As Tulare County enters the third year of the coronavirus pandemic, local leaders spoke in a virtual 210 Connect forum about what’s working and what’s not, and how the region’s hospitals, schools and farmworkers are faring.
2021 brought the widespread rollout of vaccines and a glimpse of a light at the end of the tunnel before the advent of first the delta, and then the highly contagious omicron variant threw a wrench in the prospect of things returning to normal.
Kaweah Health CEO Gary Herbst said during the Tuesday forum titled “Tulare County Voices at 210: Two Years Into the Pandemic” that more than half of the hospital’s 5,100 employees had contracted the virus throughout the pandemic.
He questioned the wisdom of widespread lockdowns.
“I don’t know if these lockdowns really work. You know, we had to shut down surgery multiple times just to prepare in case of COVID. I think the jury’s still out in terms of just how effective those precautions are,” he said.
Tulare County Public Health manager Tiffany Swarthout said that isolation and quarantine measures at the dawn of the pandemic were effective in keeping case rates down but acknowledged that they caused people to get restless over time.
“I think early on in the pandemic — when people were really abiding by quarantine and isolation procedures when they were positive and exposed — that’s where you’re seeing the most effective use of those tools,” she said. “As things progress, people understandably got restless.”
She spoke of the county’s challenges in terms of health care access. Doctors and clinics are in scarce supply in the county’s rural reaches, complicating access to vaccinations and information about the pandemic.
She also addressed the county’s lower-than-average vaccination rates, saying that it’s not the health department’s role to convince people who have made up their minds about the vaccine’s efficacy. Instead, the county has focused its efforts on reaching those on the fence by providing accurate information about the vaccine’s safety and benefits.
Both Swarthout and Herbst agreed that vaccines and booster shots remain the most effective tool we have to combat the pandemic.
The vast majority of patients who have been admitted to the hospital with COVID, or who end up in the ICU, or sadly enough pass away from COVID, the vast majority are unvaccinated,” Herbst said. “Vaccines absolutely do work.”
The hospital leader added that other factors, such as leading a healthy lifestyle and exercising regularly, can help protect residents from experiencing severe COVID cases. Most of the patients who die of COVID-19 have an underlying condition, such as diabetes or hypertension, he said.
In the fields: Reaching out to rural ag, farmworker communities
The pandemic has disproportionately impacted some Tulare County residents and industries. Among the hardest hit: Farmworkers and agriculture communities.
Community advocate and former county lawmaker Lali Moheno spoke to the importance of meeting farmworkers and hard-to-reach communities where they are. Lack of transportation and health clinics combined with a mistrust of government, particularly among the undocumented immigrant community, have created a perfect storm for COVID to run rampant across the rural county.
“In order to address a rural county all the way, you … have to go to them,” she said. “They have transportation issues. They have the language (barrier); they have fear, they have mistrust.”
To address these concerns, Moheno and other organizations have worked with the county to meet farmworkers in the fields with vaccinations available for those who want them. The groups have also provided culturally competent care and information, in Spanish and other languages, to those living in the county’s many rural towns and hamlets.
At one Porterville event, Moheno said organizers were able to vaccinate 1,200 individuals.
Herbst said Kaweah Health is working on expanding rural health access with clinics in Lindsay, Exeter, Dinuba, and Tulare. He said the clinics provide a “full gamut of services” from COVID testing to treatment and accept patients regardless of their insurance or document status.
“Our rural health clinics have never been busier as a result,” he said, adding that Kaweah is looking at other ways the hospital can “serve people where they live rather than the traditional making them come into your facilities.”
COVID-19 and schools
Schools have been particularly challenged by the pandemic, forced to juggle the community’s health with the mental health and educational needs of students — and Visalia Unified is no exception, interim Superintendent Doug Cardoza said at the forum.
The pandemic exposed and highlighted inequity among VUSD students, with some unable to access the internet or eat regularly without the district providing those services.
“We’re used to having hot meals at school, and so when we shut down our schools, and our kids were at home and online, we quickly found that weakness in our system. We found the inequities within our system,” he said.
The district implemented a successful hot meals program and expanded broadband access with mobile hotspots and antennas deployed districtwide.
“We’re much better prepared now if we had to toggle back to a situation where kids were at home. In fact, any kid that’s quarantined now, they’re able to zoom into their classroom and not miss a day of instruction.”
While the option is there for families who choose to stick with distance learning, Cardoza said the COVID-19 situation has improved considerably at VUSD campuses.
At the peak of omicron and delta’s surges, VUSD saw between 80 and 100 staff out each day who couldn’t be covered with a limited substitute pool. That number dropped to just four teachers out on COVID-19 leave this week, he said.
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“Today, we actually have some extra substitute teachers, so that’s a great sign,” he said. “But through all this we really learned that we do have some equity issues within our system that we have to address.”
COVID-19 goes ‘endemic’
The 210 forum happened on the same day that state health officials announced California had entered an “endemic” stage of the virus, meaning that public health guidance will focus on prevention and specific outbreaks over mandatory masking and business closures.
Countywide, new coronavirus cases are plateauing, and deaths are down. Tulare County Public Health reported 2,006 new infections and 11 deaths for the week of Feb. 15.
Infections peaked at 8,000 new weekly infections mid-January and 25 deaths last week, fueled mainly by the waning omicron variant, which quickly exploded across the county earlier this year.
Joshua Yeager is a reporter with the Visalia Times-Delta and a Report for America corps member. He covers Tulare County news deserts, focusing on the environment and local governments.