Health Officer Statement from
Dr. Scott Morrow - 3/5/2020
This is a difficult message to share, but it is important to recognize how difficult the
times ahead may be and how you must now take assertive action to prepare for them.
Our local situation surrounding novel coronavirus (COVID-19) is changing rapidly.
COVID-19 is spreading in our community, the extent of which is unclear. It has likely
been spreading for weeks, perhaps months. I have no reason to believe that how it’s
spreading in other counties won’t be replicated to some degree here. We now all
need to take assertive actions to inhibit the spread of this new virus. Some of those
actions are described below. I advise that individuals, schools, business, and all other
sectors of our community take immediate steps to change behaviors and take
definitive action.
Our lives will be significantly disrupted by the measures needed to respond to a
global pandemic. A pandemic is a global occurrence of an infectious disease. A
pandemic is a disaster with unique characteristics. The two most important
differences between a pandemic and other disasters are that the whole world is going
through this disaster at the same time, and people may become fearful of other
people. The current COVID-19 outbreak clearly has the potential to turn into a severe
pandemic.
County Health continues to work with the federal Centers for Disease Control and
Prevention (CDC) and our state and local partners to manage testing and monitoring
of persons who have been exposed to COVID-19. But our focus is rapidly changing
from a containment strategy (identifying cases and contacts) to one of community
mitigation—taking steps to lessen the broad impact of the disease. County Health
and our public and private partners are taking steps to increase our ability to
respond and are planning for a sustained response to COVID-19.
How the world operates during a pandemic is different from how the world operates
normally. This is not business as usual. With a pandemic comes significant
disruption to supply chains (the process of how things get from where they are made
to where they are used), transportation, and travel. Even if the disease is not rapidly
spreading in our area, we may face difficulty obtaining the goods and services we are
accustomed to, public events may be canceled, and our ability to travel might be
restricted.

 San Mateo County Health continues to advise that the steps to prevent the spread of
flu will also guard against the spread of COVID-19: cover your cough and sneeze,
wash your hands frequently, avoid shaking hands and touching your face with
unwashed hands, and if you are not feeling well or are experiencing cold, flu, or other
symptoms, stay home from school or work. If you are mildly ill, there is no need to
contact your primary care provider as they are very busy right now. If you are
significantly ill, contact your primary care provider.
Here are the most important things for you to consider to improve your personal and
organizational preparedness:
•
What matters most is how households, neighborhoods, community groups,
businesses, and other organizations prepare. What does that mean? Preparedness
equals self-sufficiency. The government will help where it can, but it may have a
limited ability to respond directly to you due to the scale of the disruptions.
•
Individual and community preparations should focus on three tasks—
reducing each person’s chance of getting sick (see both individual and more general
public health recommendations both above and below), helping households with
basic survival needs during a pandemic, and minimizing and coping with larger
disruptions in how the normal day-to-day world works.
•
All businesses and other organizations should now be done reviewing their
continuity of operations plans for how they will operate if their employees are unable
to work and how they will interact with members of the public and prepare to
implement these plans soon.
•
All medical facilities and providers should be done reviewing their surge plans
for how to handle increased numbers of patients and be prepared to implement.
•
Getting ready for a pandemic is largely about preparing for possible shortages.
In a pandemic, supply chain disruptions are inevitable but are also unpredictable.
•
Since it contains vital supplies, a good start is to make sure your earthquake
kit is up to date and ready to go. Of course, having supplies beyond the typical
earthquake kit is a good idea. What you decide to have on hand is based on your
individual and family situation and your individual preferences.

 •
One likely shortage will be medications. You should attempt to obtain a
couple of months supply for your critical meds.
•
If you have other critical supply needs, you should conserve them and stock
up on them now.
•
Now is also the time to think about how you will care for loved ones at home if
they or you are sick and how you would limit spread within the family.
•
Frequent and appropriate hand-washing is far from a perfect solution, but it’s
easy, under your control, and has no significant downside.
•
Like washing your hands, wearing a surgical mask may help a bit, but you
need to know that surgical masks don’t offer much protection when they are worn by
people who are well. They are most helpful when worn by those who are already sick
so that they are less likely to transmit the disease to others. Surgical masks and
masks offering higher levels of respiratory protection are already in short supply and
should be prioritized for use in health care settings.
•
You should use a barrier, such as a paper towel or tissue, to touch commonly
touched surfaces, such as any door handles or elevator buttons.
Change from my previous message: I am now asking for the implementation of the
activities below at this time.
•
All non-essential gatherings should be canceled, postponed, or done remotely.
Unfortunately, at this time, I have no standard definition of “non-essential” or
“gathering” to guide your decisions. Use your best judgement.
•

Stop shaking hands.

•
Increase in the amount of remote working or teleworking to the extent
possible especially for those who appear at higher risk for developing the disease,
those over the age of 60 and those with co-morbid conditions.
•
Under all circumstances, stop touching your face, eyes, nose, or mouth with
your unwashed hands.
I am not asking for the implementation of these activities, but these are the types of
activities we may need to implement in the future:

 •
School closures. Schools are an essential gathering. School closings present a
particularly vexing social distancing dilemma but may be necessary to protect public
health. Once school closings occur, they may be extensive and extended.
•
Social distancing—staying at least 6 feet away from all other people—should
be attempted where possible.
•
Rationing (a formal process of prioritizing distribution and use) of critical
supplies may need to occur.
•
To get ourselves through the hard times that may be coming, your community
may need volunteers. Think now about the skills you have and how you can help
your community. Heed the call should volunteers be requested.
•
Other public health interventions that have been used with some effect in
other countries include commandeering of both real or personal property,
conscription, curfew, and cordons. It is unlikely that these interventions would be
used here due to practical considerations.
Issues around testing for COVID-19. You may have received incorrect information
from the federal and state government on March 4, 2020. San Mateo County does
not currently have testing available independently of the state and CDC. The amount
of testing that is available through the state and CDC is severely limited. Should
testing become more widely available, testing will be prioritized based on healthcare
infrastructure concerns, risk of exposure, and/or very sick hospitalized patients.
Tests will not automatically be given upon request or by a physician’s order. This
may change as testing capacity evolves over the next few months.
Scott Morrow, MD, MPH
San Mateo County Health Officer
March 5, 2020
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