Category Archives: California Department of Public Health

California public health juggling the numbers, easing restrictions too soon, doing away with color-coded tiers

Solano County Public Health overly optimistic

[Editor: Note five highlighted references to Solano County.  – R.S.]

California plans to retire color-coded tiers, as more Bay Area counties poised to enter orange

San Francisco Chronicle, by Aidin Vaziri, April 2, 2021
Sam Benson (left) serves water as co-partner Tanner Walle greets guests March 12 at Valley Bar & Bottle, a new wine shop, bar and restaurant in Sonoma.
Sam Benson (left) serves water as co-partner Tanner Walle greets guests March 12 at Valley Bar & Bottle, a new wine shop, bar and restaurant in Sonoma. Yalonda M. James / The Chronicle

California is preparing to retire its color-coded tiered reopening plan as vaccination rates improve and coronavirus cases continue to drop, state officials said Friday, as several Bay Area counties prepared to move into a less restrictive tier next week.

Details about a so-called green tier — which would presumably allow almost all activities to resume in counties with very low threat from the virus — will be “coming soon” as part of the state’s transition toward shutting down the tiered system entirely, said Dee Dee Myers, the state’s top economic adviser.

“We said we would reopen the economy as soon as it was safe to do so,” Myers said during a Friday briefing during which she and the state health officer introduced guidance bringing back indoor events and large private gatherings.

The optimistic update from the state came as cases continue to climb in other parts of the United States and public health officials nationally and locally advised extreme caution in reopening the economy.

Cases are still declining in California, though they’ve flattened in some counties, and the state plans to open vaccine access to everyone 16 and older in less than two weeks as supply improves. Only three counties — none in the Bay Area — remain in the most restrictive purple tier of California’s pandemic reopening plan.

The four Bay Area counties in the red tier, the second most restrictive, could all move to orange next week. Only Sonoma County is currently meeting the state’s orange tier metrics, but the other three — Contra Costa, Napa and  Solano  — could move too, based on an expected readjustment to the metrics tied to vaccine equity.

The new metrics could also allow San Francisco to move to the least-restrictive yellow tier a bit faster, though the earliest it would be eligible is April 13.

Sonoma County, which had been stuck in the purple tier for more than six months before moving to red three weeks ago, is poised to move into orange on Tuesday unless its numbers suddenly tank — as happened with Napa County last week, when it just missed moving to the orange tier.

“It’s hard to predict for sure, but at the moment, it looks likely that we’re on track to enter orange tier sometime next week,” said Kim Holden, a spokesperson for the county’s Public Health Department.

The move would mean wineries could open indoor tasting rooms and bars, and music and sports venues could open outdoors with limits. Sonoma County would join San Francisco, Marin, San Mateo, Alameda and Santa Clara counties in the orange tier. The state announces new tier assignments every Tuesday, and the relaxed restrictions take effect on Wednesday.

The three other Bay Area counties that remain in the red tier don’t currently meet metrics to move to orange. But they will once the state readjusts those metrics.

California announced a plan in early March tying the number of vaccinations in low-income communities to an accelerated reopening system. The tier assignments already were loosened once, when the state reached 2 million vaccinations in those communities. They will be further loosened when the state hits 4 million vaccinations.

As of Friday the state was at 3.7 million vaccinations in low-income communities. “It’s very possible that sometime next week we will be crossing that (4 million) threshold,” said Dr. Tomás Aragón, the state health officer, on Friday.

Currently, counties need to report fewer than 3.9 cases per 100,000 residents, adjusted based on the amount of testing they do, to move to the orange tier. Contra Costa, Napa and  Solano  counties are all above that rate. But when the metrics are readjusted, the new maximum case rate for the orange tier will be 5.9 per 100,000. All three counties meet that metric.

“We are currently holding steady and well within the red tier at 5.5 cases per day per 100,000, and especially so when the state closes in on the 4 million doses,” said  Shai Davis, a spokesperson for Solano County’s health department . “We aim to see a downward trend in daily new cases and be able to progress to the orange tier when eligible.”

The tier adjustments also would lower the case rate for the yellow tier — from 1 case per 100,000 currently to under 2 cases per 100,000. San Francisco is meeting the second goal, but under state rules it must remain in the orange tier for at least one more week before moving to yellow.

