SMC Health Officer Breaks From Pack In Opposing New Restrictions

SAN MATEO COUNTY, CA – After standing in virtual lockstep with his Bay Area public health official peers for nearly nine months, San Mateo Health’s top health officer has broken from the pack.

Dr. Scott Morrow in a statement Monday explained his decision not to join five Bay Area counties who on Friday preemptively issued stay-at-home orders amid an explosion of reported COVID-19 cases locally and throughout the nation.

Santa Clara, Alameda, Contra Costa, San Francisco and Marin counties, along with the city of Berkeley, jointly announced the temporary shutdown of most nonessential businesses now in effect despite intensive care unit capacity being above the state's 15 percent threshold for such an order.

Conspicuously absent from the announcement was Morrow, who explained the reasoning behind his decision in Monday’s statement. Morrow's statement followed two statements from the county's Joint Information Center reinforcing its stance.

"When I look at the trend data, the Bay Area seems to mostly move as a region, and it seems to me to be pretty independent of individual Health Officers' action," Morrow said.

San Mateo County's unadjusted case rate of 16.3 new cases per day per 100,000 is less than the state's case rate of 30.2 per day per 100,000, according to the state's data.

Statewide, ICU capacity is at 14.2 percent, compared to 25.7 percent in the Bay Area region, and 32.6 percent in San Mateo County. But according to Morrow, there is no standard method for understanding ICU capacity on a county or regional level.

"Basing such extreme decisions on non-standardized and poorly understood metrics seems fraught to me," he said.

While Morrow noted that hospitalizations are also going up, he said the county's hospitals are equipped to deal with the surge.

County data shows that there were 84 hospitalized COVID-19 patients as of Sunday, with 59 ICU beds in use and 21 available, plus an addition 88 ICU surge beds available.

Morrow said that an enforced stay-at-home order could slow down COVID-19 transmission rates, but described the Bay Area's new order as "symbolic" and "without any hint of enforcement."

He doubted that a new order would change behaviors of those who were not adhering by COVID-19 guidelines before.

Morrow’s view, however, is not shared by the Bay Area's most prominent public health official.

Santa Clara County Health Officer Dr. Sara Cody, the architect of the nation’s first stay-at-home order in the early days of the pandemic, said in a statement Friday that "We cannot wait until after we have driven off the cliff to pull the emergency break."

"We understand that the closures under the State order will have a profound impact on our local businesses,” Cody said. “However, if we act quickly, we can both save lives and reduce the amount of time these restrictions have to stay in place, allowing businesses and activities to reopen sooner."

San Mateo County is already in the most restrictive (purple) tier of the state's reopening system, which limits indoor activities.

Restaurants, gyms and places of worship are just some of the activities that are outdoors only, and other indoor facilities have stricter capacity limitations.

The new order would restrict business activities even further.

However, Morrow said that he was not aware of data showing that activities — like the ones that would be restricted under a new order — are driving COVID-19 cases up.

Nevertheless, if or when the state mandates a stay home order for the Bay Area, San Mateo County will follow it, as Morrow and other county officials reiterated.

Morrow even said that new data may convince him to take action before the state's action, and again encouraged people to take individual action.

To prevent the spread of COVID-19, people should wear a face covering when around people outside of their household, practice social distancing, avoid gatherings and only travel for essential purposes.

"The power and authority to control this pandemic lies primarily in your hands, not mine," Morrow said.

— Bay City News and Patch Editor Gideon Rubin contributed to this report