COUNTY ADDS 17 ENFORCEMENT WORKERS
State considers federal mandate to vaccinate those age 65 and older
As the number of staffed and available intensive care beds continued to run low Tuesday, county supervisors moved forward with the biggest changes to date in enforcement of local health orders, bringing in 17 more workers and allowing more proactive pursuit of blatant violations.
Those changes came on the same day that federal officials urged states to begin administering COVID-19 vaccines to people age 65 and older and anyone with pre-existing medical conditions.
Though some places have already implemented such changes, San Diego County, home to more than 473,000 people in that age bracket, isn’t among them.
“We will open eligibility as directed or allowed by the state,” said county communications director Mike Workman in an email.
The governor’s office tweeted Tuesday afternoon that the state’s vaccine advisory groups are studying the federal 65 and older recommendations. Dr. Mark Ghaly, the state’s secretary of Health and Human Services,
says the state will likely issue new guidelines by this afternoon.
It is an important question because age, as shown by local and national statistics, is the most accurate predictor of COVID-related mortality. About 15 percent of San Diegans age 80 and older who’ve gotten COVID-19 have died — more than one in seven.
Those age 19 and younger, by comparison, have so far come through without a single coronavirus-related death, according to the county’s weekly surveillance report, though children and young adults have died from the disease elsewhere in the U.S
Vaccinating the region’s most senior residents, then, has the potential to prevent the most deaths.
Tuesday’s daily COVID-19 report underlined that fact with 41 additional deaths among 3,524 additional cases reported. Sixteen were age 80 or older.
For Maureen Martin, 69, bringing age into the vaccination picture can’t happen fast enough. The Encinitas resident worries about her 80-year-old husband, whose medical history includes cancer and heart disease.
“I feel like I’m biting my fingernails waiting to see my husband get that vaccine,” she said. “Every day, I hear from somebody that I know who has actually said goodbye to somebody, and that’s getting a little scary.”
But health care workers, who have been the focus of vaccination campaigns to date, face their own daunting reckoning as the number of COVID patients in local hospitals continues to put pressure on the entire health care delivery system.
There were just 33 intensive care beds listed as “staffed and immediately available” in Tuesday’s report, which ref lected the situation in hospitals Monday. An internal report by the Hospital Association of San Diego and Imperial Counties sent to members Monday afternoon indicated that 20 of those beds were at Rady Children’s hospital, meaning there were just 13 staffed and available adult ICU beds not located in military hospitals across the county.
It’s a particularly thin margin given that hospitalizations associated with New
Year’s celebrations are expected to f lood in this week.
The situation did not seem to be causing Dimitrios Alexiou, the association’s president, to feel fatalistic. Hospitals, he said, are finding creative ways to stretch staff and bed capacity to meet demand.
“We aren’t at the point of running out of beds, but the continued growth in admissions is unsustainable, and we would reiterate the importance of staying at home whenever possible, avoiding large gatherings, wearing a mask when out and maintaining social distance,” Alexiou said.
Health care workers, especially those outside local hospitals, received a significant vaccination surge this week with the opening of a massive super center across the street from Petco Park. Officials said Tuesday that the operation finished Monday having put 3,200 doses in arms with an estimated 3,102 added Tuesday. The goal remains to get to 5,000 doses a day by Friday.
At the moment, most social activity in the community — including outdoor dining and gym-based exercise
— is verboten, banned until Southern California’s collective intensive care bed availability, currently said to be zero, once again exceeds 15 percent.
It has been plain to see, however, that businesses of many types have stayed open, and, for the most part, regulators have looked the other way unless someone lodges a formal complaint.
But that stance appeared to change significantly Tuesday with a 4-1 vote from the San Diego County Board of Supervisors. With supervisor Jim Desmond in opposition, the board opted for a more “proactive” approach to enforcement, which will include bringing in an employee to look for violations, rather than simply waiting for complaints to arrive.
It’s the first time that the county’s Safe Reopening Compliance Team has been directed to take a proactive, rather than reactive, posture toward health order enforcement.
In addition to having one person on the team out looking for egregious violations, Workman said Tuesday that the team will also now be empowered to look around a bit when they do head into the field to investigate specific complaints. If, say, investigators arrive at a restaurant to verify a complaint and observe that another restaurant down the block is also out of compliance, they will now be free to start the enforcement process even if no complaint has yet been filed.
And, the county will also begin to enforce situations where businesses and other organizations are failing to comply with various parts of their “safe reopening ” plans.
To date, enforcement has largely been focused on “egregious” violators who have kept businesses open that are supposed to be shut down. The new plan, Workman confirmed, is to bring in eight additional enforcement workers who will help enforce operating standards such as mask-wearing and social distancing.
Another eight, he added, were already inbound to the enforcement team to help process a large increase in health order violation complaints from the public.
Counting the new worker assigned proactive duties, that’s 17 additional people brought in to help with enforcement.
It didn’t sit well at all with Desmond, who was the lone no vote on upping the enforcement ante Tuesday.
“I’m all for increased education, enforcing health and safety protocols, but not on closing down businesses,” Desmond said.
Newly seated Supervisor Joel Anderson attached an amendment to the enforcement item, asking that all such actions be “based on scientific evidence and applied consistently.”
A lack of sound scientific evidence that infection is spreading in businesses that have been shut down has been one of the most common criticisms of the governor’s regional shutdown order. But board chair Nathan Fletcher was unfazed by the amendment, saying that “all of the efforts we’re taking under the leadership of Dr. (Wilma) Wooten are guided by scientific data surrounding how the virus spreads.”
San Diego County restaurateurs, already frustrated by the weekslong shutdown of in-person dining, were not especially pleased to learn that money will be spent on hiring more enforcement personnel. Ben Clevenger, who heads the board of the San Diego chapter of the California Restaurant association, couldn’t help but offer his sarcastic take on the county’s latest move.
“I’m assuming they hired more enforcement officers because they have to go to all the big box stores to shut them down because they’re not following the rules and are causing the biggest spread of COVID in the industry,” said Clevenger, who owns Eastbound Bar & Grill in Lakeside. “I think it’s a waste of resources. Our officers should be out doing other things and not worry about whether businesses are open and trying to survive.”
Jeff Rosman, past president of the local chapter board, said the county action is a reminder of how uncertain the near-term future is for so many small businesses.
“I wonder if we are ever going to reopen,” said Rossman, who is limiting operations at his Terra American Bistro in San Diego to takeout and delivery only, per the current stay-at-home order.
He says he has “mixed emotions” about those who have chosen to defy the order.
“If we were on our last leg and I was about to lose my home and my car, I don’t know if I would do that,” he said. “I do know there are a lot of businesses that are being forced that hand.
“California is so behind other states where we still don’t even have our patios open. Our ICUs are pretty good, but we’re just lumped in with L.A. on this order.”