Under questioning at the Board of Supervisors meeting Tuesday, Kern County's top public health official acknowledged concerns about a potential shortage of supplies and healthcare workers to meet an expected wave of COVID-19 cases, and defended his department's limited release of data despite clamoring by the public for more details about COVID-19 cases in the county.
Tuesday was the first supervisors meeting since the COVID-19 outbreak as the meeting scheduled two weeks prior was canceled as concern about the virus began to spread. Chambers were closed to the public but board chairwoman Supervisor Leticia Perez said staff were researching a way to include the public in the meetings in the future. The body's first order of business was to discuss the public health department's response to the epidemic and ratify a local health emergency declaration by unanimous vote.
Kern County Public Health Services Director Matt Constantine said the county has fulfilled more than 100 requests from local healthcare providers and facilities in the past two weeks for personal protective equipment; however, supplies are dwindling and replenishments from the state are spotty. More than two dozen other requests have gone unfulfilled, he said.
Based on current inventory, there is a two-week supply of masks, gowns, goggles, hand sanitizers and other equipment, Constantine said.
"Beyond that we exhaust our supplies locally," Constantine said.
Requests by the county to the state for additional supplies have yielded uneven results, Constantine said. Last week, a truck with 23 pallets of supplies arrived, he told supervisors, but this week only one pallet arrived.
Constantine said he doesn't know when shipments will arrive or how much is being shipped until it arrives.
"It makes it very difficult for me, when I get requests from hospitals, to know when I'm going to be able to fulfill them. It has been a challenge," Constantine said.
The county's supply is meant to provide “temporary relief if local providers are unable to find resources themselves,” Constantine said.
And that's exactly what's happening at many hospitals.
Kern Valley Healthcare District CEO Tim McGlew, reached at his office Tuesday, said his facility's normal vendors have been unable to fulfill orders for the past two weeks.
"It's difficult. You place your orders and you anticipate supplies be there at a certain time, when they don't show up it gets to be a little bit of panic mode," McGlew said.
"We would have (hand sanitizer) orders placed and it's due to be delivered today or tomorrow and suddenly we get an email saying your order is canceled," he said. "And there's no date on when it will be filled."
Given that situation, supplies could become a major issue if a surge in patients happens in the coming weeks.
Supervisor Mike Maggard raised the possibility of calling on local medical offices not providing acute care — a gastroenterologist, for example — to donate surplus supplies they have on hand. Or, he asked, would the county have the authority to commandeer those supplies if necessary?
Maggard also asked if local businesses and facilities with the ability to manufacture or do 3D-printing could help produce some of the needed supplies.
Constantine said he is exploring all options.
Also at the meeting:
Additional medical staff is another major concern if hospitals become inundated and have to scale up their patient capacity, and if the county needs to activate the alternative care site being established at the fairgrounds.
Constantine said he is unsure yet how he will staff the alternative care site being built at the Kern County Fairgrounds. Maggard asked if the county should look into trying to rehire people with medical experience.
"I think any additional opportunity to bring back people with that background should be explored," Constantine said.
Constantine defended the public health department's decision on the limited amount of data being released on positive COVID-19 cases.
Supervisors at times grilled him on why more data couldn't be released.
Once 100 positive cases of COVID-19 is reached in the county, another level of data will be released, Constantine said, most likely age ranges.
"It would sure be nice if we can understand for the betterment of the community that we had a pocket of virus infected people in you know this place, so we could better manage the community," said Supervisor Mick Gleason, who represents Ridgecrest and other desert areas. He asked if there wasn't a way to better balance privacy rights and using the data we have to manage the situation in the best way possible.
Constantine responded saying he disagreed: "I don’t believe it's helpful to know a house or a street where somebody is positive. COVID-19 is in your community now. It is likely being spread through the community. It does not help to focus on a certain location. It is here; we all need to take protections."
The department is reporting cases in five regions of the county, each with a similar population. The vast "desert" and "mountain" region public health has identified is related to the population in those areas.
Asked if other counties that were releasing additional data were violating state guidelines, Constantine said it seemed some are.
Constantine said his job "is to protect privacy rights," for ethical purposes and so the county isn't sued.