San Mateo County Health Advisory Stresses Community Interventions to Limit Surge of COVID-19

San Mateo County Health issued a new health advisory, with recommendations for community interventions to limit the surge of COVID-19. By reviewing the science, epidemiology, and local case investigations, the County is focusing on reducing transmission from social gatherings and among household members. Health officials are emphasizing three core practices and the science behind them that everyone should follow.

The advisory, which is sent to health care practitioners in the county and reinforces recommendations and actions for the public, may be found here.

These preventive measures build upon guidance from the California Department of Public Health (CDPH) and new science emerging from the Centers for Disease Control and Prevention (CDC). Acknowledging that pandemic fatigue affects adherence to additional governmental restrictions, health officials emphasize three recommendations:

·      Always mask in public, particularly when talking.

·      Insulate your household and any small, stable “Social Support Bubble” from the virus

·      Mask – Isolate – Quarantine – Test. Immediately for any symptoms, or after an exposure.

“The surge of cases has been alarming, and we need to increase our response immediately. We recommend that community leaders, health care, and public health work together more than ever,” said Curtis Chan, MD, the county’s deputy health officer. “Community leaders have told us that people want to learn more about how transmission occurs. Clear information that the virus is transmitted by someone without having symptoms helps people plan their lives under pandemic rules and quickly respond if a household member develops symptoms.”

“Much of the preventable transmission occurs because of social gatherings and within households, particularly from asymptomatic or pre-symptomatic individuals,” said Catherine Sallenave, MD, the County’s communicable disease controller. “Our case investigators and contact tracers are listening to the worsening stress and circumstances that families are experiencing and hearing the need for psychosocial support to increase their wellness and ability to function in these unprecedented times.” 

The health advisory is clear to explain the science behind these measures. “The majority of transmissions occurs from people with no symptoms of COVID-19,” said Chan, “and airborne droplets are the primary way the disease spreads. This is why we’re emphasizing always wear face coverings even if you have no symptoms and particularly when you’re talking.”

To stop transmission from social gatherings, particularly among young adults, Vanessa de la Cruz, MD, the county’s medical director of Behavioral Health and Recovery Services highlights the importance of a harm-reduction approach in limiting transmission “We’re trying to urgently change behaviors of people who haven’t been following health orders,” she said. “Behavioral health experts emphasize the importance of providing people with scientific information and facts.” Health messages, she said, can be more effective if they allow individuals to maintain personal control and make a personal impact for their families and friends.

Infectious disease experts worked with behavioral health physicians to develop an approach to insulate households and “social-support bubbles” from the virus. These social-support bubbles should be small (1-2 households) and stable, with the same members across periods of weeks. The function of social-support bubbles is to provide essential physical, emotional, and social support. With the epidemic worsening, it’s important to further insulate these households and social-support bubbles to prevent the virus from entering.

San Mateo County Health strongly discourages any social gatherings these next few weeks, particularly those across different households and those indoors. The California Department of Public Health defines gatherings as social situations that bring together people from different households at the same time in a single space or place. When people from different households mix, this increases the risk of transmission of COVID-19.

To minimize household transmission, County Health recommends immediate actions when symptoms develop, instead of waiting for test results. 

Anyone developing symptoms suggestive of COVID-19 should IMMEDIATELY isolate themselves, mask all household members, quarantine household contacts then get tested.

·      Mask for all: The symptomatic individual and everyone else in the household should wear a mask. SARS-COV-2 is most infectious in the 2 days before, and the first 5 days after the onset of symptoms.

·      Isolate: The symptomatic individual should stay in a separate room and avoid common areas. Open windows widely to increase ventilation, if possible. 

·      Quarantine for household members and close-contacts should be considered.

·      Test the symptomatic person immediately, along with any contacts developing symptoms.

Individuals should also contact their personal health care provider, who can help individuals interpret the test, and decide if further isolation and quarantine is necessary.

Residents without a health care provider should call 211 to be connected to San Mateo County’s system of support.

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