At a special agenda meeting to update the San Diego County Board of Supervisors on the numbers associated with the Hepatitis A outbreak impacting the region, the County Health and Human Services Agency provided "misleading and inaccurate" information to the Supervisors.

Three of the four supervisors present expressed concern about the accuracy of the 10-page PowerPoint presentation provided by the agency, which was designed to provide a progress report.

In particular, Supervisors Ron Roberts, Kristin Gaspar, and Dianne Jacob had a problem with the first line of the slide, "Confirmed Outbreak Cases":

That line indicates that the number of Hepatitis A cases in San Diego grew by 28 from the weeks 10/24/17 to 11/06/17. But after being quizzed by the Supervisors, it became clear that wasn't the case at all.

Dr. Wilma Wooten, the region's public health officer, admitted that the +28 cases are counted from last April, not the last two weeks and therefore didn't give an accurate measure of how the outreach and vaccination efforts have been going. As to those efforts, Dr. Wooten said, "The number of cases being reported daily is one to two versus the past months of three to four. That's good news and speaks to the success of the outreach efforts."

In frustration, Supervisors Roberts and Jacob asked that the numbers be changed to accurately convey the clearer picture. Denoting any progress being made. Supervisor Roberts said, "We're looking for trends here and the numbers are misleading. We want to make this as clear as possible for the community."

"Neither" Needs To Be Clarified As Well

The other troubling issue in the report, according to Supervisor Kristin Gaspar, was the "Neither" line in the slide.

That examines Hep A cases that are not connected to the Homeless or Drug Use populations, and, according to the slide, the "Neither" section noted a +16 increase, making it the third largest increase over the past two weeks.

Gaspar said that is worrisome and noted, "we need to break out the 'neither' population. If these numbers are accurate, we have more cases that are advancing that aren't related to the at-risk populations."

County health officials noted her concerns and said they will be providing additional slides to clarify the "neither" population section for the next meeting.

Again though, with the admitted discrepency in numbers, it's hard to gauge if these are real world numbers.

Vaccination and Outreach Efforts 

To the county's credit, it appears they have been working overtime to get control of the Hep A outbreak within their jurisdiction.

According to their most updated numbers, the county has:

• Installed 149 hand-washing stations, up from 142 in October;
• Provided 90,725 vaccinations, up from 83,963 in October;
• Passed out 8,172 hygiene kits; and
• Made 1,399 2-1-1 calls to educate the public.

Fiscal Impact

By an unanimous 4-0 vote, the County Board of Supervisors voted to spend approximately $1.9 million for their November outreach and vaccination efforts.

The costs will be covered by existing department appropriations, including the use of Management Reserves, funded with General Fund balance and General Purpose Revenue.

Another meeting between the County Health and Board of Supervisors is expected in the coming weeks.