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Advisory from SM County Public Health Officer

Original post made by Peter Carpenter, Menlo Park, on Mar 6, 2020

Update on Novel Coronavirus (COVID-19)
March 5, 2020: New statement issued from San Mateo County Public Health Officer Dr. Scott Morrow.

Public Health Officer Statement (3/5/2020)
This is a difficult message to share, but it is important to recognize how difficult the times ahead may be and how you must now take assertive action to prepare for them. Our local situation surrounding novel coronavirus (COVID-19) is changing rapidly. COVID-19 is spreading in our community, the extent of which is unclear. It has likely been spreading for weeks, perhaps months. I have no reason to believe that how it’s spreading in other counties won’t be replicated to some degree here. We now all need to take assertive actions to inhibit the spread of this new virus. Some of those actions are described below. I advise that individuals, schools, business, and all other sectors of our community take immediate steps to change behaviors and take definitive action.

Our lives will be significantly disrupted by the measures needed to respond to a global pandemic. A pandemic is a global occurrence of an infectious disease. A pandemic is a disaster with unique characteristics. The two most important differences between a pandemic and other disasters are that the whole world is going through this disaster at the same time, and people may become fearful of other people. The current COVID-19 outbreak clearly has the potential to turn into a severe pandemic.

County Health continues to work with the federal Centers for Disease Control and Prevention (CDC) and our state and local partners to manage testing and monitoring of persons who have been exposed to COVID-19. But our focus is rapidly changing from a containment strategy (identifying cases and contacts) to one of community mitigation—taking steps to lessen the broad impact of the disease. County Health and our public and private partners are taking steps to increase our ability to respond and are planning for a sustained response to COVID-19.

How the world operates during a pandemic is different from how the world operates normally. This is not business as usual. With a pandemic comes significant disruption to supply chains (the process of how things get from where they are made to where they are used), transportation, and travel. Even if the disease is not rapidly spreading in our area, we may face difficulty obtaining the goods and services we are accustomed to, public events may be canceled, and our ability to travel might be restricted.

San Mateo County Health continues to advise that the steps to prevent the spread of flu will also guard against the spread of COVID-19: cover your cough and sneeze, wash your hands frequently, avoid shaking hands and touching your face with unwashed hands, and if you are not feeling well or are experiencing cold, flu, or other symptoms, stay home from school or work. If you are mildly ill, there is no need to contact your primary care provider as they are very busy right now. If you are significantly ill, contact your primary care provider.

Here are the most important things for you to consider to improve your personal and organizational preparedness:

What matters most is how households, neighborhoods, community groups, businesses, and other organizations prepare. What does that mean? Preparedness equals self-sufficiency. The government will help where it can, but it may have a limited ability to respond directly to you due to the scale of the disruptions.
Individual and community preparations should focus on three tasks—reducing each person’s chance of getting sick (see both individual and more general public health recommendations both above and below), helping households with basic survival needs during a pandemic, and minimizing and coping with larger disruptions in how the normal day-to-day world works.
All businesses and other organizations should now be done reviewing their continuity of operations plans for how they will operate if their employees are unable to work and how they will interact with members of the public and prepare to implement these plans soon.
All medical facilities and providers should be done reviewing their surge plans for how to handle increased numbers of patients and be prepared to implement.
Getting ready for a pandemic is largely about preparing for possible shortages. In a pandemic, supply chain disruptions are inevitable but are also unpredictable.
Since it contains vital supplies, a good start is to make sure your earthquake kit is up to date and ready to go. Of course, having supplies beyond the typical earthquake kit is a good idea. What you decide to have on hand is based on your individual and family situation and your individual preferences.
One likely shortage will be medications. You should attempt to obtain a couple of months supply for your critical medications.
If you have other critical supply needs, you should conserve them and stock up on them now.
Now is also the time to think about how you will care for loved ones at home if they or you are sick and how you would limit spread within the family.
Frequent and appropriate hand-washing is far from a perfect solution, but it’s easy, under your control, and has no significant downside.
Like washing your hands, wearing a surgical mask may help a bit, but you need to know that surgical masks don’t offer much protection when they are worn by people who are well. They are most helpful when worn by those who are already sick so that they are less likely to transmit the disease to others. Surgical masks and masks offering higher levels of respiratory protection are already in short supply and should be prioritized for use in health care settings.
You should use a barrier, such as a paper towel or tissue, to touch commonly touched surfaces, such as any door handles or elevator buttons.
Change from my previous message: I am now asking for the implementation of the activities below at this time.

