It’s time to get the care you’ve been waiting for at Antioch’s Sutter Delta Medical Center

By Monique Binkley Smith, Sutter Health News Bureau Communications Manager

ANTIOCH, CALIF. — California is slowly reopening, but like so many unknowns with COVID-19, it’s unclear how long the return to routine will last.

“A surge in virus spread and infected patients could occur this fall or winter,” says Bill Isenberg, M.D. chief quality and safety officer for Sutter Health. “If this happens, and overlaps with the normal flu season, there could be a significant strain on healthcare services.”

With this in mind, medical experts agree that if you had an appointment postponed or canceled due to COVID-19, now is the time to reschedule it.

Pittsburg resident Norma Lester-Atwood is a mammographer, so she knows the importance of catching breast cancer early. Lester-Atwood is typically right on schedule for her own mammogram, but this spring, shelter-in-place orders delayed her mammogram by two months. As soon as she could, she had the screening procedure and she’s glad she did, because her mammogram and a subsequent biopsy revealed a Stage 0 (non-invasive) tumor in one of her breasts. After a lumpectomy to remove the tumor, Lester-Atwood feels she is well on her way to recovery.

“As a mammographer, I tell my patients that it’s important to come in for a mammogram because I’ve seen patients who developed fast-growing tumors between screenings,” says Lester-Atwood.

As Lester-Atwood’s experience shows, timing is everything when it comes to staying healthy. Getting cancer screenings at the recommended intervals can help spot early signs of tumor growth before it turns into advanced cancer.

“Some women don’t realize that mammograms are needed regardless of your family history, because most women with breast cancer have no family history or other identifiable risk factors,” says Octavio De La Rosa, manager of Medical Imaging Services at Sutter Delta Medical Center in Antioch, part of the Sutter Health not-for-profit integrated network of care.

Screening for colorectal, prostate and lung cancers are also vital. “Simply put, screening saves lives,” says De La Rosa. “Delayed screenings can postpone detection of cancer, which may translate into needing more intensive treatment and a more difficult path for patients.”

Taking Steps to Protect Patients and Staff

Sutter Delta’s imaging center, located inside Sutter Delta Medical Center at 3901 Lone Tree Way, has resumed screening mammogram services and is taking steps to protect patients:

• Mandatory Masking – Staff, patients and visitors must wear masks at all times.
• Isolation – Anyone with COVID-19 symptoms is isolated from waiting areas, patient rooms, entrances and spaces the general population uses.
• Cleaning –Increased the frequency of cleaning and disinfecting in all spaces.
• Screening – Everyone is screened for symptoms of COVID-19 before entering.

Resources to Help with Health Insurance Disruption

Health insurance coverage can be disrupted by wage or job loss, but there are options available.

In California, the Every Woman Counts program covers mammograms and cervical cancer screening for women with no or limited insurance who meet other eligibility criteria. Call 1-800-511-2300.

Other options include extending employer-based coverage through COBRA and CalCOBRA, shopping for plans and applying for premium assistance through Covered California or Medi-Cal. Charity care and financial assistance may also be available.

By Allen Payton

In response to some concerns by county residents and questions to county Supervisor Candace Andersen and health services spokespeople, it was revealed this week that Contra Costa is accepting patients from hospitals as far away as Imperial County along the border with Mexico. That’s because our county has mutual aid agreements with that and other counties in the state.

In response to a resident’s question “is CCC getting patients from other counties that are overloaded (such as Imperial County, or other counties)?” Gayle Israel, Chief of Staff for Board of Supervisors Chair Candace Andersen, wrote in an email, “We have two patients in Contra Costa hospitals from Imperial County. Also have 15 Contra Costa residents in Alameda County Hospitals. Reporting shows hospitalizations by county where hospitalized, not by residency. So, we are +13 beyond what is reported on our hospitalized dashboard.”

Asked by the Herald why the patients from Imperial County are in Contra Costa, Will Harper, Communications Specialist for Contra Costa Health Services responded, “We took on these patients as part of a mutual aid agreement to provide relief to hospitals in Imperial County,”

Asked if there are patients transferred to hospitals in Contra Costa County from any other county in the state, he responded, “Yes. We have mutual aid agreements with counties and offer help when they become over capacity.”

