What Alameda is doing to prepare for the coronavirus

Relentlessly (if parochially) focused on all things Alameda, the Merry-Go-Round began to wonder, as we watched and read the stories about the coronavirus (aka COVID-19) crisis, what our local public agencies were preparing to do about it.

So we decided to find out.

Today, we’ll report what we learned from the City of Alameda, the Alameda Unified School District, and Alameda Health System (which owns Alameda Hospital).

The City, AUSD, and AHS all have posted advice on their websites about how residents can reduce the risk of catching and/or spreading the coronavirus.  “Communication to the public and organization of ways to slow down the spread of the disease and to better protect yourself is a core function for the city,” City Manager Eric Levitt told us.  “We have used multiple modes including on city facilities, the website and social media to do this.”

One of the “modes” to which Mr. Levitt referred is this flier, which is available online and at City-owned buildings:Of course, if everyone in Alameda follows the advice in the flier – and if we’re lucky – no one on the island may ever get the coronavirus.  Indeed, both the City and AUSD websites cite public-health officials as opining that “the health risk from novel coronavirus to the general public remains low” (City) and “the risk of contracting the coronavirus in Alameda County (and indeed throughout the United States) is still considered low.” (AUSD)

This ain’t Donald Trump talking, so we take some solace in statements such as these.  But to us the more difficult (and therefore more interesting) questions are:  Other than providing advice, what are our local public agencies themselves doing to prevent the spread of the virus?  And what do they intend to do if Alamedans in fact become sick?

The primary answer to the first question is:  Enhanced sanitation at public buildings.

Mr. Levitt told us that the City has “increased the level of cleaning” at City-owned facilities.  Similarly, AUSD has “expanded” its cleaning program.  The District’s latest update to families reports that, over the weekend, maintenance personnel were “able to safely clean every site, and almost every surface got a thorough wipe down.”  During the week, custodians will clean doorknobs, sinks, drinking fountains, handrails, and banisters twice a day; clean tables, desks and counters once a day; wipe down lunchroom tables between each lunch shift; and check and refill soap dispensers and paper towels in bathrooms several times a day.

Unfortunately, we can’t provide equally definitive information about Alameda Hospital.

Ronica Shelton, the Hospital’s Chief Administrative Officer, didn’t return our calls.  We then contacted Terry Lightfoot, AHS’s “Director of Public Affairs and Community Engagement,” who assured us that the Hospital was following each and every one of the recommendations made by the federal Centers for Disease Control to hospitals to prepare for the potential arrival of COVID-19 patients.

Under “environmental cleaning,” these recommendations include five specific items, including what kind of disinfectant (an “EPA-registered hospital-grade disinfectant with EPA-approved emerging viral pathogens claims”) a hospital should use on hard, non-porous surfaces.  We have to assume, based on Mr. Lightfoot’s assurance, that Alameda Hospital is using the right stuff in the right way.

And now for the hardest part of all:  What happens if the coronavirus does hit Alameda?

City Manager Levitt told us that he had overseen municipal responses to viral epidemics during his stints as city manager in Sedona, Arizona (SARS) and Janesville, Wisconsin (H1N1).  Perhaps as a result, he was, well, a bit cautious during our conversations.  “How we respond is dependent on how it evolves,” he told us.

Nevertheless, the City Manager was willing to disclose this much:

He has put together an “executive team” to identify issues, get input from City departments, and develop contingency plans.  This team consists of himself, Assistant City Manager Gerry Beaudin, Public Information Officer Sarah Henry, Human Resources Director Nancy Bronstein, and Fire Chief Edmond Rodriguez.  (Why not Police Chief Paul Rolleri as well?  The coronavirus posed a “medical” issue, Mr. Levitt told us, and the fire department was “in charge of emergency management.”)

The team has been meeting “virtually,” Mr. Levitt said, rather than physically at the multi-million-dollar Emergency Operations Center on Grand Street, which the public had been told the City needed to build, and taxpayers needed to pay for, to provide space and communications equipment for situations like this.

One issue discussed through cyberspace was what Mr. Levitt called “continuity of operations” planning.  Suppose City employees got sick from the virus and couldn’t go to work.  What were the “core services” the City would need to keep providing?  How would it do so with a reduced workforce?

Obviously, public safety – i.e., police and fire – tops the list of “core services.”  But Mr. Levitt pointed out that the list may contain more mundane items, too.  For example, who’s going to sweep the streets and fix the traffic lights if the public-works department loses personnel?  Who’s going to write the checks to pay the City’s bills if the accounting department shuts down?

A second issue under consideration by the executive team involves what actions the City could or would take if a significant number of local residents became infected with COVID-19.  Mr. Levitt emphasized that the City had no power to impose a city-wide quarantine; only the Alameda County Public Health Department could do that.  The City, he said, would “work in coordination with” ACPHD, but he declined to elaborate on what such “coordination” would entail.

