THE GOOD DOCTORFree Access

Eric Sergienko has been on the front lines of the Covid fight

Dr. Eric Sergienko points to a white board Monday that has a lot of crucial information about Covid-19 in Mariposa County. Photo by Greg Little

Dr. Eric Sergienko points to a white board Monday that has a lot of crucial information about Covid-19 in Mariposa County. Photo by Greg Little

The residents of Mariposa County are lucky in many ways.

They are able to live in a safe, rural community surrounded by beauty. That’s not even mentioning the majority of Yosemite National Park is within the county.

But there’s another crucial thing the county is lucky to have during a global pandemic. Well, a person, not a thing.

Dr. Eric Sergienko.

“New Year’s Eve,” said Sergienko, the Mariposa County Health Officer, about when he first learned about the Covid-19 virus. “That’s when the Chinese government reported it to the WHO (World Health Organization).”

As a doctor and health officer, Sergienko said “every day” there are various emails and information which are released about “all open source news of diseases.”

In that particular case, Sergienko, who spoke to the Gazette on Monday afternoon, said it was listed as a “new pathogen in Wuhan, China.”

It certainly raised a red flag with Sergienko, who said “anytime” there are reports of a virus appearing in China, it can be concerning. The reason, he said, is because of the “close mingling of people and animals.”

 

In China, at least then, there are live animal markets throughout the vast country. In these markets, people can come there, pick out a live animal and then come back in an hour and it is processed and packaged.

In most cases, Sergienko said it is a new flu strain which becomes front of mind for scientists. It was no different in this case, he said.

“We were planning for influenza and it was not surprising to hear,” said Sergienko.

By the middle of January, Sergienko said officials were warning of “pandemic potential” from this particular novel virus. He also began discussing the situation with other local officials, including the Mariposa County Board of Supervisors.

“It was concerning for us,” said Sergienko.

So much so, he said he knew then if this disease was going to threaten America, including this region, it would take a “whole of government response” to address the virus.

He said it is important that “everyone” is involved in the “response” to the virus.

A unique area

One of the interesting aspects in this region is the dependence on the hospitality industry as part of the overall economy.

Sergienko said one of the big issues is that many of the people who work in that industry, including housekeepers, cooks and others, live in close quarters, many times in congregate living.

“How do we limit our co-mingling?” said Sergienko.

In a perfect world, he said if everyone froze in place for 14 days and stayed 10 feet apart, the virus would be done.

“You can’t do that shy of shutting down society,” said Sergienko.

Instead, they are doing many other things in order to at least limit the spread of the virus.

“We’re looking for disease in all the right places,” said Sergienko.

In the beginning

But before getting into those places, it is important to understand the level of expertise Sergienko has ­— one of the reasons local residents are lucky.

Sergienko was actually working as a seasonal ranger in Yosemite in 1988 and was trying to figure out his next steps.

“Like most people, I was pretty broke,” said Sergienko.

Then his mother sent him a newspaper column written by Ann Landers. In the column, she wrote about the Uniformed Services University of the Health Sciences in Bethesda, Md.

He enrolled as a member of the U.S. Navy and spent four years as a junior officer.

After that, he was assigned to Guam and it just “happened” that’s when the SARS virus appeared globally. He worked closely on that virus and said after a couple of years, he “convinced the Navy” to send him to the Centers for Disease Control and Prevention in Atlanta.

There, he became part of the Epidemic Intelligence Service. Then he was assigned to the Washington State Department of Health where the focus was epidemiology and influenza plans.

After that, he was assigned to Navy Headquarters in Washington, D.C., where he spent six years focusing on issues like influenza and pandemics.

In 2009, he said H1N1 happened but he said it was “much milder” than what we are seeing with Covid-19. But even then, he said there were a “lot of unknowns,” including impacts on Native people and pregnant women .

Eventually, he landed back in Washington, D.C., where he was a Department of Defense liaison to the CDC.

The specialty?

Ebola.

That’s a pretty impressive resume for someone who’s next job was being the health officer in Mariposa County.

The poop test

One local issue which has made national news is how the county is testing sewage treatment plans in three locations: Wawona, El Portal and Mariposa.

One of the issues which has been confusing to people is how the results are determined. All three plants tested positive for Covid-19, though in Mariposa, the last test showed no virus being detected.

“Why is that?” Sergienko asked himself, saying they are trying to determine that answer.

He said it “may be the messaging” that is happening and people who would normally be traveling here may be staying home and are more “self aware.”

At El Portal, the company doing the testing, Biobot, released figures after the July 4 weekend that indicated up to170 infected people may have passed human waste into the sewage system.

But Sergienko said because the testing process is new technology, he likes to think of it in ranges. In that case, he said the range could be 100 to 200 people.

Still, with not even close to 100 cases being reported in Mariposa County, it is a clear indicator that many people infected with the virus likely spent time at Yosemite during the holiday weekend.

In Wawona, he said the first test showed “just a trace” of the virus, but now it is “picking up.”

