Grand Jury makes recommendations after evaluating County epidemic preparedness

SANTA BARBARA COUNTY, Calif. – On Wednesday, the 2024-2025 Santa Barbara County Grand Jury issued a report of its findings and recommendations regarding the County's readiness for a future epidemic.

Wednesday's Grand Jury report noted the reactive nature of the County Public Health Department's preparations for a future epidemic and recommended that the County expand wastewater testing, use advanced technologies, and develop more effective cooperation with external health partners.

County-based public health departments have defined responsibilities under California Health and Safety Code Part 3, Chapter 2, Sections 10125 to 101165 which includes:

• Tracking the spread of diseases and identifying outbreaks through data collection and analysis
• Developing and maintaining public health emergency response plans
• Informing the public about disease mitigation and prevention methods and measures
• Coordinating responses with state, federal, and private healthcare providers
• Organizing vaccination campaigns and ensuring access to medical treatment during an epidemic

"Another epidemic in Santa Barbara County is not merely a possibility—it is an inevitability," noted the Grand Jury in Wednesday's report. "The emergence of new infectious agents that may cause devastating outbreaks is occurring at an alarming rate. The 2024-2025 Grand Jury has identified shortcomings in Santa Barbara County’s readiness for a new epidemic. Our County must adopt a proactive approach to preparedness."

Wastewater testing -or Wastewater-Based Epidemiology- is a crucial tool for monitoring diseases and traditionally, the County of Santa Barbara has tested wastewater for organisms such as E-coli which pose a threat at local waterways shared the Grand Jury report.

According to the Grand Jury report, there is one site where epidemic wastewater testing is ongoing thanks to a private grant in Lompoc and the Goleta Sanitary District has recently begun to perform testing in a partnership with the California Department of Public Health.

That data is shared with a statewide database that is then presented on a national dashboard that you can check out at data.wastewaterscan.org.

There was a non-profit funded testing site in the City of Santa Barbara, but it is no longer in operation and there is no current epidemic wastewater testing major population centers including Santa Maria stated the Grand Jury report.

Other California county-based public health departments have assumed the responsibility of wastewater testing for epidemic pathogens including Los Angeles, San Francisco, Sacramento, Santa Clara, Fresno, Riverside, Orange, Kern, and Alameda detailed the Grand Jury report.

Santa Barbara County Public Health Department does not operate or supervise any wastewater treatment facilities, does not routinely receive results of testing, and there is no defined process to review local or regional wastewater test results explained the Grand Jury report.

Currently, the Santa Barbara County Public Health Department relies on reporting from area hospitals and healthcare providers about certain diseases noted the Grand Jury report.

Local health providers can upload detections to a state program called the California Reportable Disease Information Exchange (CalREDIE).

However, there are some gaps in that system noted the Grand Jury report.

Witnesses told the Grand Jury that the program does not always provide sufficient information because hospitals may not report infection information to protect privacy or when symptoms are unusual or unexplained and fall outside of the diseases that might be recognized as reportable.

Additionally, there is no reporting for non-hospitalized patients, even if they have symptoms of an infection that might spread and the CalREDIE program does not systematically analyze data from national or international sources added the Grand Jury report.

There are software platforms that provide more robust risk assessment and early detection of epidemic threats that use sometimes use artificial intelligence to gather, analyze, and detect infectious risk signals from multiple sources -such as testing laboratories, pharmacy sales, and travel data- explained the Grand Jury report.

Examples of those software platforms available to county health departments noted by the Grand Jury report are:

• ESSENCE: The Electronic Surveillance System for the Early Notification of Community-based Epidemics developed by the U.S. Department of Defense
• BioSense Platform: A cloud-based early detection, integrated electronic health information system through the National Syndromic Surveillance Program within the Centers for Disease Control
• Epi Info: A Centers for Disease Control-sponsored public domain site
• HealthMap: A platform that gives real-time tracking of emerging global health threats
• ArcGIS: A geospatial platform that allows public health departments to map out epidemic risks
• BlueDot: An artificial intelligence model that collects data from around the world to track infectious diseases
• Metabiota: A software platform that uses artificial intelligence to project likely outbreaks
• Epidemic Intelligence from Open Sources (EIOS) Initiative: An open-source, web-based system for epidemic intelligence from the World Health Organization
• PHC Global: Software program developed for epidemic detection that is currently in beta testing

While not noted in the Grand Jury report, the Epi Info page states that the Centers for Disease Control will be phasing out support for Epi Info after Sep. 30, 2025, and the Trump Administration's decision to halt communication from the Centers for Disease Control to the public as well as information sharing with the World Health Organization will limit the accuracy and impact of some of the collaborative disease tracking programs above.

The third recommendation from Wednesday's Grand Jury report was improving communications amongst health providers and health agencies.

"Several California public health departments have established community task forces or advisory
groups for epidemic preparedness," explained the Grand Jury report. "These task forces typically include public health officials, healthcare providers, emergency responders, community leaders, representatives from jails and prisons, and sometimes representatives from local businesses and schools."

Some public health departments, including Los Angeles and San Francisco, have established pandemic planning groups that meet regularly and publish their conclusions and while the Santa Barbara County Public Health Department has held meetings with local healthcare providers, those meeting do not occur regularly, recommendations are not formally communicated, and crucial stakeholders -including Vandenberg Space Force Base, county jails, and the Lompoc Federal Correctional Complex were not represented noted the Grand Jury report.

The Grand Jury also noted that unlike other county-based public health agencies that regularly communicate with federal agencies about bioterrorism, there is no formal communication regarding those types of threats between federal agencies and the Santa Barbara County Public Health Department.

The Grand Jury report concludes that these proactive measures would alter the current reactive process used by the County Health Department and potentially improve public health responses to future epidemics.

The image below, from the Grand Jury report, shows a visual comparison of the current and recommended approaches to future epidemics.

Every county in California has a Grand Jury made up of citizens who investigate and report on the operations of local government agencies.

Under California state law, the Santa Barbara County Board of Supervisors has 90 days to respond to the findings and recommendations of the Grand Jury.

If you have something you would the Santa Barbara County Grand Jury to investigate, visit www.sbcgj.org and file a complaint online or you can mail you complaints to:

Santa Barbara County Grand Jury
1100 Anacapa Street, Santa Barbara, CA 93101