Five years ago this week, life in the north state changed forever.
The specific date is March 19, 2020. That’s when Gavin Newsom became the first governor in the U.S. to issue COVID-19 shutdown orders — three days before President Donald Trump declared the coronavirus outbreak a pandemic and two weeks after Newsom’s initial declaration of a health emergency.
Monica Soderstrom remembers exactly where she was that March 19th. Butte County’s new public health director, then midway into her 10-year tenure with Butte County Public Health, oversaw BCPH’s Community Health Division and Public Health Nursing under then-director Danette York. Soderstrom was visiting her father and stepmother “the day the world turned upside down,” and as she and her son drove back, they stopped for lunch — their last meal out for quite a while.
Newsom’s order prompted BCPH to open its Department Operations Center, and Soderstrom served as DOC operations section chief.
“We got to work,” Soderstrom recalled in an interview last week. “I think we knew some sort of temporary shutdown might need to occur because of the very fast-paced changes we saw with the spread of COVID in our country. But I don’t think anybody had an idea that it was going to be so long and so profound.
“I remember when it first happened, it was looked at as a temporary pause, just trying to get ahead of that transmission — and trying to find out really what we were dealing with.”
California may have been a trailblazer for countermeasures, but the state wasn’t among those hit hardest first. Accounts out of New York and Washington seemed like scenes from a disaster movie with hospitals overrun by seriously ill patients and piles of body bags for those succumbing to the disease.
Hindsight is 20/20, of course. Looking back, it’s tempting to dismiss stay-at-home restrictions, mandatory masking and social distancing as overreactions. In the moment, though, fear and uncertainty permeated society — and health care — at all levels.
Dr. Andy Miller worked side by side with York and Soderstrom. He was the county public health officer, a position that by state law must be filled by a physician. Miller held significant authority during the declared emergency while serving as the subject-matter expert advising the Board of Supervisors.
By phone from Denver International Airport (where, ironically, he was when the declaration got issued), Miller said he sometimes wonders about what he might have done differently but also feels assured BCPH did the best it could given the evolving information it had.
“Some days, I feel like I should have pushed harder with the trust and the power my position had,” said Miller, now medical director for community health at Enloe. “I am not sure if that ultimately would have led to a better outcome, because there were people not wanting me to do that, so I easily could have been made less effective.
“But it’s still hard for me to say sometimes, ‘What else could I have done?’ because there are things on that menu of options that I could have done. There are reasons I didn’t at the time, but I still don’t know if that’s right or wrong.”
Fears and unknowns
Not among most in the medical community, though in a vocal segment outside of it, a big thing added to the menu of options proved a lightning rod of controversy so severe that it put public health officers and public health directors under incredible pressure.
That, of course, is COVID-19 vaccination. Shutdowns aimed to contain the spread until scientists could find a remedy to roll out. Therapies such as monoclonal antibodies lessened the severity of the coronavirus, but no “cure” emerged. Vaccines proved to be the answer accepted by front-line clinicians, health officers and ultimately the president.
Dr. James Moore, an emergency room physician who served as Enloe’s chief of staff later in the pandemic, was the first person vaccinated in Butte County. If not for a fateful flight, he might have rode out the shutdown in South America. He and his family were vacationing in Colombia when the order came down; the Moores and two other passengers caught the last plane out.
“It’s a lot of mixed emotions,” he said last week. “Especially in the Emergency Department, but in health care in general, it was such a challenge navigating that disease and what it did to Chico, did to the country, what it did to families — it was just all-encompassing; it just devoured everything. We all remember; how could you not remember?
“Here in Chico especially, even more than in other communities, we gravitated to this and owned it really early, even before it came to us. We were really late in the game when we got our surge (in December 2020); we were five, six months behind other parts of California. But the work getting our surge plan together, even getting the tent outside the E.D. (for COVID patients) before the surge really came, gives kudos to the community outreach not just from our hospital but from all the physicians and health care agencies in the area to prepare ourselves for what was ultimately a big hit to our system.”
Moore, like other medical leaders, credits vaccination with mitigating what could have been deadly devastation. Even if he hadn’t gotten the opportunity to receive the first shot Dec. 17, 2020, Moore said he would have stepped up to be among the first. He trusted the vaccine because, even though the development occurred in a condensed timeframe, the scope of the outbreak provided ample patients for clinical trials.
Moreover, the technology for this type of vaccine — mRNA (messenger ribonucleic acid) — began development decades earlier.
“Unfortunately, the country in a lot of ways did itself a disservice by allowing politics to split the conversation from something that should have been very medical and scientific to something that was very emotional,” Moore said, “and at the time, it created a lot of conflict with ‘the people’ versus the medical system.
“It was easily the toughest part of my career to try to be so tactful and diligent to try to save lives when daily you’re confronted with misinformation and patients who assumed that the latest TikTok superseded what our health care institutions were recommending. It was pretty heartbreaking to be dealing with all the despair and death around us.
“And the fear — there was so much fear. We showed up to work every day still not knowing what this disease was capable of, then having to go home to our families and always having this concern that we were bringing it home to them.”
Flash forward
We now know what COVID-19 could do. In the first year, a reported 7,390 cases in Butte County led to 96 deaths — a mortality rate of 1.2%, a hair below the national rate of 1.7%. As of the last county-level reporting, in July 2023, the county had 42,213 cases resulting in 503 deaths — a similar 1.1%, mirroring the national rate at the time.
Impacts transcend medical transmission. Community businesses and agencies took financial hits that infusions of federal money, via the American Rescue Plan Act and Payment Protection Program, could not fully offset. Schools’ shifts from classrooms to virtual learning created gaps that educators still work to bridge, years after reopening. Societal effects may take even longer to quantify.
“This was a once-in-a-lifetime event,” said Dr. Sean Maiorano, Enloe’s chief medical officer. At the height of the pandemic, when Dr. Marcia Nelson helmed that post, he worked as a hospitalist treating seriously and critically ill patients admitted for intensive care.
“Before we had access to a vaccine, our armament of treating this was limited — and, frankly, still is limited, though the disease is less lethal that it was because it’s mutated. But the vaccine was a ray of hope for us.”
Miller agreed. He considers the first public vaccination clinic among the high points of his medical career. Along with providers from Enloe and BCPH, he helped administer vaccines to over 750 people that day — predominantly to seniors but also to others particularly susceptible to respiratory diseases. Per CDC data, adults over 65 accounted for 81% of COVID-related deaths in 2020 and suffered a fatality rate 5.8 times higher than Americans as a whole.
By that math, Miller estimates the vaccine saved over 100 lives that day alone.
As Maiorano noted, the coronavirus has mutated into variants less virulent than the original COVID-19 virus and its immediate strains. That’s the pattern of the previous worldwide pandemic, the Spanish Flu in 1918-20. In fact, public health officials track COVID in tandem with the flu and other respiratory viruses, and like the flu shot, COVID vaccines change annually based on the variants scientists projects as most prevalent.
Soderstrom, who succeeded York as public health director two months ago, harkens to local experiences with disasters: the Oroville Dam spillway crisis, the Camp Fire, COVID-19 and wildfires that followed. Agencies, hospitals and citizens at large already had mindsets of resilience and cooperation that other communities hadn’t developed. These relationships endure, and best practices remain ingrained.
“The world has really changed,” she said. “For me, although there have been disagreements in some parts of our society at large, overall I was really proud of the way our community here really worked together and tried to work together under some very difficult circumstances.”
Butte County toll totals
2020
7,390 cases
96 deaths
Today*
42,213 cases
503 deaths
*-County-level tracking ended in 2023
Source: Paradise Post