Though he’s not sure exactly why, Sergienko said weddings and family gatherings are “still allowed” under state rules.

Concerning large gatherings, Sergienko had a piece of advice: “It’s probably not a good idea.”

He said county officials will be “doing more clinical testing” at the park and in the communities that closely border Yosemite, like Wawona.

“We know people can shed the virus in poop before they have symptoms or after they have symptoms,” said Sergienko.

Monitoring the youth

Another major issue in Mariposa County is the school system. Sergienko has worked closely with the administration and school board as officials have struggled with a decision about starting school.

Last week, the board voted to start virtually, but allow some small groups of students to meet with teachers; if the teachers agreed.

More recent data around the country has indicated that older students (10 and above) “are almost as effective” at spreading the virus as adults, he said. But the younger students under 10 are not as effective spreaders.

Sergienko said there “are ways” to open some schools but it would almost certainly have to be on the elementary level. He said there is “no way” he would recommend opening the high school.

“The age range is key,” said Sergienko.

Where we stand

One issue Sergienko has brought up with the board of supervisors is the possibility of the county rolling back some restrictions to get ahead of state regulations.

The state has a “County Data Monitoring List” which sets off “triggers,” said Sergienko.

A glaring example of that is Mono County, which had 22 positive cases over a 72 hour period, prompting the state to put it on the list. The majority of those cases were related to indoor dining in restaurants.

In fact, all of the counties around Mariposa County are on the list with the exception of Tuolumne, which he said is “teetering.”

For Mariposa County, the benchmark is having 18 positive cases over a 14 day period. That, however, is flexible and based on when cases are reported and considered complete. Sergienko called it a “moving window.”

Should the supervisors decide to act in advance of any potential restrictions, it could mean the county would be quicker to get off the list.

He goes back to the Mono County situation.

“That’s what we saw in Mono and that’s what I am so concerned about here,” said Sergienko.

He did say if there “is a huge boost here,” the county would “have to scale back.”

What that means is those triggers would be enacted and could mean gyms would have to be outdoors, church services would have to be scaled back and either outside or online and haircuts would have to be done outside. And those are just some of the issues.

Complicating matters, said Sergienko, is how fast Covid-19 is spreading in the Central Valley.

“Their healthcare systems are strained,” said Sergienko.

The issue is if a patient at John C. Fremont hospital needs an ICU bed, finding one in the valley might be a challenge. In fact, Sergienko said the last patient transferred from JCF to a hospital went to the Bay Area.

Sergienko also said Mariposa County, as well as the valley areas, are “still in the first wave” of the pandemic and the possibility exists there could be even more cases as fall approaches.

He did say the state of California is sending in “unified support teams” to various areas in the valley to see what can be done “for response and to lower cases.”

In fact, he was scheduled to meet with one of the teams on Wednesday because of Mariposa County’s proximity to the rising number of cases in the region.

Now, he said, Mariposa County is in “a good spot,” though that could change quickly with a surge in cases.

Testing, testing

A national issue that has local ramifications is testing, including the time it takes to get back results.

Though wait times have been increasing, that trend is reversing, said Sergienko, who added: “I think we’re okay.”

For now, at least.

He did say conditions have improved since March, when the virus had a huge impact and testing was so limited.

In fact, he said JCF has the ability to do a certain type of test that can produce results in hours.

“It is nice having JCF as a resource,” said Sergienko. “I’ve got options, which is more than I had in March.”

Sergienko said having the testing site on Silva Road has also been a benefit for the county. He said various groups of people can get tested on a regular basis. That includes hospitality workers, emergency responders and more.

Generally, he said, those results are now coming back in four to five days.

The mask debate

One issue that is both medical and political is the debate over wearing a face covering when in public settings.

Sergienko said when the virus first surfaced, scientists believed it “was like the flu,” which relates to when the news first broke of the novel virus from Wuhan.

In general, Sergienko said masks are not effective with the flu and it is not transferable from people who are asymptomatic.

But, since that time, scientists and medical professionals have learned and now they say face coverings are important when it comes to reducing the spread of the virus.

“Now we know to wear masks,” said Sergienko. “My concern is for the most at-risk.”

That includes the elderly and those with preexisting conditions that could be augmented by the virus.

Sergienko said there came a “tipping point” when it was clear mask wearing was crucial. The governor issued the statewide order more than two weeks ago as cases began spiking in California.

“It makes sense for everyone to wear a cloth mask,” said Sergienko.

He believes the surgical masks, including the N-95 masks, should be saved for medical professionals.

Sergienko also stressed that having good hand hygiene and not touching your face has to be part of the process.

He said the “vast majority” of people should wear masks, and those who can’t should be wearing face shields.

Sergienko said the science is uncovering how much the virus can spread by droplet transmission and aerosol transmission and having masks can slow that spread.

Part of the mask debate also is about enforcement.

“There are things we can do,” said Sergienko, referring to the Mariposa County Department of Health and Human Services.