Despite the encouraging signs, the  Solano County Department of Health and Social Services  on Thursday urged residents to continue to adhere to coronavirus mitigation measures through the upcoming religious and spring break holidays, noting an uptick of new cases.

“The rising number of COVID-19 cases is concerning, especially as we approach the holidays where the risk of spread can increase,” said  Dr. Bela Matyas, the county’s health officer , in a statement. “Being in the red tier does not mean we can let our guard down.”

Santa Clara County’s public health officials also cautioned vigilance as they are continuing to see increases in the number and proportion of confirmed cases of coronavirus variants.

“We’re already seeing surges in other parts of the country, likely driven by variants. Combined with the data we are seeing locally, these are important warning signs that we must continue to minimize the spread,” said Dr. Sara Cody, the Santa Clara County health officer.

As of last week, every variant of concern has been detected in Santa Clara County, including variants that are more infectious and may be partially resistant to vaccines. Officials said the county continues to face inadequate vaccine supply.

“If we can’t get more supply, and continued adherence to behavior like wearing masks, then we do anticipate another surge. I would hope it would be a swell, not a surge,” Cody said. She defined a swell as a less intense surge.

“We need people to hold on just a little bit longer,” she said. “Don’t indoor dine, don’t host an indoor gathering, don’t travel. Even if it’s allowed under the state rules, don’t do it. It’s not safe, not yet.”

Solano and other Bay Area Counties – detailed tracking of status on State COVID watchlist

[NOTE: Details on Solano County below.]

Coronavirus:  How close are Bay Area counties to coming off state monitoring list?

Santa Clara and San Mateo are nearing the threshold

Vallejo Times-Herald, by Evan Webeck and Harriet Rowan, 8/6/20

It’s been close to a month since Gov. Gavin Newsom announced additional restrictions for counties on the state’s COVID-19 monitoring list. In that time, the list has grown to encompass every county in the Bay Area and over 90% of the state’s population.

Is there anywhere in the Bay Area close to escaping the list? We’re tracking the metrics county-by-county below, using data compiled by this news organization. Currently, hospitalizations are trending in the right direction in most of the region, but there isn’t one county that meets the per-capita case threshold necessary to come off the list, according to our calculations.

San Mateo County, with a rate of 12.5 cases per 10,000 residents over the past two weeks, is closest to falling below the state threshold of 10, followed by Santa Clara County, with a per-capita rate of 13.9 per 10,000.

The California Department of Public Health uses six criterion to determine if there is elevated disease transmission, increasing hospitalizations or limited hospital capacity in a county.

  1. Testing rate: Below 1.5 per 1,000 population per day over past 7 days
  2. Case rate: Above 10 per 10,000 population over the past 14 days
  3. Positivity rate: 8% or higher over past 7 days if 14-day case rate is less than 10 but higher than 2.5 per 10,000
  4. Hospitalizations: Increase of 10% or more in 3-day average vs. previous 3 days
  5. ICU capacity: 20% or less beds available
  6. Ventilator capacity: 25% or less ventilators available

Falling out of line with any one of the six metrics for three days lands a county on the list. To come off, a county has to meet all six markers for three straight days.

Under the most recent health order, counties on the monitoring list for three days are also forced to close gyms, personal-care services, nonessential offices, places of worship and malls in addition to the statewide closures of bars, indoor dining and other indoor entertainment. To be eligible to open schools for in-person learning, a county must be off the list for 14 days.

Note: CDPH uses a 7-day lag when tracking its data, while this news organization compiles the most up-to-date data from county health departments. Recently discovered underreporting of tests and cases could skew the data. Because of the faulty data, CDPH has temporarily paused adding or subtracting counties from the monitoring list. There is no standardized number of ICUs and ventilators per county publicly available, so that data is not included below.