A host of questions come to mind.  Would the City make available City-owned facilities as  places where individuals known to have a contagious infection could be isolated and treated?  Would it provide vehicles to transport infected Alamedans to these or other locations?  And if ACPHD or some other public-health agency orders an infected resident to “self-quarantine,” what would the City do to enforce such an order?  (Maybe then it will be time for the executive team to seek out Chief Rolleri’s input.)

It is “difficult and possibly misleading” to answer specific questions like these, Mr. Levitt told us.  So, at this point, one can only hope that the answers never need to be given.

Next, the schools.  Susan Davis, AUSD’s senior manager for community affairs, told us that the District recently adopted a policy of sending home students who exhibit signs of fever, coughing, or labored breathing and who either have been exposed to someone with COVID-19 or recently traveled from mainland China, Iraq, Italy, or South Korea.  (Ms. Davis was unable to give us data on how many students, if any, have been sent home for this reason so far, but AUSD’s latest update to families reports that, as of Sunday,  “there are no known cases of COVID-19 in our school district.”)

In addition, like the City, AUSD is considering how it could continue operating in the event of staff shortages caused by the coronavirus.  According to AUSD’s March 3 update to families, District staff has “asked principals to create plans” for keeping the schools open “if a large number of your teachers are out sick and we don’t have enough subs to cover those illnesses.”

The real disruption will occur, of course, if schools actually have to be closed.  The “guidance” issued Friday by ACPHD states that any decision about whether to close schools “must balance the potential benefits of protecting the school community and slowing the spread of disease with the potential societal disruption and impact.”  A school district cannot act unilaterally; ACPHD must be involved in the process.

For AUSD, any school-closure decision would be made by the County Public Health Department, Ms. Davis told us.  According to AUSD’s latest update to families, the guidance the District has received from the County “dictates that if a  case of COVID-19 was confirmed in one of our schools we would close that school for likely 14 calendar days.”  Ms. Davis added that shutting down all of the schools in the District would occur only “in collaboration with surrounding districts (because many of our employees live in those districts and vice versa) and ACPHD.  Eventually, the California Department of Education (because of issues around our budget and instructional minutes).”

In the meantime, AUSD is following ACPHD’s directive to begin considering ways to conduct “off-site learning” in the event that schools are closed.  According to AUSD’s latest update, District staff is “working to create some guidelines for how we might support student learning during a closure using online learning, suggestions for independent reading and writing, teacher emailed assignments, and other activities.”

Update: On March 9, AUSD published another update stating that, “Out of an abundance of caution and a commitment to keeping our community safe, we have decided to cancel or postpone ‘non-essential’ AUSD events for the next 14 school days.”

Again, we are less confident in reporting on Alameda Hospital’s plans.  The CDC has published a “hospital preparedness assessment tool” for hospitals to use in determining whether they are ready for patients showing symptoms of COVID-19.  The checklist is long and detailed, and it addresses everything from ensuring a sufficient supply of “PPE” (i.e., personal protective equipment) for staff, to testing and checking “AIIRs” (i.e., airborne infection isolation rooms) for patients.

As we noted earlier, AHS’s “Director of Public Affairs and Community Engagement,” Mr. Lightfoot, told us that Alameda Hospital had taken all of the steps on the CDC checklist.  As it happens, earlier the same day we talked to Mr. Lightfoot we read an article in the New York Times reporting that a survey by the National Nurses Union had cast doubt on whether the nation’s hospitals were adequately prepared to deal with the potential arrival of coronavirus patients.  (Of the 6,500 nurses who participated in the survey, the Times reported, only 29 percent said their hospitals had a plan in place to isolate potential coronavirus patients, and only 44 percent said they had received guidance from their employers about how to handle the virus.)  So we read each action item in the CDC checklist individually to Mr. Lightfoot, and, for every one of them, he responded, “Yes,” Alameda Hospital has done that.

Maybe our local hospital is indeed at the top of the national list.  If so, Mr. Lightfoot is the right guy to be its spokesman.  “For more than 20 years, I’ve been telling stories for businesses, organizations and people,” he writes on his LinkedIn page.  “I love revealing ‘the’ story that sets clients apart from their competitors and connects them with their customers.”  We are compelled to note, however, that he does not work at Alameda Hospital, nor is he a medical doctor.

So that’s what we know for now.  We’d encourage readers to check the coronavirus pages on the City and AUSD websites for updates on the preparations those entities are making.  As for Alameda Hospital, we’ll just have to trust ‘em to stay (or get) on the ball.

Sources:

National and state “guidance”: CDC Coronavirus Hospital Preparedness Assessment Tool; ICMA, Considerations for Local Governments; California DOE, Coronavirus Guidance Update (3-5-20); ACPHD, Guidance for Childcare Programs . . .

Alameda websites: https://www.alamedaca.gov/RESIDENTS/ALERTS; https://alamedausd-ca.schoolloop.com/coronavirus

AHS website: http://www.alamedahealthsystem.org/2019-novel-coronavirus/