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CORONAVIRUS CORONAVIRUS THE DOCTOR WHO 5,446

‘You’ve got your first positive’ positives, 118 deaths SHUT IT ALL DOWN in state Good news: Santa Clara County saw fewest new cases since March 20

By Emily DeRuy and Nico Savidge Staff writers California hit several grim milestones Saturday in the coro- navirus pandemic, surging past 5,000 positive cases and surpass- ing 100 deaths even as people re- mained sheltered at home in a desperate bid to stem the spread. Continuing a steady march up- ward over the weekend, the num- ber of positive COVID-19 cases in California reached 5,446 and deaths soared to 118 by the after- noon, according to data compiled by the Bay Area News Group. And, Gov. an- nounced during a visit to Sunny- vale earlier in the day, the number of people in intensive care beds across the state because of the vi- rus doubled overnight to 410 from 200 on Friday. Still, officials said they hoped the weekend’s rainy weather would prompt more people to re- main indoors and stick to Califor- nia’s shelter-in-place order, with being the best tool to fight COVID-19. Data compiled by this news organization showed there were 1,801 confirmed COVID-19 cases in the 10-county Bay Area as of Saturday afternoon, up from 1,648 on Friday, and 46 deaths, up from 36. Santa Clara County alone re- corded 17 new cases Saturday for DAI SUGANO — STAFF PHOTOGRAPHER a total of 591 and five new deaths Gearing up for the coronavirus response, Santa Clara County Public Health Officer Dr. Sara Cody called on a cadre of advisers for help. for a total of 25. But there was a spot of good news — the county, which has been the hardest hit locally, saw the fewest new cases With the first reported positive case in Santa Clara County, Sara Cody was since March 20. Still, epidemiologists and other quick to take steps to stem the outbreak while fearing she was too late medical experts have said they CALIFORNIA » PAGE 9 her cellphone rang. It was 6:49 a.m. By Julia Prodis Sulek “You’ve got your first positive,” the [email protected] voice said. INSIDE: Trump issues travel advi- She is the Bay Area’s , sory for New York, New Jersey. A4 Santa Clara County’s most “essential” A virus’ lethal journey Bay Area companies turn to tech- employee, the one who banished us Right then, Cody — Santa Clara nology to serve customers. A3 from Sharks hockey games, canceled County’s public health officer since her own daughter’s high school prom 2013 — was positive that even by Sili- — and eventually shut in 6 million con Valley standards, life as we know Bay Area residents in six neighbor- it here was about to change. Santa ALONE AND AFRAID ing counties to slow the stampede of Clara County had recorded the Bay a deadly pandemic. Area’s first case of the coronavirus — You could be forgiven if you’d never SANTA CLARA COUNTY PUBLIC HEALTH DEPARTMENT the seventh in the U.S. Later that day, Pandemic heard of Dr. Sara Cody before Jan. At the Santa Clara County Medical Health President would re- 31 — what seems like a century ago, Joint Operations Center, county officials led strict most travel from China, where when Kobe Bryant’s death was still by Santa Clara County Public Health Officer the stealth virus had begun its lethal exacerbates what shocked us. That’s the day Cody Dr. Sara Cody, standing, review incident and journey across the planet. was already feeling late, sitting at her section objectives for the day in response to But early that morning, Cody was dining room table in Old Palo Alto, the coronavirus. The county activated the preparing to tell the public that it had isolation gulping down a cup of coffee when operations center on Jan. 28, relatively early. CODY » PAGE 8 of seniors ‘We just want to do everything we can to slow the train down’ Advocates worry about food, health, loneliness

By Erica Hellerstein GILEAD’S GAMBIT [email protected] For the past few weeks, as the coronavirus radically al- tered daily life in the Bay Area, Who gets access to experimental drug? 79-year-old Diana Fernandes has been struggling quietly inside her Wide demand but limited are pinned on Gilead’s experimen- home, weathering a challenge tal antiviral agent called remdesi- from within. supply for promising yet vir. Demand was further fueled by Fernandes lives alone — her unapproved treatment President Donald Trump, who in husband died in 2017 — and has news conferences has promoted been left to manage a painful foot remdesivir and other unproven injury and the threat of the virus By Lisa M. Krieger drugs. [email protected] on her own. As an asthmatic, she An exponential increase in re- is in a higher risk category, so she No one yet knows if a Bay Area quests for the drug “has flooded has been avoiding contact with medicine can help save the lives an emergency treatment access people. She hasn’t seen another of coronavirus patients. system that was set up for very person since March 14. Yet demand is so high, and des- limited access to investigational She misses watering