San Mateo County Health Officer pushes back against state-mandated closures

Dr. Scott Morrow, San Mateo County’s top health officer, issued a statement Thursday voicing disapproval of the state’s actions to force the closure of local businesses as the COVID-19 case count rises countywide.

“I am not supportive of these actions and, for San Mateo County, I believe they are misdirected and will cause more harm than good,” he said, apologizing to the businesses that were shut down this week. He said that while Gov. Gavin Newsom had taken “many great, broad and appropriate actions,” he believed that Newsom “isn’t being given good advice.”

Instead, he called on residents to stick to the best practices that have already been put in place: extensive use of face coverings, social distancing and no gatherings outside of immediate households.

In his statement, Morrow pointed to a number of signs that indicate San Mateo County’s fight against the spread of the coronavirus is stabilizing.

The best estimate for the rate at which COVID-19 is spreading in San Mateo County is a number called the “R-eff”, or effective reproduction number, he said.

According to the most recently available data, the R-eff in San Mateo County was 0.91, and represents the average number of people an infected person will infect. An R-eff value of less than 1 means that the rate of spread is decreasing, according to the county’s COVID-19 data website.

That rate has been dropping for at least four weeks, which is a positive sign, Morrow said. In addition, hospitalizations are stable and may be decreasing, and the number of deaths has been low recently, he added.

What’s causing the spread is not primarily the activities of businesses that were shut down, Morrow argued. He said he didn’t have evidence that the business and nonprofit activities that were most recently shut down, such as gyms, nail salons, hair salons or barber shops, and places of worship, are spreading the coronavirus at a higher rate than other businesses and operations that are permitted to continue.

Additionally, he argued that the state health department’s actions represented overreach.

“While it is true the State Health Officer and the Local Health Officer have partially overlapping statutory authorities, it is generally understood, and there is very long precedence, that the State Health Officer doesn’t take action against the Local Health Officer unless there is an ask to do so, the Local Health Officer can’t take action because of extenuating circumstances, or the Local Health Officer is negligent,” he said in the statement.

“I didn’t ask for these actions to be taken, I’m certainly capable of taking these actions if warranted, and I do not believe I’m being negligent,” he continued.

He pointed to a number of problems he has with the state’s “watch list” system. The system has issues with the quality and consistency of its data; adherence to the state’s benchmarks may vary widely because of small, variable numbers at the local level; and some of the state’s metrics are based on state actions that local governments don’t have control over, which can unfairly reflect negatively on a county’s performance. For instance, the state may restrict testing or, as has happened in San Mateo County, it could transfer sick prisoners from state prisons like San Quentin to local hospitals, thus increasing the number of hospitalizations reported within the county.

He also asked to instead see case-control studies, as the state might be able to perform, that provided evidence about how COVID-19 is spreading in the community.

Access the full statement here.