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Napa County health leader discusses criteria for a return-to-normal
Public Health

Napa County health leader discusses criteria for a return-to-normal

From the Complete coronavirus coverage from the Napa Valley Register, St. Helena Star, and The Weekly Calistogan series
Whole Foods line, April 11

A line of socially distancing customers waits to enter Whole Foods on Saturday.

Someday, shelter-at-home orders will be relaxed, though Napa County’s public health leader warns against expecting an instant return to the good old days of just a few months ago.

“I don’t think it’s going to be an on-off switch, that shelter-at-home is here today, it’s gone tomorrow,” Public Health Officer Karen Relucio said. “It’s going to be more of a phased approach.”

Think of it as a dimmer switch, she said.

Perhaps the definitions of essential businesses and essential activities are expanded. For example, people might return to work, but still be banned from having large gatherings, she said.

Relucio gave updates on the local COVID-19 situation to the county Board of Supervisors on Tuesday and on Napa County Facebook Live last Friday.

She didn’t suggest possible dates for dialing back restrictions. Instead, she listed possible criteria.

Among them are no new hospitalizations for 14 days, wide-spread testing, the ability to identify and isolate 100 percent of COVID-19 cases, the ability to quarantine 90 percent of COVID-19 case contacts, sufficient personal protective equipment for hospitals and sufficient hospital staffing.

“This is not set in stone,” Relucio said. “These are just some ideas.”

Napa County isn’t acting in a vacuum, given Gov. Gavin Newsom has all of California under a shelter-at-home order. The Napa County order issued by Relucio gives more specifics for this county.

Supervisor Ryan Gregory expressed concern that Bay Area counties might reopen in a disorganized fashion, with some communities causing pressure on others that aren’t as ready.

Supervisor Brad Wagenknecht asked how testing is going, given that expanded testing is a key to relaxing social distancing orders. As of Tuesday morning, 731 residents had been tested, resulting in 38 known cases. Testing has been a challenge statewide and nationwide.

“Although there have been a lot of announcements about increasing testing, the faucet has been dripping slowly,” Relucio said “We see a little more gradually. I’m going to be measured and say ‘I’ll believe it when I see it.’”

On another front, computer modeling suggests Napa County will indeed “flatten the curve” if residents adhere to shelter-at-home and social distancing. The goal is to spread out infections so hospitals can handle the peak of COVID-19 cases that require hospitalization.

Napa County has looked at four computer models. Three show that good social distancing practices might result in an early-summer-to-early-fall hospital surge peak in the range of 13 to 25 patients. Slack practices might push this up to 171 to 476 patients. These results are better than previous modeling.

The outlier, a Stanford University model, shows a peak of 392 patients in late July with good practices and a peak of 802 in early May with lax practices.

Relucio said the modeling is not a crystal ball and has limitations. Still, she described the overall picture as “hopeful.”

Developing a COVID-19 vaccine will be a long road. No vaccine has been developed for a coronavirus, she said.

Meanwhile, prolonged shelter-at-home has socio-economic and emotional repercussions. Efforts to protect against the disease have effects downstream, she said.

Some publications talk about allowing some portions of the population to be infected in a controlled way to create “herd immunity.” Then these people’s immunity would slow transmission, Relucio said.

“In the state of California, where there are a lot of mixed-generation families, that’s going to be risky,” Relucio said.

Another proposal is to shelter high-risk populations and let others go free, she said.

“These are just ideas,” Relucio added, mentioning them as information for supervisors rather than giving her endorsement.

Napa County plans to use such sites as the Napa Valley Expo fairgrounds in the city of Napa as places for additional patient beds, should hospitals become swamped. But the county won’t immediately set up beds there.

The California Department of Public Health asked communities to slow down alternative care site planning. It said it believes hospitals have enough surge capacity to meet the needs of people who will need to be hospitalized, Relucio said.

Relucio addressed the topic of face coverings such as cloth masks to prevent the wearer from giving the coronavirus to another person. About a quarter of COVID-19 cases are asymptomatic, she said.

“We highly encourage people to wear face coverings, especially if they’re going to be shopping for groceries and other essential services,” Relucio said. “But it’s not a mandate.”

Relucio wore a mask to Tuesday’s Board of Supervisors meeting.

Editor’s Note: Because of the health implications of the COVID-19 virus, this article is being made available free to subscribers and non-subscribers alike. If you’d like to join us in supporting the mission of local journalism, please visit

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Napa County Reporter

Barry Eberling covers Napa County government, transportation, the environment and general assignments. He has worked for the Napa Valley Register since fall 2014 and previously worked 27 years for the Daily Republic of Fairfield.

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