her plants peration so great, that Gilead Sci- medicines and never intended for outside and shopping at Trader ences is tapping into its old stock- use in response to a pandemic,” Joe’s for her favorite foods: apri- piles, scaling up manufacturing according to a statement last cots, figs, English muffins, moz- and announcing new rules for week from Gilead, a Foster City zarella and sun-dried tomatoes. who gets access to its promising pharmaceutical powerhouse. Now, she’s relying on regular de- but unapproved drug. Of all the drugs under inves- COURTESY OF LORI LEWIS liveries from Meals on Wheels for With little but supportive care tigation for COVID-19 treatment, Grant Reffell, seen with his daughters, is fighting for his life in an food. to help sick people, global hopes DRUG » PAGE 7 ICU and waiting for access to the experimental drug remdesivir. SENIORS » PAGE 9

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and deserves a great deal ily, as his daughter cried in Cody of credit for that,” he said. the hallway outside. “In retrospect, they could “We need to do some- FROM PAGE 1 have been more aggressive thing more,” Cody told the sooner. But if they are go- lawyers, “and we need to do already landed right here. ing to be criticized for that, it right away.” Ever since, she has been in all the other health de- a furious race against the partments would deserve ‘Embrace the risk’ virus, making critical deci- greater criticism.” Cody had just gotten off sions that would shut down Like Dr. Fauci, the infec- the phone with health of- festivals and family gath- tious disease scientist and ficers Tomas Aragon from erings, ban people from trusted voice on Trump’s San Francisco and Morrow school, work and church coronavirus task force, from San Mateo County. — all in a grave attempt to Cody — who spent her first They debated the race- save untold lives. 15 years at the county inves- against-time decision, the It was Cody who would tigating measles, meningi- consequences for faltering eventually lead her Bay tis and other communicable — the kinds of stuff of Hol- Area cohorts to pull the diseases — has risen from lywood scripts. trigger March 16 on the his- public obscurity to relative They compared the trend toric seven-county legal or- prominence in these past lines of COVID-19 cases in der — the first of its kind two months. the Bay Area with Italy’s a in the country — that re- And she has been both week and a half earlier, just quired residents to “shel- praised for her decisive before the situation there ter in place,” days ahead of leadership and criticized turned dire. If they didn’t Gov. Gavin Newsom’s simi- for doing too little or too ANDA CHU — STAFF ARCHIVES take bold action, the Bay lar mandate for the entire much. In webcasts of her Santa Clara County Public Health Officer .Dr Sara Cody speaks during a news conference Area could be next. state. news conferences, Facebook in San Jose on Feb. 28, after officials confirmed a third case of the coronavirus. “It was clear to me al- And it is Cody who is car- commenters have griped ready how quickly it was rying the burden of those about how long it took THE CRISIS IN RELATION TO SANTA CLARA COUNTY 591 cases 600 moving, and that’s what decisions and the uncer- her to “CLOSE SCHOOLS The timeline highlights the grave news developments here 19 20 gave me a sense of urgency,” tainty of whether they will NOW” and “the time to act and abroad as the number of coronavirus cases climbed 500 Cody said. “We just needed work. was last week!” in Santa Clara County — the Bay Area’s hardest hit county. to embrace the risk and do 400 “We just want to do ev- After one news confer- 18 it.” erything we can to slow the ence, she became the sub- 300 The three of them 17 train down,” Cody, 56, told ject of a viral meme when Confirmed cases 16 agreed: Ordering nearly 7 the Bay Area News Group she implored people to re- 15 200 million Bay Area residents in Santa Clara County 14 in a series of interviews last frain from touching their 12 13 to stay at home was the best 10 11 100 week, “so that when it hits faces, then licked her fin- 1 2 3 4 5 6 7 8 9 way to slow the disease. It the curve in the track it will ger to turn a page. 0 wouldn’t stop the spread, 21 31 5 17 21 23 2829 3 5 6 9 11 13 16 17 19 2426 28 not derail.” But Cody’s measured JANUARY FEBRUARY MARCH but it could buy time for public pleas have been 1 Jan. 21. First case in the U.S.: In Washington state, a man who returned from Wuhan, China hospitals to gear up for the ‘When do you need me?’ muted compared with the is diagnosed with COVID-19. onslaught and create hope In these unparalleled dramatic daily briefings of 2 Jan. 31. First case in the Bay Area: A man returning from Wuhan is diagnosed with the virus that the number of patients eight weeks, colleagues politicians like New York in Santa Clara County. On the same day Trump restricts travel from China, and suspends each day would be manage- from Cody’s inner circle Gov. and entry to the U.S. for any foreign nationals who traveled to China within the previous 14 days. able. say, she has seldom hes- the often combative up- 3 Feb 5. quarantined: The docks in Japan. At least 712 out of By noon, seven health of- itated. The morning she dates from the Trump the 3,711 passengers and crew were infected, and eight ultimately died. ficers from six counties and learned of the county’s first White House. 