Assemblymember Joaquin Arambula —with his wife Elizabeth Arambula in this photo— pressured Fresno County Supervisors to prepare a plan for the County to confront the pandemic (Photo by Peter Maiden).

Failed County Leadership • Joaquin Arambula pushes for better outcome

By James Mendez

The Fresno County Board of Supervisors (BOS) has failed to demonstrate leadership since the beginning of the Covid-19 pandemic. The most recent example of their failed leadership occurred on July 28. The BOS met with the Fresno City Council for the first time since the Covid-19 pandemic began.

This City-County joint meeting occurred due to pressure from the City Council, local organizations and Assembly Member Joaquin Arambula (D–Fresno). They met to discuss strategy on how to best deal with the Covid-19 pandemic.

After the meeting, it was apparent the BOS has no interest in addressing the Covid-19 pandemic in the urgent and transparent fashion required. The body demonstrated a complete lack of interest in the health of the people of Fresno County. The BOS failed again.

The expectation by the local groups was that the city and the county would work together to develop a collaborative plan to spend the state and federal monies the city and county have received.16 One of the requests by local groups was to increase testing for Covid-19 in rural areas using community-based organizations (CBOs). CBOs have the trust of people in their communities that the BOS and the County lack. Using CBOs would identify more people for Covid-19 testing, which could slow the spread of the infection.

No Transparency. No Urgency.

Another request was for the BOS to be more transparent not only in spending but also in identifying the locations of clusters of infection. The BOS was slow to start identifying the location of large clusters of cases and is still not identifying businesses with clusters of cases.

Identifying businesses with clusters of cases would allow the public health department to close those businesses and institute practices to make those businesses safer to run. Per the Fresno Bee, health officials said that “getting timely or useful information from large employers hasn’t been easy.”10

The July 28 joint City-County meeting was led by Supervisor Buddy Mendes, chair of the BOS.21 With poor advertising for the meeting and no link to a virtual audience, there was minimal opportunity for input from the public during the meeting.21

Per GVWire, the meeting was “held in the ballroom of the Fresno County Plaza building, [and] only about 20 members of the public were allowed in at a time. There were approximately another 25 elected leaders and staff also in the room. The posted seating is 560. Another 20 waited in the courtyard outside the ballroom, able to listen in to the meeting.”2

The GVWire also reported that Mendes acted as though he was attending the meeting under duress. He wanted to be able to say that the BOS met with the City Council and be done with it. He cut off speakers and limited questions.21 It was clear that he did not plan, expect or want anything to be accomplished during the meeting. And indeed, nothing was accomplished, again.

Time Line of Covid-19

The BOS has been slow to respond since the beginning of the epidemic. When the BOS has responded, it has not been in the best interest of the majority of people in the county. The following is a time line of some Covid-19 events:

  • On Dec. 31, 2019, China reported a cluster of cases of pneumonia in people associated with the Huanan Seafood Wholesale Market in Wuhan, Hubei Province.
  • On Jan. 7, 2020, Chinese health authorities confirmed that this cluster was associated with a novel coronavirus, which at that time was called 2019-nCoV and is now called SARS-Cov-2.3 SARS-Cov-2 is the virus that causes the disease Covid-19 (similar to the rubeola virus causing measles or herpes zoster causing chickenpox and shingles).  
  • On Jan. 20, “the first laboratory-confirmed case of Covid-19 in the United States was confirmed and reported to CDC on January 22, 2020.”4 He was a 35-year-old man who had returned to Washington state on Jan. 15. He had traveled to Wuhan, China, to visit family. He was a healthy, nonsmoker with a four-day history of cough and subjective fever. He survived.3
  • On Feb. 6, the first autopsy-confirmed U.S. death due to Covid-19 occurred in Santa Clara County, nearly three weeks before deaths in Washington state.5
  • On March 4, in response to the increasing threat of Covid-19 Governor Gavin Newsom proclaimed a state of emergency.
  • On March 7, the first Covid-19 case was identified in Fresno County.
  • On March 17, the BOS unanimously declared the novel coronavirus an official emergency, but took no action.
  • On March 19, Newsom issued a stay-at-home order to protect the health and well-being of all Californians and to establish consistency across the state in order to slow the spread of Covid-19.
  • On May 8, “the stay home order was modified. In addition to essential activity, retail is allowed, along with the infrastructure to support it. As of May 12, offices, limited services, and outdoor museums are also permitted to open.”8
  • On May 18, an order from the Department of Public Health (DPH) was amended from “All residents shall use cloth masks” to “All residents should wear a mask.”11
  • On June 18, Newsom ordered all Californians to wear face coverings while in public or high-risk settings, including when shopping, taking public transit or seeking medical care.16