In addition, the resident asked Supervisor Andersen, “how many of the hospitalizations are from the four active nursing home outbreaks, and how many of the deaths are from the nursing home outbreaks?”

Israel responded, “Ten of the 11 deaths since Friday were from congregate care facilities, nine from the same facility. Had a record number of cases over the weekend, but also hit target for first time for tests per day – higher amount of tests = higher cases. Health Officer says we have the data for # of hospitalizations from congregate care facilities, but he didn’t have at his fingertips. We are asking for that information – however, we have been told all along that those critically ill in skilled nursing facilities are not typically transferred to hospitals, so that number is likely low.”

As a result, communications staff for county health services were asked if a statistic can be included on the County Health Services’ Coronavirus Hospital Dashboard that shows in which other counties Contra Costa patients are located and which patients in Contra Costa hospitals are from other counties, Harper responded, “currently, there is not, though we are always working to expand the amount of data on our website and have added many dashboards over the past 1-2 months.”

Some county residents have expressed concern that people are crossing the border from Mexico, which for now is closed to non-essential travel, testing positive and filling up hospitals in California, and might be increasing the state’s Coronavirus statistics, resulting in a negative impact on decisions by government officials regarding reopening businesses, schools, sports and other activities. In addition, a video about what is happening in Riverside County, that COVID-19 patients are being flown in from Imperial County, raised questions about how the patients arrived in Contra Costa County.

The following additional questions were asked of county health services spokespeople.

People are wondering are those patients you referred to American citizens, or at least residents of Imperial County, or are they Mexican citizens or residents who have come across the border and entered the hospitals, there? Also, how did they arrive in Contra Costa? Do you know if they were flown, here to our county?

Please check back later for answers to the questions and any other updates to this report.

Will it affect the county’s planned Road Ahead reopenings?

By Allen Payton

Contra Costa County experienced the greatest one-day spike in COVID-19 cases since the beginning of the pandemic at 103 between Thursday, June 18 and Friday, June 19, 2020. According to CCHealth’s Coronavirus Dashboard, the number of cases increased from 2,146 on Thursday to 2,249 on Friday. There was another increase of 45 cases between Friday and Saturday for a total of 2,294 people who have tested positive for the virus in the county, to date.

That has some residents concerned that the county might pull back on some of the planned openings of businesses and activities that are scheduled for July 1st and 15th, as well as schools in July and August, as well. (See related article)

However, in addition to that statistic, the county had 2,457 residents get tested for the Coronavirus between Thursday, June 18 and Friday, June 19, which was also the greatest one-day statistic, in that category.

As of Sunday, June 21, 2020 at 11:30 a.m. there are currently 30 people in the hospital in the county who are infected. There have been a total of 62 deaths attributed to the Coronavirus, which is slightly more than one-tenth (1/10th) of one percent of those who have been tested in the county, which currently stands at 57,989. Also, of the 2,294 people who have tested positive, 1,734 have recovered or 75.6%. That means there are currently 468 people in the county with the virus who are quarantined at home.

Of those who have tested positive, 2.7% have died. That statistic, which has remained fairly constant and actually dropped by 1/10th of one percent in the last month, might alleviate the concerns by county health officials.

However, with residents wondering if the spike in cases could have been caused by all the people participating in protests in the county over the past few weeks, an email was sent Sunday to county health spokesperson, Kim McCarl asking that question. She was also asked if those who test positive are asked what activities they have participated in over the previous two weeks and if there are any concerns by County Health Officer Dr. Chris Farnitano and county health staff that the spike in cases could impact the Road Ahead schedule for reopening.

6/22/20 UPDATE: Will Harper, Media Relations Specialist for Contra Costa Health Services, responded, “We are closely monitoring recent increases in the number of COVID cases and hospitalizations in the county. We expected some increases as more businesses and activities reopened and as we expanded testing. Still, the upward trend is concerning and could affect our reopening timeline.