4 Feb. 17. China cases peak: Active cases hit a high of 72,000 in China — at this point it has the city of Berkeley — plus coronavirus case she was And she hasn’t scolded more than 95 percent of the world's known infections. Cases have been declining since then. the two county lawyers — already calling two of her us, like bearded San Ma- 5 Feb. 21. Grand Princess begins ill-fated voyage: The cruise ship sets sail from San were on the phone, wrap- most trusted advisers, now teo County Public Health Francisco to after returning from a trip through the Mexican Riviera. ping their heads around retired, from the health de- Officer Scott Morrow, who 6 Feb. 23. Italy locks down: Ten towns in Lombardy region close schools and sporting events. the monumental and sober- partment. blasted scofflaws who are ing step they were about to 7 Feb. 28. Virus spreads in Santa Clara County: Officials announce the county’s first case of She had worked with ignoring the stay-at-home “community transmission.” take. What businesses are them during the Sept. 11 order, declaring in a state- considered essential? Must 8 Feb. 29. U.S. records first death: A Seattle-area man becomes the first U.S. death, and a terrorist attacks and sub- ment that “you spit in our skilled nursing facility in Kirkland, Washington, experiences the nation’s first cluster of cases. it be ordered so soon? sequent anthrax scare: her face” and “you will contrib- Cody discussed the im- 9 Mar. 3. Santa Clara County issues new guidelines: Officials recommend older and sick predecessor Marty Fenster- ute to the death toll that people avoid mass gatherings. pact of school closures, that sheib and Karen Smith, will follow.” 10 poor students would miss Cody, with her neat bob Mar. 5. County steps up guidelines: The new recommendations suggest that employers who had recently retired as suspend travel, workers telecommute, and sick and elderly stay away from crowds, among free lunches, that critical the state’s public health of- haircut, tailored blazers other measures. Most schools remain open. health care workers might ficer and was on a girls’ ski and blue-framed glasses, have to stay home to care 11 Mar. 6. Grand Princess stricken: Nineteen crew members and two passengers test positive weekend at Donner Sum- is more reserved and prac- for coronavirus as the ship idles 20 miles from the San Francisco coast. for their children, that em- mit when she got Cody’s tical. ployees on the financial 12 Mar. 9. First local ban on gatherings: Santa Clara County records its first death and call. “I’m a pretty calm per- announces a legal order banning gatherings over 1,000 people, set to take effect on March 11. fringes would lose pay- “When do you need me?” son,” she said. “And never, The Grand Princess docks in Oakland after days of uncertainty at sea. checks. Smith asked. never has my temperament 13 Mar. 11. NBA halts season: It becomes the first sports league to suspend its season, while She stewed over the so- “Right now,” Cody said. been so useful.” the White House announces new restrictions on travelers from Europe. cial and spiritual impact of When Smith arrived at Not that she doesn’t get 14 Mar. 13. County announces all schools to close: With 79 cases confirmed in Santa Clara canceled graduations and the Public Health Depart- sentimental — “I’m a little County, the Public Health Department announces all schools will close starting March 16 as funerals and religious ser- ment on Lenzen Avenue bit of a crier at weddings well as a mandatory order banning public or private gatherings of more than 100 people. vices. in San Jose that late Janu- and funerals,” she said — 15 Mar. 16. Bay Area announces lockdown: Led by Santa Clara County, seven Bay Area health “People need to nourish ary afternoon, she greeted and she did briefly choke departments announce a historic stay-at-home order for more than 6 million residents. their soul,” she remembers Cody with a hug in the same up on March 13 when she 16 Mar. 17. Shelter in place begins: The Bay Area’s offices and streets clear out as residents thinking. conference room where she announced the legal order begin to adjust to what is still legal to do. ‘This is unprecedented’ and Fenstersheib had inter- banning gatherings of 100 17 Mar. 19. Statewide lockdown unveiled: Gov. Gavin Newsom announces a statewide viewed the Stanford and people or more. stay-home order for 40 million Californians, following the Bay Area model. But the expectation of Yale graduate 22 years ear- “I was thinking about 18 Mar. 24. New York governor pleads for ventilators: Gov. Andrew Cuomo announces a spike massive loss of life, espe- lier. the