'The Red Flags are Flying' 

With cases surging locally at unprecedented levels, Humboldt County Health Officer Teresa Frankovich gave her final media availability Dec. 1 before stepping into a lesser role with Public Health, offering a last plea for the local community to stay the course of sacrifice while expressing optimism that recent vaccine developments mean the end is near.

Hired in January to what was then a part-time role shortly after she moved to Humboldt County from Michigan, Frankovich announced in September that she would be resigning from what by then had become a more than full-time position as soon as the county hired a replacement, saying she felt the county pandemic response was in good shape and she needed to make good on some promises made to her family, including her recently retired husband. The county held interviews for the health officer post last month, with the Humboldt County Board of Supervisors slated to approve the new hire Dec. 8. Deputy Health Officer Josh Ennis will serve in an acting role until the county's next health officer is announced, and Frankovich has pledged to stay on in a part-time capacity as long as needed.

"I just want to say again how grateful I am for having had the opportunity to serve as the health officer for Humboldt County," Frankovich read from a prepared statement to start her final availability. "I have found out the hard way that the fastest way to find out what is at the core of your new community is to face a pandemic together. I don't recommend this approach. But the gift has been seeing the incredible heart of this place, the way most of us have recognized this as the moment to put into practice the things we teach our children about kindness and the responsibility we all have to one another. And as hard and as exhausting as this has been, I would do it all again because it has been a privilege to be able to do important work and to do it alongside and on behalf of people I deeply respect and admire. Every day, I am literally surrounded by my personal heroes at Public Health and the (emergency operations center) who have given their all to this effort for 10 months and still show up every day to do it again."

But while Frankovich took time to express gratitude for county staff and the community, and to extoll the work put in to build response infrastructure locally, she conceded a "challenging period" looms as cases surge to unprecedented levels locally, statewide and nationally. The county reported 21 new confirmed COVID-19 cases the same day — making 69 over two days and putting Humboldt on track for another record-breaking week after it confirmed 328 cases in November.

When the state updated its county COVID-19 risk tiers Dec. 1, Humboldt County remained firmly in its most restrictive "widespread" purple tier for a third consecutive week, having confirmed an average of 10.7 new cases daily per 100,000 residents with a test-positivity rate of 3.2 percent for the week ending Nov. 25. Numbers have only worsened since, with the county having seen an average of 12.3 new cases confirmed daily per 100,000 residents and a test-positivity rate of 6.3 percent between then and when the Journal went to press Dec. 1.

The state's purple tier — which now includes 52 of its 58 counties and 99.2 percent of its population — requires that counties shutter bars and close indoor operations at movie theaters, restaurants and places of worship, while also imposing a limited shelter-in-place order requiring people to stay home nightly from 10 p.m. to 5 a.m., save for essential outings. But Gov. Gavin Newsom warned Nov. 30 that the current rate of new cases and hospitalizations throughout the state may necessitate further restrictions.

During a press conference, Newsom explained data indicates roughly 12 percent of daily COVID-19 cases will be hospitalized two weeks after they're reported, and that 10 to 30 percent of hospitalizations will require intensive care or respiratory support. Those numbers put the state on a dangerous track, he said, adding that ICUs in Northern California are already at 85 percent capacity, with state projections indicating they will pass 130 percent of capacity by early December.

If Newsom's numbers prove accurate, Humboldt would see roughly 15 local residents hospitalized the week of Dec. 7 (two weeks after it recorded 122 new cases the week of Nov. 23), with as many as five requiring intensive care treatment, and the numbers looking poised to rise from there.

"The red flags are flying," Newsom said. "If these trends continue, we'll have to take much more dramatic — arguably drastic — action, including taking a look at those purple tiered counties."

The governor later added that he would consider a widespread stay-at-home order akin to the one issued in March in regions where hospitals are on the verge of becoming overwhelmed.

Frankovich said she "certainly" has concerns about local healthcare capacity given the case rate increases currently being seen in Humboldt County but said she feels local hospitals have worked hard to expand capacity and bring in additional equipment, like ventilators. She also said the 100-bed alternate care site at Redwood Acres Fairgrounds is standing by and, if activated, would provide a safety valve by taking in less acutely ill patients, freeing up hospital beds for those in more dire need.

"We still hope to never need it but it will be there if we do," she said of the Redwood Acres facility before being asked whether there would be enough healthcare providers to staff all those beds should they be needed. "We're counting on all of our healthcare friends in the county to step in and help when we need that, and we also have our disaster service volunteers that we'll be looking at, as well. In addition, the state potentially has assets, depending on what's happening, and the state, of course, is able to ask the federal government as well. So it's a work in progress."

Frankovich also referenced the federal government when asked about what she'll reflect on as the biggest challenges of her 10-month tenure.

"Probably the single most challenging issue has been the lack of national policy on COVID-19 response and the political divisiveness that arose out of that," she said. "I think it has made this more complicated than it had to be and I think it'll be a lesson going forward."

Despite the challenges of working in an environment that was devoid of federal leadership and left states and counties competing against each other to secure supply chains and build the infrastructure needed to respond to the pandemic, Frankovich said Humboldt County has done well positioning itself for whatever is to come.

"For a very long time — longer than every other large county — we held COVID-19 at bay," Frankovich said. "Finally, as most of the country and the state surged in cases, we began to see the impossibility of keeping COVID forever outside our gate. But the time gained has made us far better prepared than we would have been last spring."

Frankovich then touted county efforts to greatly expand testing capacity and its contact investigation team, both crucial to any efforts to identify virus clusters and limit their spread, and again mentioned the Redwood Acres site. But she also made no bones about the fact that the current situation is dire and that residents need to do all they can to keep the current surge from spilling out of control.

"We are entering a challenging period in this pandemic, with surging cases and threatened hospital capacity statewide," she said. "It's going to take concerted effort by all of us and continued sacrifice to move through this wave with fewer severely ill individuals and fewer lives lost. But the vaccine is coming. Data suggest it will be safe and effective and is likely to be the thing that propels us forward out of this pandemic and the enormous toll it has taken on all parts of our community, children, families, businesses, schools and the most vulnerable across the county. But I am hopeful we will celebrate its end soon, and we will celebrate it together. All of us. Healthy and together. It will be a most amazing day."

Thadeus Greenson (he/him) is the Journal's news editor. Reach him at 442-1400, extension 321, or [email protected]. Follow him on Twitter @thadeusgreenson.