As people do venture outside their homes and back to normal social interactions, it’s important to do everything possible to reduce the risk for getting or spreading COVID-19. Wear a mask. Maintain six feet social distance. Wash your hands often. Stay home when you are sick.

Regarding the impact of protests: It is challenging to link cases to specific events, especially a gathering where you may not know anyone else who was there with you. We have a small number of reports tied to recent cases that did attend protests, but it is hard to attribute their presence at the protest with their infection versus other contacts they may have had in the past 14 days.”

Asked, again if people who get tested are asked about their activities over the previous 14 days, Harper responded “No, they don’t go back 14 days.” 6/24/20 UPDATE: He later clarified that statement writing, “we do contact investigation/tracing for contacts during the infectious period, which is defined as 2 days prior to symptom onset until patient is isolated (for symptomatic) and 2 days prior to COVID test date until patient is isolated (for asymptomatic).But we also ask where they may have been exposed 14 days from symptom onset/test date. This can be useful information, although keep in mind that we wouldn’t call people (ie close contacts) beyond the 48-hour infectious period mentioned above.”

Following are the businesses that will be allowed to reopen and the activities that will be allowed to resume based on Contra Costa County’s updated Road Ahead issued Wednesday, June 17, 2020.

July 1st – Personal services not involving the face (massage, nail salons, tattoo, body waxing, etc.) • Indoor dining • Bars (with or without food) • Indoor religious services • Gyms, fitness centers & personal training • Limited indoor leisure (arcades, billiards, bowling alleys, etc.) • Indoor museums • Hotels (for tourism & individual travel)

July 15th – • Personal services involving the face (skin care, permanent makeup, facial waxing, etc.) • Movie theaters

However, although “These openings are a direct response to your patience and observation of the health order” as is written on the new Road Ahead, and they “hope to continue opening up the county” the county health officer “may need to reconsider openings based on the course of the pandemic.”

Download a copy of the latest Road Ahead, here.

From Contra Costa Health Services

The State of California this week granted Contra Costa County a variance that allows more local control over when some activities restricted by the COVID-19 pandemic may resume.

The variance allows Contra Costa to move ahead with its road map for reopening at a pace that is appropriate for local conditions, which includes hair salons, indoor dining, gyms and schools in coming weeks.

“We are able to reopen more businesses and activities because the people of Contra Costa have diligently followed the health orders restricting our activities for many months,” said Candace Andersen, chair of the Contra Costa County Board of Supervisors. “We remain committed to a safe and careful reopening for our county.”

In an attestation filed to the state this week, Contra Costa Health Services (CCHS) outlined the progress at managing the spread of COVID-19 locally and how the local healthcare system is preparing in the event of a new surge in cases.

If safe to do so, hair salons and barber shops can reopen for business on June 17, according to a timeline released by CCHS. Indoor dining, bars, gyms and fitness centers, hotels and some indoor entertainment venues may follow July 1.

The county’s timeline could change if community health indicators worsen, such as an increase in the number of new cases or patients hospitalized with COVID-19.

Contra Costa is the first of six counties in the lower Bay Area to seek or receive a variance from the state COVID-19 health order, joining the North Bay counties of Napa, Solano and Sonoma.

Visit cchealth.org/coronavirus for more information about Contra Costa’s response to the COVID-19 pandemic.

 

Claims “Restricting Religious Gatherings to 12 Participants Unconstitutionally Violates Right to Equal Protection”

“…the County’s Order violates federal and state law while unashamedly discriminating against houses of worship.”