people who live in our in cases to nearly 26,000 and criticizes the Trump administration for offering 400 ventilators cially of the elderly and “We don’t hug anymore,” county,” Cody said, “the when the state needs 30,000. frail, was too great. Smith said. The virus is too people that run small busi- 19 Mar. 26. U.S. leads in coronavirus cases: The U.S. overtakes Italy and China in coronavirus By afternoon, they were contagious. ness, the people who are liv- cases, with more than 82,000 confirmed. unanimous. Williams and Back in the early 2000s, ing right on the edge, and 20 Mar. 28. California tops 5,000 cases: In one week, the Golden State quadruples its Hansen stayed up all night with the country on edge how what I was doing was confirmed cases, as the virus spreads and more tests become available. putting the 10-page legal after 9/11, Cody, Smith and going to profoundly impact Source: Santa Clara County and Mercury News reporting HARRIET ROWAN AND PAI — BAY AREA NEWS GROUP order together, making ex- Fenstersheib led the health them personally and profes- ceptions for hospitals, gro- department’s effort to build sionally.” cery stores, gas stations and Santa Clara County’s model She said she knows how information. flow charts that organized decisions can’t be over- other “essential” businesses. for a massive, coordinated lucky she is — she lives in Through the years, she planning, logistics and op- whelming,” Ho said. “She At lunchtime the next day, emergency response to a a house where her children has learned that public erations. tried to center on breath- all seven gathered in a bioterrorism attack or pan- have their own rooms in health officers never have The enormity of what ing. She mentioned child- county briefing room, tak- demic that included social case they get sick and the all the information they lay ahead was daunting. birth, taking that breath ing their places in two rows distancing, shutting schools family has a washer and need and are always oper- With each case, Cody’s and breathing through the on the dais, spreading out 6 and, the most extreme, dryer to keep them from ating with uncertainty. team began the meticu- moment.” feet apart. mandating that people taking trips to public laun- But the stakes are so lous process of interview- Cody was introduced stay home. It’s the one they dromats. much higher now. ing every infected person, The big decision first. Throughout the Bay would turn to this month to Like everyone else, how- The second confirmed tracing back every place One of Cody’s greatest Area, she said, 273 cases slow the untraceable path of ever, her family is endur- case of the coronavirus in they had been and every- advantages through this had been confirmed and the this new disease known as ing the same pressures of the county came 48 hours one they had contact with, crisis has been her long- number was accelerating. COVID-19. the stay-at-home restric- after the first; both were and monitoring them in standing and rare collab- “I recognize that this is “None of us really be- tions. Her husband, a Stan- travelers from China. But quarantine. The impera- oration with the county’s unprecedented,” she said. lieved we would do it,” ford professor, “is comply- the criteria for sending tive was to stop the chain legal staff. Over the years, “But we must come together Smith, 63, said in a recent ing with my order,” she swabs for testing to the of transmission. Cody, County Counsel to do this, and we know we interview. “I was slightly ter- said, working from home U.S. Centers for Disease But as the number of James Williams and chief need a regional response. rified to think we were put- and keeping an eye on their Control and Prevention in cases escalated, keeping up assistant counsel Greta … We must all do our part ting in place stay-at-home teenage son, who is tasked Atlanta was so stringent, became nearly impossible. Hansen worked together to slow the spread of CO- orders, tools that we think with folding laundry and and the bottleneck for On March 3, Cody started on landmark lawsuits tak- VID-19.” work but don’t really know.” walking the dog, Alfie. test results so long, that issuing guidelines every few ing on the lead paint and It was the kind of clear They postponed a the county was left ham- days, recommending every- opioid industries and, just a leadership her inner circle Real numbers a mystery planned mother-daugh- strung trying to figure out thing from telecommuting few months before the coro- had come to expect. It’s too early to know ter tour of colleges dur- how big of a problem it re- to cancellations of large navirus crisis, imposing se- “She approaches those whether the extreme mea- ing spring break. And their ally had. gatherings. vere restrictions on tobacco decisions in just the way sures will make a major daughter delivers groceries Not until nearly a month By March 9, the sick vaping. you would hope, which is difference. The number of to Cody’s mother, who lives later, on Feb. 28, two days woman in her 60s — the “You