure of our health capacity and our ability to take care of those people who get it. Speaker 1: 02:40 So the governor said that, uh, the increase in hospitalization rates around the state is 16% it's increasing, but it's the increase is slowing. What's the situation for San Diego hospitals this week? Speaker 2: 02:52 I think it's quite similar. Uh, you know, we saw an upswing in cases two or three weeks ago, and the hospitalizations to lag behind that because it takes people one or two weeks to get sick enough to be put in the hospital. So the fact that their hospitalization rate is beginning to decrease as a good sign. It may be we're getting towards the end of this most recent peak that started in the middle of June. Speaker 1: 03:16 And was that peak caused because do you think that we opened too soon? Speaker 2: 03:21 Almost certainly. I'm not sure open too soon as that is the key ingredient. The key ingredient is people gathering in enclosed spaces and not wearing masks. So, you know, I'm of the opinion that if we could just get people to wear masks, when they're within close contact, meaning six feet of other people that we could probably go about our business more or less as we have been up until now, but people seem reluctant or subsets of people seem reluctant to do that. Speaker 1: 03:51 Yes. Now it's interesting because the other factor seems to be being outside. And the governor said the state's put new guidelines out for hairdressing salons to operate outside. And today San Diego mayor Kevin Faulkner signed an executive order, allowing churches and businesses like hair sandals and gyms and nail salons to operate outside in private parking lots. Um, I saw a chair service in a neighborhood park yesterday, and there were very few masks. There were people were sitting close together. What do you think about whether services can be done safely just by moving outdoors? Speaker 2: 04:26 Well, there's no doubt that the outdoor environment is much better for people, whether you have a mask on or not. We have learned in the last couple of months that closed spaces with a little air circulation are a bad setup for spread of the Corona virus. So that's been seen in houses it's been seen in other environments. So I certainly endorsed the idea that, that if you're going to be around other people, if you can do that outdoors, you're better. I think it's still important to wear masks because outdoors is not a perfect solution. So if you combine wearing a mask and being outdoors, then your chance of getting infected is very low. Speaker 1: 05:08 Oh, there's some businesses that you have more concerned about than others, even if they're outdoors, you know, for example, is it more risky to be working out than sitting, having your haircut? Yeah, Speaker 2: 05:18 I, you know, I think a lot has been made about people singing and shouting and spewing out virus. I think that's a minor component. I think whenever you're within a few feet of another person, whether they're just sitting quietly or whether they're talking, you have the potential to get infected. So I think the emphasis should be on a distancing. Remember that six foot measure between other people and masks. If we just did those two things, we'd be in much better shape. Speaker 1: 05:48 Do you have any concerns about the variety of face coverings that are passing as masks these days? I mean, what is the key factor that makes them effective? I think any Speaker 2: 05:58 Barrier in front of your face that prevents you from coughing out particles is good. You know, there is a spectrum all the way up to what's called the [inaudible] that are used in very high risk situations in the hospital, but I think people should focus less on what their mask is made of and focus more on it, putting their mask on when they're around somebody, the tendency is to take it off to talk or, or to smile at somebody. And then you forget to put it back on. And then the next thing you know, you've been in close contact. Speaker 1: 06:30 Hmm. Let's talk about contact tracing the, the rate of COVID cases that were investigated by contact tracers fell to 7% over the weekend in San Diego. Um, in the big picture of all the ways that we seem to be falling short and managing the virus. How serious is the shortage of contact tracers? Speaker 2: 06:48 Well, I, I think that is one of the longterm strategies that we're going to have to rely on. And we've learned that in part from other countries, who've been able to do it a little better than we have it. If you can just identify all of the active cases quickly, then you can notify them and notify the people around them that they're at extreme risk and they will need to really be careful. And if you do that, you interrupt the transmission. It's, it's the inadvertent transmission, because you don't know you're infected or you don't know you've been exposed that leads to the widespread outbreaks that we've seen in the last month. So we need to know who's got the infection. Speaker 1: 07:29 Do you have any words for people who are contacted by our contact racer? Speaker 2: 07:34 Oh, you should absolutely listen to them and respond to their questions because you're going to be a key ingredient in interrupting this, this pandemic. If, if we could just reach everybody and, and let them know they're infected and get instructions about how to respond after, you know, you're infected that. I think we're going to win the battle. Speaker 1: 07:56 Now, one of the big issues of course right now is schools reopening in the fall or not reopening in the fall. What do recent studies tell us about the risks to children? Speaker 2: 08:06 Well, first of all, I was talking about the risk of them when they get infected. The only good story in this whole SAR Scobey to pandemic is that children tend to not get very sick, which is great news. We've we've only had a few dozen children hospitalized at Rady children's hospital in San Diego, in contrast to all of the adult hospitals who have been bursting at the seams. So that's the good news. And I know there has been some, some coverage of the concept that children don't spread the infection as well as adults do. And although that may be true to some extent or in sub subsets of children, it's certainly not absolutely true. So we do know that children can transmit the infection. We do know that they can be infectious, even without in fact, maybe they're more likely to not have symptoms when they're infected. And so they're among these groups of inadvertent transmitters who don't know they're infected and he had spread it to their family. Speaker 1: 09:09 Do you think it's possible to reopen the school safely at this point? Speaker 2: 09:13 I think it's possible, but there are a number of challenges we have to maintain the same social distancing that we're maintaining everywhere else. And that right off the bat is going to be difficult in schools. Ideally, we would have children who are old enough, wear a mask in schools. Uh, so you know, a number of strategies have been put forth staggering classes, staggering days of the week when certain children come to the actual school and doing some of the learning online, I think if we could implement all those strategies, there's a chance that we could reopen schools, but unless the school is prepared to do that, then I do think there's some risk and going right back to business as usual and schools, Speaker 1: 09:58 We just have a minute left. I wanted to ask you to your reaction, to the latest surveys that find a significant number of Americans are either unwilling to have a vaccine. Once one is developed or unsure if they will. Speaker 2: 10:10 Yeah. I have a feeling they'll change their tune when it's a real yes or no answer. We certainly see people flocking for the H one N one influenza vaccine. When it came out in 2009, we have some early results, actually, some just released today of one of the new vaccine candidates, which are quite encouraging. So I am optimistic that we're going to have a vaccine in a matter of months rather than years. And I think when it becomes available, I'll be surprised if people don't want to go get it. Speaker 1: 10:42 Good. Well, thank you so much for bringing us your expertise, dr. Sawyer. Thank you. That's dr. Mark Sawyer and infectious disease specialist at radius children's hospital, who is also chair of UC San Diego's immunization project.