The Miller Report: Local Test Ruled False Positive by State Health Department

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The Miller Report: Local Test Ruled False Positive by State Health Department

Miller Report for the Week of June 1, 2020
By William Miller, MD – Chief of Staff at MCDH

Reviewing all of the facts of a situation is important before jumping to conclusions. Last week, one of our staff who works at North Coast Family Health Center had a positive test result for COVID-19. The test was done elsewhere as part of routine pre-procedure screening. The person never had any symptoms and their last date of working in the clinic was 7 days previously. Also, the person had no patient contacts in the preceding 14 days. Given a number of aspects of the case, we suspected that this might be a false positive. We immediately conferred with the County Health Department, consulting with both Drs. Doohan and Flaherty, our County Health Officer and Deputy Health Officer respectively. When the person returned to Ft. Bragg where they live, they were immediately retested using two different brands of analyzers and both were negative. “It was the two negatives on same day [as the first test], run on two different machines, that made me think it was false positive,” stated Dr. Doohan. We then presented the findings to the California Department of Public Health who had their adjudication team review the case and they officially declared it a false positive.

A false positive means that the test turned positive when the infection is not actually present. It is an error. All medical tests have the potential for errors and false results. There are many reasons that a test could give such an erroneous result. With PCR tests, one potential problem can be cross contamination since PCR can detect extremely small amounts of the genetic material of the virus. Thus, even a small accidental contamination in the lab or at the testing site could turn the test positive when it should have been negative. It could also be a problem with the chemical reaction of the test itself that for some reason did not react the way it was supposed to. Another possible source of lab error is mislabeling of the sample with the wrong patient’s name. All of these errors can and do occur.
The implications for this being a false positive are important for us here on the Mendocino Coast. It means that we still have no evidence of community spread. This will help us justify carefully rolling back on some more of the shelter-in-place stipulations. We should keep in mind that will also mean opening our community back up to tourism and other influx from the outside. People who live here will also begin to travel elsewhere to visit friends and relatives or go on vacations. While opening back up to tourism is crucial for our economic survival, it will invariably also bring with it the coronavirus. It is unavoidable and there will certainly come a day, probably not in the too distant future when we will have the virus here. At that point, a strong community surveillance-testing program and contact tracing will be imperative.
The County Health Department is working with Mendocino Coast District Hospital, Mendocino Coast Clinics and the City of Ft. Bragg, to set up such a testing program. Despite claims at the federal level that “anyone who wants to get a test can”, it remains a challenge for many rural communities like ours to have such readily available testing that would allow ongoing surveillance of the population.
So, one might say, why did we go through all of this shelter-in-place stuff if we are eventually going to have it here in our community anyway? The answer is, that by doing this, we have avoided overloading our health care system. If our health care system had become overloaded and crashed, then a lot more people would die and not just from COVID. So, while the price we have paid is high, the benefit is real. The key to keeping that benefit, which we have paid for so dearly, is maintaining social distancing, wearing face coverings and washing our hands. As simple as these three things might sound, they will absolutely have a really big effect on controlling further transmission.

Updates from the City
By Tabatha Miller, Fort Bragg City Manager
As we enter the beginning of the twelfth week of Shelter-in-Place (SIP), things are still evolving.
• Last week at the regular City Council meeting on Tuesday May 26th the Council approved a resolution to allow the HOME grant funding to be used for low to moderate income tenant-based rental assistance for those residents impacted by COVID-19. This assistance may be applied through December 31, 2020. Staff is waiting for additional guidance, which we expect any day, from the Department of Housing and Community Development on how to administer this newly available program. As soon as that is available we will make announcements on who will qualify for the grant and how to apply.
• At that same meeting, the City Council unanimously approved Urgency Ordinance 962- 2020, which allows existing businesses to request a temporary waiver of zoning requirements and standards in order to adapt their business model to fit within the SIP. For example, several restaurants have applied for a waiver to allow seating on the sidewalk and/or in public or private parking areas. The CA Department of Alcoholic Beverage Control (ABC) has temporarily suspended many of their regulations and is allowing businesses to expand their licensed footprint. The ABC is even allowing licensees that don’t sell food to partner with a business that does sell meals to provide pre-mixed cocktails and food to go – abc.ca.gov/fifth-notice-of-regulatory-relief/. The City’s Ordinance also allows businesses to temporarily change use, so long as there is not an increase in intensity and the use is allowed in that zoning district. Email smallbiz@fortbragg.com with questions, inquiries and/or to request the temporary waiver form.
• On May 28th, at a Special City Council Meeting, the City Council approved a 30-day extension of the City’s Eviction Moratorium which was set to expire on May 31st. The moratorium provides both commercial and residential tenants protection from eviction, if they are unable to pay their rent due to significant financial impacts from COVID-19. The moratorium doesn’t waive any rent due but allows tenants 180 days (six months) after the moratorium ends to repay the unpaid rent.
• On Monday, June 1st, 2020, the lobby at City Hall and the lobby at the Police Station were From Tabatha Miller, our Fort Bragg City Manager: 3 | Page opened to the public. To comply with social distancing and the Mendocino County Health Officer’s Orders, you are required to wear a face covering (unless exempt under the Order), use the hand sanitizer just inside the door, stay six feet apart, respect the limited number of individuals allowed inside and of course stay home if you are sick or running a temperature. Until further notice, City Hall will be open Monday, Tuesday and Thursday from 9:00 to 5:00 with a lunch break from 12:30 to 1:30 pm.
• In the spirit of reopening, Staff and the City Council are working out the details on how to open City Council meetings to the public. We anticipate an in-person meeting at the end of June or first meeting in July if all the details can be worked out.
• Mendocino County Health and Human Services hopes to get funding to extend the Great Plates Delivered program, into the summer. The Great Plates program delivers meals to qualifying homebound seniors or high-risk individuals who do not receive meals from another federal program. Three prepared meals a day are prepared by a local restaurant and delivered. As of May 26th, more than 4,600 meals had been delivered in Mendocino County including many here in Fort Bragg. For more information, call (707) 463-7900.
• Finally, an update on the Fort Bragg surveillance testing of essential workers that Mendocino Coast Clinics have conducted in collaboration with the City. The labs continue to be the bottleneck on getting back results. While all of the results have been negative, the majority of the 180 plus results from May 19th and May 21st are still outstanding. Those tested will receive confirmation of their test results.