When Sacramento County health director Dr. Peter Beilenson recently suspended the 14-day quarantine for people who’ve been exposed to COVID-19, he described it as a shift from trying to contain the illness on an individual level to slowing its spread on a population scale.
He’s faced backlash for that decision, and he’s defending it. He said Sacramento is “behind the eight ball” on combating the virus because of a shortage of test kits.
“Because we didn’t have the testing available, we have not been able to do the kind of quarantining that we want to do, so we’ve switched to a mitigation strategy,” he said.
The county was initially focused on identifying positive cases, tracing their recent contacts and asking anyone who may have been exposed to stay home. But Beilenson said Tuesday that there was “no point” to keeping healthy people quarantined without a way to test them.
Some CapRadio listeners have asked whether Beilenson took a step backward in ending the quarantine.
We spoke to a number of public health organizations such as the California State Association of Counties and the National Association of County and City Health Officials. Their representatives say Beilenson made the right move.
In the public health world, mitigation is considered a more aggressive step for when containment doesn’t work. Kat Deburgh, executive director of the Health Officers Association of California, said it’s a way to “flatten the curve,” or reduce the number of people who get sick at the peak of an outbreak. Having fewer people sick at once means less of a strain on the health care system, she said.
“Instead of trying to stop it completely, you’re trying to slow the growth in order to ease the burden on all of our systems,” she said.
Deburgh said health agencies all over the state are moving toward mitigation as their caseloads increase. She said many are taking a dual approach by continuing to enforce quarantines while also putting community-wide restrictions in place.
But some Sacramento residents feel the end of containment happened too early in Sacramento, and without firm plans to reduce the spread.
“They had no plan for mitigation,” said Jonathan Eisen, a UC Davis microbiologist who’s been following Beilenson’s announcements. “Everybody around the country was talking about reducing large gatherings … and if they think it’s time to switch over from containment, you should have a mitigation plan.”
Beilenson initially did not move to cancel large gatherings or close schools, arguing the county would take that step as case numbers grew. Instead, they urged seniors and medically fragile individuals to refrain from crowded public spaces, and asked people experiencing COVID-19 symptoms such as cough and fever to stay home.
But Sacramento has published new guidelines following California Gov. Gavin Newsom’s Wednesday decision to cancel all events of 250 people or more and new recommendations from the U.S. Centers for Disease Control and Prevention. The county now says large gatherings should be postponed or canceled, though smaller events may proceed if people can stay six feet apart.
Seniors and other people at high risk should avoid gatherings of more than 10 people, according to the new guidelines.
Still, critics say the county didn’t go far enough.
“They should’ve been way more aggressive two weeks ago, let alone a week ago,” Eisen said. “And switching over to this yesterday is late.”
Beilenson says the governor’s decision to cancel mass gatherings makes sense. But he stands by his approach of focusing on at-risk groups.
“Once the cat’s out of the bag if you will, it’s really important to mitigate and be more surgical in our approach, which is trying to keep people from exposing seniors to the virus and keep seniors from being exposed,” Beilenson said.
This shift in thinking is necessary when agencies are strapped for resources, said Deburgh of the Health Officers Association of California. Containment is effective, but it takes money and staff.
“And local health departments don’t have an unlimited number of people to call anyone who may have come into contact with someone who may have been exposed to COVID-19,” she said.
Officials are reminding individuals to wash their hands, and call their doctor if they feel sick before showing up in a health care setting.
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