On Wednesday, June 10, 2020 a formal legal letter was by attorney Harmeet Dhillon, founder of the Center for American Liberty, to members of the Contra Costa County Board of Supervisors, to ensure county health services staff follows through with their commitment to change the requirement to a recommendation that places of worship gather names and contact information of those who attend services and provide it to the county upon request. (See related articles, here, here and here). In addition, the letter points out that the county’s health order limiting indoor services to 12 people also violates the Constitution. 2020.06.10_HDhillon CAL Letter to Contra Costa County

June 10, 2020

Contra Costa County Board of Supervisors

651 Pine Street

Martinez, CA 94553

Re: Unconstitutional Contra Costa Health Services Order No. HO-COVID19-17, Specifically Regarding “Additional Businesses” (section 3 of Appendix C-1, Updated June 5, 2020)

Dear Board of Supervisors:

We write today, on behalf of clients in Contra Costa County, to demand the immediate rescission of Contra Costa Health Services Order NO. HO-COVID19-17 (the “Order”). The Order is concerning for two reasons: (1) Its requirement that houses of worship—and only houses of worship—keep and upon request disclose “a record of attendance” to Contra Costa Health Services violates both state and federally protected rights of associational privacy; (2) Restricting religious gatherings to no more than 12 participants violates First and Fourteenth Amendment protection. And while we appreciate the County’s recent announcement that it plans to revise its requirement that houses of worship keep and disclose attendance lists, until such plans manifest, we reiterate our objection over its current text.

1. Restricting Religious Gatherings to 12 Participants Unconstitutionally Violates First Amendment Rights

The First Amendment to the U.S. Constitution prohibits government actors from enforcing any “law respecting an establishment of religion, or prohibiting the free exercise thereof.” U. S. Const. amend. I; see also Cantwell v. Connecticut, 310 U.S. 296, 303 (1940) (applying the First Amendment to the States through the Fourteenth Amendment). Under strict scrutiny, the government cannot burden religious activity unless it first establishes (1) a compelling interest for imposing such burdens, and (2) that the burdens are the “least restrictive means” necessary to further that compelling interest. Federal courts routinely enjoin the enforcement of laws and policies under this standard. See e.g., Church of the Lukumi Babalu Aye, Inc. v. City of Hialeah 508 U.S. 520, 524 (1993).

The County’s Order severely burdens religious expression. The Order’s restriction on indoor religious services—limiting the number of participants to 12 persons or 25% of the building’s capacity, whichever is less—does not survive exacting scrutiny in that it is not the least restrictive means to accomplish the County’s interest in public health. Simply put, there are better ways for the County to accomplish its interest in public health that do not burden religious expression as much. For example, restricting participation on a percentage basis only—with respect to facility seating capacity—is a better solution. Twelve people in a sanctuary that holds one thousand looks very different from twelve people in a sanctuary that holds one hundred people.

In other words, percentage-based restrictions accommodate larger houses of worship while satisfying the County’s interest in public health and social distancing.

1. Restricting Religious Gatherings to 12 Participants Unconstitutionally Violates Right to Equal Protection

The Fourteenth Amendment of the Constitution provides that “[n]o State shall . . . deny to any person within its jurisdiction the equal protection of the laws.” U.S. Const. amend. XIV, § 1.

Equal protection requires the state to govern impartially—not draw arbitrary distinctions between

individuals based solely on differences that are irrelevant to a legitimate governmental objection. City of Cleburne, Tex. v. Cleburne Living Ctr., 473 U.S. 432, 446 (1985).

Here, the County’s 12-person limit on religious gatherings is nothing if not arbitrary. This is more restrictive than statewide health guidelines, according to the California Department of Health for places of worship, which currently limits attendance to 25% of building capacity or a maximum of 100 attendees, whichever is less; it is unclear where Contra Costa County’s “12 person” idea originates.

Additionally, no other establishment in Contra Costa County is subject to these more restrictive and draconian requirements. Costco, laundromats, marijuana dispensaries, and countless other purely secular entities are not burdened by this arbitrary, 12-person limitation.

On April 14, 2020, the United States Attorney General, William Barr, issued a statement addressing the disparate treatment being afforded to houses of worship.

As we explain in the Statement of Interest, where a state has not acted evenhandedly, it must have a compelling reason to impose restrictions on places of worship and must ensure that those restrictions are narrowly tailored to advance its compelling interest. While we believe that during this period there is a sufficient basis for the social distancing rules that have been put in place, the scope and justification of restrictions beyond that will have to be assessed based on the circumstances as they evolve.

