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The Kern County Board of Supervisors approved more than $2 million in spending for a field hospital at the Kern County Fairgrounds on Tuesday to treat overflow patients should local hospitals become overwhelmed by COVID-19.

But before doing so, they had several questions about the true extent of the coronavirus in Kern County, and whether such a facility would really be necessary.

"I'm not being rude. And I don’t mean to be mean and I don’t mean to be careless in my thought, but we have three deaths," said Supervisor Mick Gleason, questioning if it was premature to authorize funding for the hospital. 

A fourth person died of the coronavirus within hours of Gleason's comment, the Kern County Public Health Services Department announced, but his skepticism spoke to the confusion and mystery supervisors and many others have about the virus's impact on Kern County. 

A total of 680 COVID-19 cases were reported in the county as of Tuesday morning with 21 people currently hospitalized for the virus. Four deaths is a low number compared to other counties statewide with a similar amount of cases as Kern. There have been no nursing home outbreaks as there have been in other counties, even with fewer cases than Kern. And 15 trailers meant for homeless people impacted by the virus have yet to house a single person.

Adding to the confusion, Matt Constantine, director of public health services, told supervisors a state model inputted with local data showed Kern County's coronavirus peak wasn't expected to happen until October, at which point cases would likely exceed local hospital capacity. 

The $2 million in funding supervisors approved will cover roughly $650,000 in startup costs and two months of standby costs for the field hospital at the fairgrounds. An additional $1.7 million was approved to fund a full month of operations caring for 100 patients. Nearly all the costs should eventually be reimbursed by the state and federal governments. 

But supervisors were still cautious about expending taxpayer dollars, whether they were local, state or federal dollars. 

"What’s the likelihood we are going to need this based on our trend lines and what our hospital census is?" asked Supervisor Zack Scrivner.

Constantine said all 10 acute care hospitals in Kern currently have low occupancy, somewhere around 50 percent to 60 percent, since elective procedures have largely been canceled due to COVID-19. But by October, patient load could be three times the available hospital beds locally, and four times the available ICU beds, he said. 

That prediction is based on numbers generated by a state model that uses social distancing estimates and local hospitalization data. 

"We are tracking right now along 40 percent social distancing," Constantine said of the model, meaning local hospitalization rates most closely match with data generated when the model is run assuming that social distancing is being used in 4 out of every 10 interactions. 

However, if social distancing is increased to 50 percent, the model shows local cases should remain within a level that local hospitals can accommodate, Constantine said. 

Gleason, saying he didn't trust the numbers generated by the model, asked if the county could wait to authorize the spending until September to see how cases were trending at that time. 

Constantine agreed the model "isn't perfect" but said waiting until September would be too late. 

"This is an investment in the community and I think it’s a small investment to make because of the ... catastrophic events that could happen if we don’t," Constantine said. 

Gleason and board chairwoman Leticia Perez also questioned whether COVID-19 deaths in the county could be underreported. Gleason wanted to know if overall mortality rates in Kern were up compared to the previous year. Perez asked if it's possible some people could be dying from complications of COVID-19 without having been tested for the virus, and therefore not being counted in the virus's toll. 

"Something’s off about our numbers and I'm concerned," Perez said.

Constantine said he did not have figures on mortality rates readily available.