All non-essential gatherings should be canceled, postponed, or done remotely. Unfortunately, at this time, I have no standard definition of “non-essential” or “gathering” to guide your decisions. Use your best judgement.
Stop shaking hands.
Increase in the amount of remote working or teleworking to the extent possible especially for those who appear at higher risk for developing the disease, those over the age of 60 and those with co-morbid conditions.
Under all circumstances, stop touching your face, eyes, nose, or mouth with your unwashed hands.
I am not asking for the implementation of these activities, but these are the types of activities we may need to implement in the future:

School closures. Schools are an essential gathering. School closings present a particularly vexing social distancing dilemma but may be necessary to protect public health. Once school closings occur, they may be extensive and extended.
Social distancing—staying at least 6 feet away from all other people—should be attempted where possible.
Rationing (a formal process of prioritizing distribution and use) of critical supplies may need to occur.
To get ourselves through the hard times that may be coming, your community may need volunteers. Think now about the skills you have and how you can help your community. Heed the call should volunteers be requested.
Other public health interventions that have been used with some effect in other countries include commandeering of both real or personal property, conscription, curfew, and cordons. It is unlikely that these interventions would be used here due to practical considerations.
Issues around testing for COVID-19. You may have received incorrect information from the federal and state government on March 4, 2020. San Mateo County does not currently have testing available independently of the state and CDC. The amount of testing that is available through the state and CDC is severely limited. Should testing become more widely available, testing will be prioritized based on healthcare infrastructure concerns, risk of exposure, and/or very sick hospitalized patients. Tests will not automatically be given upon request or by a physician’s order. This may change as testing capacity evolves over the next few months.

Scott Morrow, MD, MPH
San Mateo County Health Officer
March 5, 2020


Novel coronavirus is a new respiratory virus first identified in Wuhan, Hubei Province, China in December 2019. It has now spread to many other countries, including the USA. Technically, the virus is named SARS-CoV-2 and the disease it causes is called COVID-19 (coronavirus disease 2019). See information about 2019 Novel Coronavirus on the CDC website


San Mateo County Health officials are working closely with the California Department of Public Health (CDPH) and Centers of Disease Control and Prevention (CDC) to respond to the outbreak of COVID-19. We are providing information to health care providers in our county on how to safely and effectively evaluate ill people who have symptoms. We continue to monitor the situation, work with our partners to identify any possible cases, provide information and consultation to ensure that possible cases are diagnosed and managed safely, as well as implement recommendations from the CDC. Additionally, we conduct full investigations, assist with logistics from transportation to accommodations with all positive cases.


Individuals can prevent illness:

Frequently wash hands with soap and water for at least 20 seconds;
Always cover your cough or sneeze;
Stay home if you are sick and;
If you have recently returned from a country with ongoing COVID-19 infection, monitor your health and follow the instructions of public health officials.
Individuals can prepare for the possible disruption caused by an outbreak:
Make sure you have a supply of all essential medications for your family;
Make a child/elderly/adults with disabilities care plan if you or a care giver are sick;
Make arrangements about how your family will manage a school closure; and
Make a plan for how you can care for a sick family member without getting sick yourself.

Coronaviruses are a large family of viruses that are common in many different types of animals including camels, cattle, cats, and bats. Rarely, animal coronaviruses can infect people and then spread between people. The animal source of COVID-19 is not known right now.


In confirmed coronavirus disease 2019 (COVID-19) cases, reported illnesses have ranged from mild symptoms to severe illness and death. The most common symptoms are fever, cough, and shortness of breath. CDC believes at this time that symptoms of COVID-19 may appear in as few as 2 days or as long as 14 days after exposure.