Religion and religious worship continue to be central to the lives of millions of Americans. This is true more so than ever during this difficult time. The pandemic has changed the ways Americans live their lives. Religious communities have rallied to the critical need to protect the community from the spread of this disease by making services available online and in ways that otherwise comply with social distancing guidelines.

The County may not treat houses of worship as second class entities; at a minimum, it must treat them equitably with respect to secular counterpart. Contra Costa Health Services Order NO. HO-COVID19-17 does the opposite—it targets houses of worship with more burdensome restrictions.

III. The Order Infringes Upon Constitutionally Protected Right to Privacy Under State Law

The right to privacy is an inalienable right under California law.3 This privacy interest irrefutably extends to participation in religious gatherings.

In Church of Hakeem, Inc. v. Superior Court, Alameda County, 110 Cal. App. 3d 384 (Ct. App. 1980), the court expressly declined to mandate disclosure of member names and addresses, even after allegations of criminal activity or wrongdoing by the church. In City of Carmel-by-the-Sea v. Young, 2 Cal. 3d 259 (Ct. App. 1970), the court affirmed a list of freedoms afforded constitutional protections, such as the freedom of association and privacy in one’s associations, encompassing privacy of the membership lists of a constitutionally valid organization. In Pacific Union Club v. Superior Court, 232 Cal. App 3d 60 (Ct. App. 1991), the court provided a robust analysis of associational rights and ultimately upheld a private club’s right not to disclose member lists.

Applied here, Contra Costa County’s Order requiring houses of worship to create and preserve the names and contact information of those in attendance at a worship service or ceremony, and then disclose such information “immediately upon request” unconstitutionally violates privacy rights while chilling religious expression. Whether gathering for political, social, or religious reasons, the right of association is sacrosanct. Unfortunately, the County’s Order deprives Californians their right to pray, worship, repent, and seek spiritual guidance privately. Rather, the Order subjects their most intimate religious activities to potential publication.

3 “All people are by nature free and independent and have inalienable rights. Among these are enjoying and defending life and liberty, acquiring, possessing, and protecting property, and pursuing and obtaining safety, happiness, and privacy.” Cal. Const. Art. 1 § 1

1. The Order Violates Right to Privacy Protected by Federal Law

The “Court has recognized the vital relationship between freedom to associate and privacy in one’s associations.” Nat’l Ass’n for Advancement of Colored People v. State of Ala. Ex rel. Patterson, 357 U.S. 449, 462 (1958). Citing American Communications Ass’n, C.I.O., v Douds, 339 U.S. 382, 402 (1950), the Court explained,

‘A requirement that adherents of particular religious faiths or political parties wear identifying arm-bands, for example, is obviously of this nature.’ Compelled disclosure of membership in an organization engaged in advocacy of particular beliefs is of the same order. Inviolability of privacy in group association may in many circumstances be indispensable to preservation of freedom of association, particular where a group espouses dissident beliefs.

Here, Contra Costa County’s Order tramples Californians’ right to privacy and in doing so, violates the Due Process Clause. Similar to the state of Alabama in NAACP v. Alabama, Contra County is requiring houses of worship to disclose the identities of congregants gathering to worship. And similar to the state of Alabama, this mandatory disclosure of religious expression “curtails the freedom to associate,” “denying “the ‘liberty’ assured by the Due Process Clause of the Fourteenth Amendment,” and is “subject to the closest scrutiny.” Id. at 460-61.

1. Attendance Recordation Requirement Violates Equal Protection Protected by Federal Law.

By the Order’s express terms, the Order discriminates against places of worship by requiring places of worship to create and maintain attendee lists, yet the Order places no other such burdens on any other non-religious establishment whatsoever. As the United States Supreme Court has noted, “a law burdening religious practice that is not neutral or not of general application must undergo the most rigorous of scrutiny.” Church of the Lukumi Babalu Aye, Inc. v. Hialeah, 508 U.S. 520, 546 (1993). Further, “A law is not generally applicable if its prohibitions substantially under include non-religiously motivated conduct that might endanger the same governmental interest that the law is designed to protect.” Stormans, Inc. v. Wiesman, 794 F.3d 1064, 1079 (9^th Cir. 2015) (citing Lukumi, 508 U.S. at 542–46). So, “In other words, if a law pursues the government’s interest ‘only against conduct motivated by religious belief,’ but fails to include in its prohibitions substantial, comparable secular conduct that would similarly threaten the government’s interest, then the law is not generally applicable.” Id.