Alameda

population: 1.67 million

Cases per 10,000 (past 14 days): 15.7 (+6.6% since previous 14-day period)

Positivity rate (past 7 days): 3.7%

Hospitalizations (past 3 days, average): 194.3 (-2.5% since previous 3-day period)

Contra Costa

population: 1.15 million

Cases per 10,000 (past 14 days): 15.3 (-14.5% since previous 14-day period)

Positivity rate (past 7 days): 12.32%

Hospitalizations (past 3 days, average): 98.3 (-5.7% since previous 3-day period)

Marin

population: 263,000

Cases per 10,000 (past 14 days): 31.0 (-43.7% since previous 14-day period)

Positivity rate (past 7 days): 15.86%

Hospitalizations (past 3 days, average): 23.3 (-10.4% since previous 3-day period)

Napa

population: 140,000

Cases per 10,000 (past 14 days): 21.5 (+22.9% since previous 14-day period)

Positivity rate (past 7 days): 11.24%

Hospitalizations (past 3 days, average): 8.3 (-28.8% since previous 3-day period)

San Francisco

population: 884,000

Cases per 10,000 (past 14 days): 19.7 (+22.9% since previous 14-day period)

Positivity rate (past 7 days): 2.96%

Hospitalizations (past 3 days, average): 93 (-9.4% since previous 3-day period)

San Mateo

population: 775,000

Cases per 10,000 (past 14 days): 12.5 (-11% since previous 14-day period)

Positivity rate (past 7 days): 7.16%

Hospitalizations (past 3 days, average): 55.7 (-0.1% since previous 3-day period)

Santa Clara

population: 1.95 million

Cases per 10,000 (past 14 days): 13.9 (-4.9% since previous 14-day period)

Positivity rate (past 7 days): 7.48%

Hospitalizations (past 3 days, average): 175.7 (-5.7% since previous 3-day period)

Solano

population: 441,000

Cases per 10,000 (past 14 days): 19.3 (-21.5% since previous 14-day period)

Positivity rate (past 7 days): 15.33%

Hospitalizations (past 3 days, average): 45.3 (+7.1% since previous 3-day period)

Sonoma

population: 501,000

Cases per 10,000 (past 14 days): 19.8 (+27.3 since previous 14-day period)

Positivity rate (past 7 days): 12.42%

Hospitalizations (past 3 days, average): 41.7 (-5.2% since previous 3-day period)

Solano Nursing Homes do not appear in State’s “snapshot” of homes with COVID-19 – good news?

By Roger Straw, April 20, 2020
Gateway Care & Rehabilitation Center, Hayward CA | KTVU.com

In light of news reports of serious regional [SF Chron] and national [Washington Post] outbreaks of COVID-19 in long term care facilities, we have been listening intently for information about Solano County nursing homes and congregate retirement facilities, without much luck.

On Friday, April 17, the California Department of Public Health (CDPH) released a “snapshot” listing of all known skilled nursing facilities reporting COVID-19 among staff or residents.  The list did not include any facilities in Solano County.  No news is good news, presumably.

However, according to the CDPH, the data is incomplete.  “The data is comprised of a point in time snapshot of the 86% of SNFs [skilled nursing facilities] who reported their data within the last 24 hours.”

It is possible that Solano facilities are among the 14% of California facilities who did not report during that time frame.

There are 1224 skilled nursing facilities in California.  In Friday’s CDPH listing, 258 reported having one or more COVID-19 case.

In an April 17 newsletter, Solano County Public Health stated “Solano Public Health staff is checking in with long-term care facilities and skilled nursing homes to ensure that these agencies are prepared to handle outbreaks and that seniors continue to be protected.”  It is not clear whether County officials plan to share publicly what they find.

California Advocates for Nursing Home Reform (CANHR) does an excellent job of describing the missing elements in the State’s report:

California Identifies 261 Nursing Homes with Residents and Staff Who Have COVID-19
What Data’s Missing; What Action is Needed Now?

Excerpt:
“It is critical that California start treating outbreaks in long term care facilities with the same urgency it does for wildfires. The state should deploy multi-agency strike teams that have command of all available public and private resources to every facility with an outbreak and appoint commanders to lead efforts to save residents lives and to keep the public well informed about their actions and outcomes on a daily basis.

“Beyond containing tragedies, California officials must do much more to prevent them. […continued]

Medicare identifies 9 nursing homes in Solano County, 4 in Fairfield, 3 in Vallejo and 2 in Vacaville.  Other types of long-term health care facilities are listed on the CDPH’s Cal Health Find Database.

Perhaps the best listing of congregant retirement facilities in Solano County is a simple Google search for retirement communities in solano county.