The virus is thought to spread mainly from person-to-person, between people who are in close contact with one another (within about 6 feet), and via respiratory droplets produced when an infected person coughs or sneezes. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. See How Coronavirus Spreads.


It is cold and flu season now, and many people have symptoms of illness that are not related to COVID-19. If you have fever, cough, or shortness of breath, contact your medical provider right away and tell them about your symptoms and any recent travel. Be sure to call ahead before you visit the office, clinic, or hospital, so that the medical provider can prepare for your visit.


On March 4, 2020, CDC updated their guidelines for evaluating and reporting persons under investigation (PUI) for COVID-19 to expand testing to a wider group of symptomatic patients. To avoid overburdening our local health care system this new guidance should be interpreted with caution. We are working with CDC and the California Department of Public Health (CDPH) to determine how these changes will be operationalized. Once available, we will disseminate additional guidance to medical providers San Mateo County through the routine pathways.

The updated CDC guidelines expand testing to a wider group of symptomatic patients. Clinicians should use their judgment to determine if a patient has signs and symptoms compatible with COVID-19 and whether the patient should be tested. Decisions on which patients receive testing should be based on the local epidemiology of COVID-19, as well as the clinical course of illness. Most patients with confirmed COVID-19 have developed fever and/or symptoms of acute respiratory illness (e.g., cough, difficulty breathing). Clinicians are strongly encouraged to test for other causes of respiratory illness, including infections such as influenza.

Epidemiologic factors that may help guide decisions on whether to test include: any persons, including healthcare workers, who have had close contact with a laboratory-confirmed COVID-19 patient within 14 days of symptom onset, or a history of travel from affected geographic areas* within 14 days of symptom onset.

(*Affected areas are defined as geographic regions where sustained community transmission has been identified. Relevant affected areas will be defined as a country with at least a CDC Level 2 Travel Health Notice. See all COVID-19 Travel Health Notices.)

Good hand washing techniques are the most effective ways to prevent yourself from getting sick. This means washing your hands often with soap and water and rub for at least 20 seconds. If you have a fever or cough, a face mask is recommended to prevent spread of germs to others around you. Currently, there is no recommendation to wear masks. However, if you choose to wear a face mask, it is important to understand that face masks are not a substitute for hand washing which is the priority.


CDC currently recommends that travelers avoid all nonessential travel to China and South Korea. CDC also lists Iran, Italy, and Japan as countries where there is sustained community transmission of COVID-19 and that older adults and those with chronic medical conditions should consider postponing nonessential travel. The worldwide COVID-19 situation is evolving rapidly, and more countries may be added to these lists. Stay up to date by checking the CDC travel health notices related to this outbreak.


No. Efforts to develop a vaccine are underway in many places globally, but currently, there is no vaccine available to protect against novel coronavirus.


The treatment right now is to take care of the symptoms. There is no specific treatment for novel coronavirus.


For information, referrals, and assessments for local mental health and substance use services, please contact your health insurance company to connect to a resource within your insurance company’s network. For residents insured by Medi-Cal, call Behavioral Health and Recovery Services’ ACCESS Call Center at (800) 686-0101.

For 24/7 confidential crisis support from local/national organizations, call (650) 579-0350 or 1-800-273-TALK (8255). Chat online: text “START” to 741741.


We have information about novel coronavirus and other health alerts for clinicians here.


You can visit San Mateo County Health’s COVID-19 page or visit the CDC’s website COVID-19 page You can also find more information by accessing the links listed below.


Infographic Poster – COVID-19 Stop the Spread of Germs [Simplified Chinese] [Spanish]
Frequently Asked Questions and Answers from CDC [Simplified Chinese] [Spanish]
CDC COVID-19 Fact Sheet [Simplified Chinese] [Spanish]
CDC What to do if you are Sick with COVID-19 [Simplified Chinese] [Spanish]
CDC Infographic: COVID-19 Symptoms [Simplified Chinese] [Spanish]
Main CDC COVID-19 Website


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