No Action from the Supervisors

Since the first Covid-19 case was identified in Fresno County on March 7, the BOS has refused to accept the seriousness of the illness or to implement aggressive plans to decrease the spread of Covid-19. Just like Trump, the supervisors refused to respond in a way that would protect the health of the people of Fresno County.

For example, on March 17, the BOS unanimously declared the novel coronavirus an official emergency, but took no action. The supervisors admitted that they did so only to obtain state funds, not because they believed declaring an official emergency would help people get care.

At that meeting, in his usual racist and condescending fashion, Supervisor Steve Brandau said, “I think that many in government and in our society have been overreacting to the Chinese coronavirus. This overreaction causes me great concern over the economy.”6

The most vulnerable people in the Central Valley are the poor, Latinos, front-line healthcare workers, essential agriculture workers and meat-packing workers. The BOS refused to take action that would protect the health and well-being of the most vulnerable people in the county. Actions such as providing masks for all essential workers, requiring social distancing at all places of work and prohibiting gatherings of large groups of people like in churches.

As a result of inaction by the BOS, the Covid-19 epidemic rapidly spread throughout the county and has affected vulnerable communities in much higher numbers.14

Instead of pushing for a strong public health safety proposal for the county, as the City of Fresno did, the BOS demanded that the DPH water down the scientific and medical recommendations requiring everyone to wear a mask when in public. An order from the DPH was amended on May 18 from all residents “shall” wear a mask to all residents “should” wear a mask.11 In actuality, few people in the county are wearing masks and many in the city are not either, citing the county ordinance.

In addition to not encouraging people to wear masks and to socially distance, Supervisors Mendes and Brandau refused to push to increase testing in the county. They refused to be leaders in this area and instead set an example of irresponsible behavior. They both refused to wear masks while holding BOS meetings indoors.

On June 29, in response to Supervisor Sal Quintero attending the meeting by Zoom due to concern about Covid-19, Mendes said that he would rather “die in the saddle” than require others to wear a mask or socially distance or to do so himself.7 That was said even though, in addition to his age, Mendes has admitted to having two major conditions that increase the risk of death from Covid-19.

Fresno County Did Not Qualify

When Fresno County did not qualify for Phase 2 of the reopening of the economy, the BOS pressured the health department to get a variance from the state. The initial criteria were not met by Fresno County. The initial science-based criteria included the following:

  • A positive rate of people tested under 5%. (Fresno County did not meet.) 
  • Fourteen straight days of decreasing new cases. (Fresno County did not meet.)
  • No deaths for 14 days. (Fresno County did not meet.) 
  • Availability of adequate testing. (Fresno County did not meet.)
  • Availability of hospital and ICU beds. (Met at the time of the request.)

State officials initially required zero deaths for two consecutive weeks in order for counties to reopen businesses. In response to pressure from businesses, cities and counties, the state changed the criteria to reopen so some counties could open if other criteria were met. The state eliminated the zero death standard, and changed the new case standard from fewer than one new case per 10,000 residents to 25 coronavirus cases per 100,000 (2.5 cases/10,000) residents in the previous 14 days.