Sergienko is temporarily in charge of the entire department since the departure of Chevon Kothari, though the board of supervisors is conducting interviews to fill the position.

He said the governor’s order, which is also the order of the state health officer, is an “individual mandate.”

That means it is up to individuals to comply by the order.

“I don’t have any power over individuals,” said Sergienko.

However, he does have power over businesses, including restaurants and grocery stores.

“We could close down a business if it does not adhere to the guidelines,” said Sergienko.

That happened in Mono County, where a bar was closed because officials determined the business was not complying by the rules.

He also pointed out other state agencies have powers to close businesses which are not complying. That includes the Alcoholic Beverage Commission as well as CalOSHA.

“Let’s continue to do education,” said Sergienko of the current approach.

He feels more people are starting to comply with the order to wear masks and said local businesses “are getting there.”

Sergienko also said “it’s really the individual” who has to comply and urged everyone to follow the guidelines.

He also addressed the political aspect of the issue.

“It’s not politics, it’s science,” said Sergienko.

He did say there are “avenues of enforcement,” adding he has had ongoing “discussions with the sheriff.”

The Yosemite factor

As is always the case for Mariposa County, Yosemite National Park plays a big factor in everything that is considered, especially when it comes to dealing with a pandemic.

“The park has been really good to work with,” said Sergienko.

He cited the “cooperation” and “collaboration” officials have shown during the crisis.

“Their intent is to be as closely aligned with the state as possible,” said Sergienko.

Sergienko said park officials are also working closely with a working group involving the four counties that border the park and have also cooperated in making sure the 24-hour room hold is in place at park facilities.

That, he said, is crucial to “reduce the risk for hospitality workers to get infected.”

And that goes back to the testing of the wastewater facilities, which has indicated visitors to Yosemite have had Covid-19.

But, as Sergienko points out, there have been no cases of hospitality workers in the park being infected.

“It’s hard to measure prevention,” said Sergienko.

He did say there are “three cases we know about” which were related to visitors at the park and “possibly another 30.”

However, even with that, he said workers continue to be safe at the park and he added the numbers are “now dropping,” according to the latest sewage testing results.

Social distancing, he said, is being practiced in the park which means people can “still come and have a good time,” said Sergienko.

However, he also said the concept by some people to allow more access for the public to the park is something he thinks should not happen, at least yet.

“We are at the sweet spot with Yosemite,” said Sergienko. “If we lift any restrictions, we will see more disease.”

He called the current program of limiting visitors a “good level of visitation. They are able to provide a good visitor experience.”

About 2,000 people a day are being allowed into the vast park.

A day in the life

Sergienko has been at the forefront of the Covid-19 pandemic since its onset — and a typical day in his life is proof.

Sergienko said he is generally “up before 5” in the morning, when he “feeds the cat and runs the dogs.”

By 6 a.m., he’s looking at the latest reports. He generally arrives at the office between 7-7:30 a.m., and attends a daily briefing at 8. That’s followed by a meeting of the contact tracing team at 8:30. From there, the days vary, but you can count on many meetings.

“We actually do non-Covid business,” said Sergienko.

He also had high praise for Kristina Allen, who has been his right-hand person throughout the crisis.

“She is an awesome asset for this county,” said Sergienko.

The rest of the day is spent in various ways, he said, much of it dependent on what is happening concerning the virus. At 4 p.m., there’s an area coordination team meeting on certain days and between 5-6 p.m., there are calls to state officials.

“I don’t have any meetings on Friday evenings,” he beamed.

Sergienko said on the weekends, he spends three to five hours in the office each of the two days.

What about family time?

“We try to do dinners,” said Sergienko.

But Sergienko said he probably “won’t get a vacation for a year. There is too much going on.”

He did say because of relationships built over the past six months, area health officers are working on a “cross cover” program “so at least we can get a weekend off.”

Sergienko said he believes Mariposa County may be the most well positioned entity when it comes to battling a pandemic.

“We would probably not be here if it wasn’t for Detwiler and Ferguson,” said Sergienko, referring to two major fires in the county that brought together many agencies and forged relationships.

“Plus our community,” he stressed, citing how the public cooperates during emergencies.

What’s to come?

Sergienko said he is, indeed, concerned about the coming months when it comes to the pandemic.

He said modeling shows Mariposa County’s cases continuing to rise through October.

“I don’t think we can ignore these models,” said Sergienko. “We have to be concerned about Covid until we get a vaccine.”

He added: “Now, we seem to be doing okay. But we can’t say we are out of the woods.”

He is, however, optimistic that scientists might be able to develop a vaccine, possibly by December.

“I am optimistic,” said Sergienko.

He looked back to 1976 when then-President Gerald Ford fast-tracked a vaccine for the swine flu and there were some people who had bad side effects.

He’s hoping that’s not the case with Covid and is hopeful that “new technology” will help researchers avoid situations like that and develop a vaccine.

“I think it could be into people’s arms by December,” said Sergienko.

With his credentials, that’s certainly hopeful news for everyone.

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.