Commentary: Our Fate Is in Our Own Hands

By Tia Will

I attended our Zoom Board of Supervisors meeting on 11/17/20. One of the items was an update on COVID-19 in Yolo County. A presentation was given by our new Health Officer,

Dr. Aimee Bisson. Dr. Bisson presented a crisp, concise, and easily understood report along with her recommendations. This was followed by public comment and supervisor questions and commentary.

Dr. Bisson’s recommendations have been widely published, but do not seem to have universal public support. These recommendations are:

  1. Get a flu shot
  2. Don’t gather indoors with those outside your household
  3. Confine gatherings with others to outside, distanced by 6ft, masked, no more than 3 households and no more than 16 individuals
  4. Remain distanced even outside
  5. Use masks when outside your home.
  6. Cleanse hands frequently
  7. Stay home if symptomatic (except as advised).
  8. Test if symptomatic

The title of this article is a direct quote from Supervisor Provenza. It was one of the three comments that for me defined the essence of this item. It is not only a plea for personal responsibility in following the above guidelines. It is also an acknowledgement that our community, at least on the county level, has not been successful in our efforts to curb viral spread through adherence to these recommendations.

The second quote, also from Supervisor Provenza was: “The primary goal is to save lives.” This statement would seem to me to be self- evident, but unfortunately some members of our community do not seem to share this priority, or fail to make the connection between saving lives and the economic health of our businesses and community as a whole. A healthy economy is going to be dependent on those who spend money being willing to go outside their homes. As the numbers of cases and deaths rise, the willingness to participate in usual shopping, dining and entertainment patterns decreases. A healthy economy is dependent on a health citizenry with money to spend.

The final of my memorable quotes from the meeting came from Dr. Sisson. She said:

“Now is the highest risk time for COVID-19 in Yolo County.” She is right. Our numbers have risen dramatically since the decision was made to loosen the restrictions. We now are back at the numbers of cases that we had after we prematurely opened in April/May. We were at 22 county deaths when we opened after our initial shutdown. We are now at 70 deaths. In addition to these numbers we are facing a triad of problems. We are moving into colder weather which drives people inside, the tradition of gathering in large groups for Thanksgiving and the same tradition for Christmas. This brings me to several thoughts about other steps we could be taking to help stem the spread.

First, we could be more proactive in our communications with all inhabitants of the county. One practice adopted by several adjacent counties is the use of our county emergency notification system to alert residents of the move from the red to purple tiers with the associated restrictions. Concern was expressed about “overuse of this system”, however, I am hard put with the possible exception of flooding or fire, to think of a more appropriate time to notify the public of a major danger and the mitigating steps they are encouraged to take.

Second, until now, the county has been relying largely on the honor system combined with education and communication. I heartily agreed with these as the first line approach. I considered these reasonable first steps at the beginning of restrictions. However, I would point out these have been our go-to for the past 8 months. At the beginning, they could have been considered proactive. Eight months into the worse pandemic of our lives, I can only see them as reactive and inadequate. I strongly urge our individual cities and jurisdictions to use the system of citations and fines we have adopted to underline the seriousness of compliance.

As a third step, I would like to see more information about the lesser known aspects of the disease and the possibility of not yet available mitigating factors that may be on the horizon.

While it is correct that the goal is to save lives, a second consideration is the outcomes of what have been called the long haulers. These are individuals, often younger than those at greatest risk of death, who get what initially appears to be a rather mild case, but then continue to have disabling cardiac, pulmonary and cognitive issues which can be disabling for months. The existence of these cases highlights the error of the common myth among our youth that they should expose themselves and “just get it over with”.

Finally a few words about the future. It was noted that while there may be a light at the end of the tunnel, in the form of vaccines and treatments, we are still deep within the tunnel.

As far as a vaccine, there are now two candidates. Neither have achieved complete testing so the timing of their distribution and the prioritization for various groups is still a ways off. With regard to treatment, we do have approval for the use of monoclonal antibodies. There are however, multiple challenges. This treatment is for those with mild to moderate symptoms. It can only be given IV over the course of one hour with a follow up observation period. While it is technically available, allocation is a major issue with only four treatments allocated to Yolo County to date.