Fresno County still did not meet the new criteria and asked for a variance to be able to reopen. The variance was approved when Dr. Rais Vohra, interim health officer for the DPH, gave an attestation to the state that said even though the county did not meet criteria to reopen, the county would keep the spread of the infection controlled by instituting science-based guidelines.22

The public did not follow the DPH’s recommendations. The infection continued to spread. Per Dr. Vohra on July 28, as a result of “unregulated social behavior” the “bend upward became a surge and in many ways has become a disaster.”

Business First. People Whenever.

During the July 28 City-County joint meeting, Dr. Vohra laid out the county’s preliminary spending plan, which includes $10 million for medical investigators and contact tracing.18 To deal with the increased demand for care, the county is paying an additional $11 million to operate alternative care sites, according to the administrator’s report.

Vohra previously has said that operating care sites outside of hospitals and county facilities represents a costly failure by the community at large to follow health guidelines. If people in the county had followed the guidelines they would have prevented the spread of the virus. People following the guidelines would have put less demand on the healthcare system.10

In response to the Covid-19 medical crisis, the BOS deferred to business interests and pushed to open the economy earlier rather than addressing the medical issues.12 The BOS refused to take measures that would slow the spread of the infection such as making businesses have employees wear masks and work a safe distance apart.

Yes, an epidemic affects the economy, but the economy will not improve unless the epidemic is controlled. An article in the Atlantic stated that “without a healthy population, there can be no healthy economy.”20

The supervisors ignored the health of the people. They ignored the science and medicine regarding how to slow the spread of the infection. Instead of trying to save lives, the BOS responded to requests (pressure?) from restaurateurs and businesspeople rather than to the county’s own health department physicians.12

No Action Means More Deaths

The Covid-19 epidemic in the county has worsened since the BOS reopened businesses. We are now back to square one in terms of the stay-at-home order. Now our hospitals are overflowing with Covid-19 patients, and the county is looking to open the Convention Center for needed beds and trying to get FEMA medical teams to help deal with the surge.13 There are discussions regarding decisions as to who will receive medical care and who will not.

Although the City of Fresno took legitimate and more aggressive measures to try to slow the spread of the epidemic, it was unsuccessful because of the lack of support from the county (the peeing in the pool phenomenon). Now, the city of Fresno has the most cases in the county, but the rate of infection (cases/100,000) is actually highest in rural areas of the county. Without a healthy population, there can be no healthy economy.

Without action by the BOS, the Covid-19 epidemic will continue to affect people in the county and cripple the county’s economy.1 At this time, the BOS is continuing to take a laissez-faire (aka “you’re on your own”) approach toward the Covid-19 pandemic.

Without a vaccine, this epidemic will not stop. Even though Trump has said since February 2020 that the epidemic will magically “disappear,” that is not going to happen.15 Without leadership making strong recommendations based on science and a concern for the people’s well-being, the epidemic will not stop.

Covid-19 will affect all Fresno County residents until at least 60% and probably more like 80% of all the county’s residents have been infected. At that time, we will get close to “herd immunity.” By then, 600,000–800,000 people will have been infected. About 10% (60,000–80,000) will require hospitalization. Of those infected, 1% (6,000–8,000) will have died. More will die if they are unable to receive care because of an overwhelmed healthcare system.

As of July 30, we have had more than 13,000 positive cases and 120 deaths in Fresno County. As a result, the county’s healthcare system is at its limit. If the BOS does not act now, people will be dying in emergency rooms, en route to the hospital, in their homes and in the streets. That is not an “overreaction,” as Supervisor Brandau once characterized the response to the Covid-19 pandemic.

*****

James Mendez is a retired physician. He is a supporter of public education having been a recipient from kindergarten through medical school. He and his wife are thankful for this time of their lives to spend time with their daughters and grandchildren. Contact him at almostdailyaction@gmail.com.