The County fails this standard. Houses of worship are uniquely burdened by this public disclosure requirement. And again, no other entity appears to be subjected to this standard.

In conclusion, we believe the County’s Order violates federal and state law while unashamedly discriminating against houses of worship. For these reasons, the Center for American Liberty respectfully requests that Contra Costa Health Services Order NO. HO-COVID19-17, requiring houses of worship to record and disclosure attendance at religious services, be either rescinded or amended to cure its constitutional defects. We look forward to hearing your response.

Regards,

Harmeet K. Dhillon

cc: John Gioia, Candace Anderson, Diane Burgis, Karen Mitchoff, Federal D. Glover

May also challenge 12-person or 25% capacity limit for indoor services

Following is the statement from the Center for American Liberty’s Founder Harmeet K. Dhillon concerning the Contra Costa Health Services Order No. HO-COVID19-17. (See related article)

“The Center for American Liberty was contacted recently regarding the June 5, 2020 Order issued from Contra Costa Health Services (Order No. HO-COVID19-17). This Order was concerning for several reasons and we intend to formally reach out to Contra Costa County with an analysis of our concerns.

The June 5, 2020 Order, as presently written, specifically singles out places of worship by requiring that places of worship in Contra Costa County create and preserve a list of persons in attendance, and then disclose such attendance list upon request to the government – a burden that is notably not placed on other establishments in Contra Costa County. Such burden is unconstitutional and is discriminatory on its face.

The California Constitution provides certain inalienable rights, including the right to privacy, to freely assemble, and to enjoy one’s religion- Californians deserve to freely worship and assemble without fear that his or her name and address will end up in a government database. The Center for American Liberty welcomes any official change to this June 5, 2020 Order and will continue to be vigilant about any attempts to discriminate against houses of worship or people of faith in California.

Additionally, the June 5, 2020 Order currently limits houses of worship to a 12 person or 25% limit (whichever is fewer), which is arbitrary, and we will also be monitoring, and potentially challenging, this disparate burden on places of worship and people of faith in Contra Costa County.”

By Allen Payton

Contra Costa County health officials are backing down on their requirement in the latest order issued June 5 that places of worship gather names and information of all attendees, keep it for 14 days and provide it to the county immediately upon request. According to a statement issued Tuesday morning, “health officers will be working with county attorneys to revise the order to reflect this as a recommendation but not a requirement.”

The action comes following a series of email exchanges between the Herald and county supervisors and staff over the past several days about the requirement, an article and public outrage on social media challenging the constitutionality of the requirement, the inconsistent and unfair application to only places of worship, and no other organization or business, including protesters or restaurants offering outdoor dining in which people sit for extended periods of time with their masks off in order to it.

A legal effort was in the works as of Monday, with several residents agreeing to sign on to a legal demand letter to be sent to the county. But that now appears to be unnecessary.

Following is the Statement Regarding Requirements for Religious Gatherings

“In the health order issued June 5 by Contra Costa Health Services, religious organizations were required to maintain a list of attendees at religious services and cultural ceremonies in the event of an outbreak of COVID-19. The intention was to facilitate quick, complete contact tracing if a participant at the event tests positive.

Health officers will be working with county attorneys to revise the order to reflect this as a recommendation but not a requirement. If a participant tests positive for COVID-19, the host will be asked to assist CCHS with contact tracing associated with the gathering.

To mitigate the risk of transmission to the greatest extent possible, CCHS encourages participants to wear face coverings at all times, maintain social distance when possible, practice good hand hygiene, and stay home if sick.”

According to Kim McCarl, Assistant to the Director of Contra Costa Health Services for Communications, “As we revise the language, the recommendation will apply to any allowed gatherings.”