I leave this article with my usual personal recommendations.

  1. Follow Dr. Bisson’s advice
  2. Prevention is always more effective and cost effective than treatment or mitigation.
  3. The county should be less timid and should be using the most proactive legal measures available to us rather than responding reactively.

Tia Will is a retired OB/ GYN and a board member of the Vanguard


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About The Author

Tia is a graduate of UCDMC and long time resident of Davis who raised her two now adult children here. She is a local obstetrician gynecologist with special interests in preventive medicine and public health and safety. All articles and posts written by Tia are reflective only of her own opinions and are in no way a reflection of the opinions of her partners or her employer.

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16 Comments

  1. Don Shor

    This is incredibly frustrating. The spike in infections was predicted months ago and all the reasons it was predicted played out.

    Notwithstanding that Davis ranks far below other cities in Yolo County in infection rates, I feel as though we are getting to a simple rejoinder for those who want to party on:

    Your social gatherings are the reason our hospitals are full, people are dying, and businesses are closing. 

     

    1. Todd Edelman

      social gatherings

      Indeed.

      So then, the question is not so much about why there are more restrictions in non-high-transmission environments, but how is this interpreted in thought and action by conscious citizens. Sure, there’s some new or recycled detail about home gatherings, but most of this is about extra-home gatherings with restrictions that drive people inside as acknowledged. But what’s really being done besides “please don’t?”.

      It reminds me in a way of the signs asking people to slow down while driving — but these signs are small and placed so high that they can’t be seen by people driving fast.

      Seems that there’s still a lack of direction in this regard by people with a better understand of psychology, “group think” and the like.

      Also, there’s no reason to wear a mask outside when you’re not around people. YES, one must have a mask with them, in case it’s needed, even if you don’t plan to go somewhere where you’ll need it. For good and bad reasons people resist this rule, but the end result seems to be that it makes people resistant to wearing them when they should.

      1. Alan Miller

        there’s no reason to wear a mask outside when you’re not around people.

        I am a total maskavist, but the pathology of not wearing masks goes both ways.  I was in SF last week, and was told I had to wear a mask outside because ‘everyone did’.  Sure enough, about 95% of people walking down the sidewalk in this SF neighborhood had a mask on – and I assume you are outcast if you don’t.  Doing something unnecessary is as dangerous as (almost) as not doing something that is necessary – I say that because the most important thing is for everyone to THINK, LEARN, UNDERSTAND.

        1. Tia Will

          No, Alan. While I agree on the importance of thinking, learning and understanding, doing something unnecessary is not even close to not doing what is necessary. The former will never kill anyone while the latter has killed many, and if things continue as they are, will kill many more.

        2. Alan Miller

          TW, my point is that the danger is in not understanding.  If you do something because you understand, you will do the right thing and do it right.  Overmasking creates – 1)  Doing things by rote and 2) Doing things wrong and 3) Backlash

          An example – a conservative who agrees in masking but knows that wearing a mask outside is unnecessary, and then parts ways with those who are not unnecessarily masking and causes unnecessary strife personally and politically.

          Another – persons who only know ‘you are supposed to where a mask’ but don’t wear it over their nose because they don’t know better (I have seen this numerous times).

          So yes, there is danger in doing things unnecessarily, wrongly and by route.  The best solution is for everyone to be educated, up-to-date, cooperative, and doing what is actually needed to protect each other – not more.

  2. Tia Will

    To Don’s comment, I would add the following. We have known about the increased risks of this season for months. We have also known our cases would be increasing for months given that rising case numbers precede hospitalizations which precede increasing deaths. Many people are unclear about the hierarchy of possible action. While we have defaulted to the state guidelines, we did not have to. It is possible for counties to impose tighter restrictions than the state recommendations, and in my opinion, with students returning and the triad of increased risks I mentioned, we should have done so.

  3. Tia Will

    Tod

    The issue of the psychology of mask-wearing is two-fold. Yes, there is no medical reason to wear your mask when you are outside alone walking, running, biking, or the like. However, wearing the mask also has other psychological effects. It serves as a reminder to others that mask-wearing is important. That others are giving it credence. I have also found several times when I did not put on my mask when leaving the house, I forgot it entirely, thus limiting the activities I could engage in during my excursion. While these may seem small matters, small consistencies can have a huge impact on the well-being of our community. Behaviors that become automatic are much more likely to be followed than those that are intermittent.