have to really know a profound commitment infected people and deaths in the same house where after the county was finally sentinel case — had died, your partners and you have to doing the right thing in Santa Clara County and Cody grew up five blocks given authorization to use and 43 cases had been to trust them and they have and the best thing, no mat- the rest of the Bay Area away. its own lab and judgment confirmed, the highest of to trust you,” Cody said. ter how challenging,” Han- continue to accelerate at Since that first confirmed for testing, was the third any county in California. “And it can’t move fast un- sen said. “And, you know, eye-popping rates, as they case in late January, the “positive” confirmed. Santa Clara County would less you have that high level we would do anything for are across the country, and personal toll is mounting. It would be a “sentinel now be branded across the of trust. And we have that Sara.” fears are real that hospi- “It’s almost impossi- case” — a turning point for country as a coronavirus in our county. And I never For Cody, despite all the tals won’t be able to keep ble to take a break,” Cody the virus’ spread across the “hot zone.” realized how exceptional frustrations and challenges up with a tsunami of pa- said. “First thing when Bay Area — a woman in On that day, Cody an- it was. But it turns out it’s she has faced over the past tients. you wake up in the morn- her 60s with other health nounced her first in a se- pretty exceptional. And two months, “my overrid- Already, the Santa Clara ing, your email is full, your conditions. Unlike the first ries of legal orders that that’s allowed us to be nim- ing emotion much of the Convention Center is be- texts start flying, your two, this was a clear case would force the Sharks ble and be honest and lead.” time has been gratitude,” ing outfitted as a make- phone starts ringing, then of “community transmis- to either cancel games or She would call on them she said. For her trusted ad- shift hospital ward, just it happens all day until you sion,” meaning the woman play to an empty arena, Sunday morning, March 15 visers. For the relationships in case. By Saturday after- go to sleep at night. Some- had become infected some- shut down the Cinequest — the day of her biggest de- she built over the years. noon, the Bay Area had sur- times I’m not sure what where in our community, film festival, close bars cision yet. By later this week, when passed 1,800 cases and re- day it is.” with no clear connection and clubs, and cancel Boy By then, 245 people the stay-at-home order has corded 46 deaths. But with to a traveler. Scout fishing expeditions, across the Bay Area had been in place for more than testing still woefully lim- The sentinel case “In very short order,” library story times and Pi- tested positive and three two weeks, she will have a ited, the real numbers re- Cody has spent most of Cody said, “it became ap- lates classes. had died from the virus. better idea if her extreme main a mystery. the past two months in parent we needed to start In the midst of the fre- Passengers from the Grand measures are working. One “I wish we knew,” Cody the county’s Emergency scaling up fast.” netic operations center, Ev- Princess cruise ship show- thing is certain, she said: said. “We can’t quantify it Operations Center lined Cody called old col- elyn Ho, who moved from ing symptoms were holed “This is going to go on for because we don’t have the with wall-mounted com- leagues at the CDC, where her job as the county’s com- up on the third floor of a quite some time.” surveillance tools to go out puter monitors tracking she had done a fellowship munity health planner to San Carlos hotel and at the Until then, she said, and widely test.” cases, desks for dozens of two decades earlier, and lead communications dur- Asilomar conference center there’s no time for second- Dr. John Swartzberg, a county employees pulled within 24 hours a team ing the crisis, pulled Cody in Pacific Grove. guessing. clinical professor emeritus from other departments, landed at the San Jose air- aside and asked how she And in Gilroy, 66-year- “We do not have time of infectious diseases at UC and bottles of hand sani- port to embed with her at was holding up. old Gary Young was on a for that,” she said. “We are Berkeley, gave Cody and her tizer and wipes scattered the command center. “She talked about hav- ventilator, in quarantine at where we are. What can we team high marks for their everywhere. Here, Cody has By then, Smith, the re- ing very clear reminders St. Louise Hospital, one of do now? That’s the focus.” efforts. been grappling with ques- tired state health officer for herself of how to stay the growing number of vic- “Santa Clara was out tions, doubts and a frus- who cut short her ski trip, centered in the moment, tims. He would die the next Contact Julia Prodis Sulek in front of this pandemic trating lack of testing and had created massive work- that the enormity of the day, isolated from his fam- at 408-278-3409.