References

  1. https://media.gvwire.com/wp-content/uploads/27151846/FResno-COVID19-Equity-Project.pdf (letter to the Board of Supervisors from the Fresno COVID-19 Equity Project)
  2. https://gvwire.com/2020/07/28/some-still-not-satisfied-after-joint-city-county-covid-meeting/
  3. https://www.nejm.org/doi/full/10.1056/NEJMoa2001191
  4. https://www.cdc.gov/mmwr/volumes/69/wr/mm6924e2.htm#:~:text=The%20first%20laboratory%2Dconfirmed,January%2022%2C%202020
  5. https://www.npr.org/sections/coronavirus-live-updates/2020/04/22/840836618/1st-known-u-s-covid-19-death-was-on-feb-6-a-post-mortem-test-reveals
  6. https://www.fresnobee.com/news/local/article241265771.html
  7. https://www.youtube.com/watch?v=gv8etfuCeDY
  8. https://covid19.ca.gov/search/?q=lift%20stay%20at%20home%20order%20may,%202020#gsc.tab=0&gsc.q=lift%20stay%20at%20home%20order%20may%2C%202020&gsc.page=1
  9. https://www.fresnobee.com/news/local/article244525087.html#storylink=cpy
  10. https://www.fresnobee.com/news/local/article244525087.html
  11. https://www.co.fresno.ca.us/home/showdocument?id=44811
  12. https://www.fresnobee.com/news/coronavirus/article244198537.html
  13. https://www.fresnobee.com/news/coronavirus/article244259242.html
  14. https://cofgisonline.maps.arcgis.com/apps/MapSeries/index.html?appid=1f82e8eb24c0403c90e774202c5dafea
  15. https://www.cnn.com/2020/02/27/politics/trump-coronavirus-disappear/index.html
  16. https://www.latimes.com/california/story/2020-06-18/california-mandatory-face-masks-statewide-order-coronavirus-gavin-newsom
  17. https://media.gvwire.com/wp-content/uploads/27151846/FResno-COVID19-Equity-Project.pdf Community-based organizations that want to expand testing to rural areas.
  18. https://media.gvwire.com/wp-content/uploads/27134654/Fresno-County-spending-powerpoint-July-7.pdf
  19. https://fresnocounty.legistar.com/LegislationDetail.aspx?ID=4584803&GUID=C040598A-78BB-4ABF-9335-1E4AACD10A65&Options=&Search=. Click on “ADDITIONAL INFORMATION LINK.”
  20. https://www.theatlantic.com/ideas/archive/2020/04/new-laws-pandemic-economics/609265/
  21. https://eedition.fresnobee.com/ccidist-replica-reader/?epub=https://eedition.fresnobee.com/ccidist-ws/mcclatchy/mcclatchy_frs_newsbroad/issues/33174/&token=eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJwdWJzIjp7ImZyZXNub19mcnNfbmV3c2Jyb2FkIjpbIkFMTEZSUy01MDMyIiwiQUxMRlJTLTUwMzIiLCJBTExGUlMtNTAzMiIsImVlZGl0aW9uIl19LCJpc3MiOiJNY0NsYXRjaHkiLCJzdWIiOiI1MDAzMzMxNDQiLCJzZXNzaW9uIjoxNTk4NzIzODQ5LCJpYXQiOjE1OTYxMzE4NDksImV4cCI6MTU5NjEzMjc0OX0.ILqXWEJWk3gqZmJYNeCk3zljLCvALotHlopkB5TaB74#/articles/7
  22. https://www.cdph.ca.gov/Programs/CID/DCDC/CDPH%20Document%20Library/COVID-19/Fresno%20Attestation.pdf. Attestation from Dr. Vohra asking for a variance from the state.
  • The Community Alliance is a monthly newspaper that has been published in Fresno, California, since 1996. The purpose of the newspaper is to help build a progressive movement for social and economic justice.

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