    1. Todd Edelman

      I have also found several times when I did not put on my mask when leaving the house, I forgot it entirely, thus limiting the activities I could engage in during my excursion.

      Most if nearly all places will provide or sell you a mask if you show up without one.

    2. Todd Edelman

      It serves as a reminder to others that mask-wearing is important. That others are giving it credence.

      Things like a shirt with a large pocket that says “mask(inside)”, or similar in a waist pouch and so on does the same, or perhaps it’s just as effective as wearing a bandana that hangs down, etc. Again, my strong sense is that wearing something when it’s not needed is counter-productive as a communication device.  By your logic, people could wear seatbelts around because they might sit in a car that moves, or any number of things. But they don’t need to wear a seatbelt around, because it’s stored in the car, ready to go. We need to do the same for masks. It’s fine to make this obvious. Also they should be free, available in touchless dispensers around down.

  4. Tia Will

    Bill

    Glad to see a health professional admit it is symbol, not substance…”

    I said no such thing. Masks definitely work to lower risk. They are of course less effective in situations in which the risk is already negligible, such as by yourself outdoors. In that situation, they are symbolic. In large groups indoors or out, in smaller more intimate but closely-spaced groups, they are highly effective.

    I do not mind you misrepresenting my positions when we are discussing less critical issues. I would ask you to refrain when people’s lives are at stake. You are welcome to say you consider masks symbolic. Please do not ever say I said that again.

    1. John Hobbs

      I guess I missed Bill’s comment but would like to once again thank you for your continuing information about the pandemic.

      You are so correct about the importance of portraying our beliefs by our behavior. Wear your masks, keep social distance and stop the spread.

      1. Bill Marshall

        And, John, I affirm your comments, except to the effect that “others beliefs” should be mandated for our own, unless based on science, common sense, and efficacy…

        Tia was basically correct, but IMHO, crossed some lines… I too thank Tia for the substance… good info… but literal interpretation of some of the new proposed ‘mandates’ mean I’d have to mask before taking doggie out to backyard to play, or wearing mask when I am 20-50+ feet distant from anyone else, my own car, etc.

        A constructive thought… https://med.stanford.edu/covid19/covid-counter.html

        Been doing it daily, since March… gets to science, albeit with self-reported data…

        May all be prudent, reasonable, respectful and healthy…

         

    2. Bill Marshall

      I do not mind you misrepresenting my positions when we are discussing less critical issues. I would ask you to refrain when people’s lives are at stake. You are welcome to say you consider masks symbolic. Please do not ever say I said that again.

      I do mind you misrepresenting my positions… I would ask you to refrain when common sense and science are at stake.  I take exception to some views that wearing a mask the second you walk out ones front or back door is efficacious, and/or should be mandatory… I have done the masking since March… I have done the separation from same time frame.  I do that willingly, as to common sense, science, and courtesy… but some insist that is not enough, and I HAVE to do it under penalty of law… and I should/or have to do it outside, even if I am 20-50 feet away from the nearest person.  I consider the latter symbolic, not based on science, or being efficacious.

      You posted, in substantial part:

      Yes, there is no medical reason to wear your mask when you are outside alone walking, running, biking, or the like. However, wearing the mask also has other psychological effects. It serves as a reminder to others that mask-wearing is important.

      (article)…

      Eight months into the worse pandemic of our lives, I can only see them as reactive and inadequate. I strongly urge our individual cities and jurisdictions to use the system of citations and fines we have adopted to underline the seriousness of compliance.

      You even admit to not having done that… yet, you seem to want to mandate it (article), for others…

      Please do not ever misrepresent what I post again.

      1. Tia Will

        Bill

        I take exception to some views that wearing a mask the second you walk out ones front or back door is efficacious”

        Misrepresenting by exaggeration. You just can’t stop, can you?

  5. Tia Will

    John

    Bill’s comment seems to have been removed. My quote is the only part to which I took umbrage. I appreciate that there are both medical and psychological aspects to the wearing of masks. The two should never be confused. Especially to make a specious point.

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