March 16, 2021-Dr. Michael Sequeira, San Bernardino County Public Health Officer via Zoom

Tuesday, March 16, 2021

Virtual Meeting via ZOOM

Minutes

Present:  Ruthy Argumedo, Deborah Barmack, Peter Barmack, Carole Beswick, Gregg Bradbard, Mike Burrows, Ken Coate, Sandra Cuellar, Jennifer Cusack, Michelle Decker, Kevin Dyerly, Louis Goodwin, Dick Hart, Fran Inman,  Mark Kaenel, Lena Kent, Lowell King, Mike Layne, Bill Lemann, P.T. McEwen, Darcy McNaboe, John Mirau, Vikki Ostermann, Catherine Pritchett, Thomas Rice, Michael Rivera, Elizabeth Romero, Dan Schenkel, Kristine Scott, Phil Southard, Sol Teh, Eric Ustation, Ray Wolfe, Marisa Yeager and Frank Zabaleta.

Guests:  Megan Barajas, Julian Cuevas, LaDonna DiCamillo, Arnold San Miguel, Todd Warden

Announcements:  1) Committee Chairs were reminded that next week will be focused on State issues.  2) Ken Coate, Chair, Inland Action Appointments Committee, requests candidates for the redistricting commission that will work on redrawing the San Bernardino supervisorial district boundaries.

Lowell King, Chair, presiding.

Motion by K. Scott/Second by M. Burrows/Passed: Minutes from March 9, 2021.

Karen Richmond, VP for Network Development, Health Net will replace Carol Kim as their alternate representative.
Motion by M. Burrows/Second by D. McNaboe/Passed:  Karen Richmond, VP for Network Development, Health Net will serve as their alternate representative.

John Mirau, Membership Committee made the first announcement of prospective new member: Cooperative Economic Empowerment Movement (CEEM).  Reggie Webb, Founder & Chairman would serve as their primary representative.  Please go to their web site to learn more about them at   https://www.ceem.coop/about/#values

The second announcement of prospective new member: University Realty LLC a nonprofit 501(c)(3) land developer that supports Arizona State University.  Mark Stapp would serve as primary representative and Lydia Chelle the alternate.  To learn more about them visit  https://www.asuenterprisepartners.org/university-realty/  The membership will vote next week.

Dr. Richard Hart introduced Dr. Michael Sequeira who was appointed by the San Bernardino County Board of Supervisors to serve as the County Public Health Officer in November 2020.  Previously he served as the regional director of six hospital emergency departments in the County, including medical centers in San Bernardino, Apple Valley, Colton, and Redlands.  He is a former president of the San Bernardino County Medical Society.  Dr. Sequeira discussed COVID and vaccines.

China first saw a mysterious new pneumonia that was highly contagious in late December 2019.  Some 12 days later China had their first fatality but scientists there had also published the complete DNA sequence advancing all vaccine groups.  By mid-March the vaccine entered Phase 1 trials (Pfizer first, then Moderna).  The speed of these results is unprecedented and highlights the power and impact of our scientific community worldwide.  Currently 160 different labs across the world are working on a vaccine in addition to the initial three that have been developed by Pfizer, Moderna and Johnson & Johnson.

Scientists found that the virus attacks and injects itself into the cell.  Using the DNA sequence, it was easier to overlay the messenger RNA that would tell the cell how to produce a spike protein that coats and attaches to the cell receptors.  As a response to a newly introduced protein, the body’s immune system begins to produce “killer” and “memory” T cells that fight the infection.  Dr. Sequeira clarified that the cell nucleus remains intact and is not affected, as some have expressed concern that the vaccine could influence existing genetics.

COVID is a clotting disease that begins in the lungs.  Early on doctors were in disbelief as they saw COVID-19 patients who should be experiencing severe reactions from a lack of oxygen in the body’s tissues act relatively normally.  Now termed the “happy hypoxics” these people were unaware they are being deprived of oxygen and were arriving at the hospital in much worse health than they realized.  This led doctors to put nearly everyone with breathing difficulties on ventilators. They have since learned that intubation was actually harming their lungs.  A newer technique called high flow nasal oxygen is now used for this type of patient.  Nasal oxygen flow is typically 10 liters a minute, but they found that increasing the flow to 60-90 liters per minute was most successful.  To accommodate the substantial increase in oxygen flow, the State brought in engineers to help re-plumb facilities.  Ventilators are now reserved for the severely sick.

Initially the vaccine was in short supply so tiered phases were created.  We have completed the three tiers in phase 1A (health care personnel, those 65 plus and long-term care residents) and have now moved into phase 1B which covers educators and first responders (fire and police).  The vaccination process is expanding, and the County is now vaccinating childcare workers and food and agricultural workers. Children 10 and under although not immune are less affected as they have significantly fewer ACE receptors in the nose and body that the virus attaches to and they also produce more antibodies because they get more colds.  Studies continue regarding youth vaccination.  Eligibility, per the President, is scheduled to expand to anyone over age 16 by May 1st.

All available vaccines are very effective but our homeless and other populations can be extremely difficult to track so the Johnson & Johnson’s one-shot vaccine is of great benefit.  Additionally, the vaccine can be transported under normal refrigeration enabling ease of distribution to our smaller or remote locations in the County.  The partnership between Johnson & Johnson and Merck to increase production capacity is a major breakthrough.  He asked the meeting participants, as leaders, to reach out to others encouraging vaccination.

Different populations are expressing vaccine hesitancy especially in communities of color.  Only 40% of African Americans and 50% in Hispanic communities are willing to get the vaccine.  Much of the hesitancy is based in mistrust.  Dr. Sequeira cited the Tuskegee experiments where researchers conducted studies on black men without their informed consent.  Additionally, the recent acts of racism have intensified this lack of trust.  He and community outreach groups have had successful meetings with various groups, providing information, and this work will continue and grow.  An unexpected number of front-line medical workers (35-60%) have refused the vaccine even though this group had the highest COVID mortality rate (40%) than any other group.  The surprising numbers are predominantly in the nursing field compared to 95% acceptance from physicians.  Educational outreach continues as they desire to turn these numbers around.

The drop in incidents is in part due to some form of immunity by those who have already contracted COVID, vaccine distribution and the acceptance of masks and social distancing.

The pandemic should never have become as political as it was and he hopes that science will prevail in the future.

Q & A period followed.
Meeting adjourned at 9:03 a.m.