CDC recommends entire Bay Area issue indoor mask mandate
SFGate, by Eric Ting, July 27, 2021
The CDC’s map of California counties by COVID-19 transmission rates. Masks are recommended in red and orange counties. (Center for Disease Control and Prevention) – Click here (or on the image) to go to interactive CDC map.
The Centers for Disease Control and Prevention (CDC) revised its masking guidance Tuesday to advise that all individuals — including vaccinated ones — wear masks indoors in areas with “high” and “substantial” COVID-19 transmission.
According to the CDC’s map, four Bay Area counties — San Francisco, Alameda, Contra Costa and Solano — are classified as areas of “high” transmission and the other five — Santa Clara, San Mateo, Marin, Sonoma, Napa — are classified as areas of “substantial” transmission. Masking is currently recommended but not required in every Bay Area county except Solano.
Given how Bay Area counties have previously handled the pandemic, it seems highly likely the region will turn their recommendations into mandates following the updated CDC guidance. A mask mandate is currently in effect in Los Angeles County.
Across California, most counties fall into the “high” or “substantial” categories.
California Gov. Gavin Newsom said Tuesday the state would issue updated statewide guidance sometime after the CDC guidance was released.
The CDC said the change in guidance is based on new evidence showing that while fully vaccinated individuals are protected against severe disease from the delta variant, they can transmit it to unvaccinated individuals more easily than other strains of the virus.
CDC Director Dr. Rochelle Walensky said that when earlier strains of the virus were dominant, infected vaccinated people were found to have low levels of virus in their nose and throats and were deemed unlikely to spread the virus. That has changed with the delta variant, where Walensky said the level of virus in infected vaccinated people is “indistinguishable” from the level of virus in infected unvaccinated people.
If the Golden State was still using its four-color reopening blueprint for ranking counties by infection rates, at least a dozen, including Los Angeles, Alameda, Contra Costa and Solano now would be in the most-restrictive purple tier, and many businesses would not be fully open.
And that’s using new metrics introduced in March that made it easier for counties with higher case rates to move into lower-restriction tiers once the state reached what it considered equitable vaccination rates. Using the state’s original tier definitions, 29 counties, including San Francisco, now would be purple, which meant that the virus was widespread, a Bay Area News Group analysis found.
The dire picture comes a little over a month since California authorities on June 15 dropped the reopening blueprint and its color-coded restrictions on gatherings and business activities and eased requirements for face masks in public to slow the virus’ spread. Since then, sports venues, bars and amusement parks have fully reopened, and people throughout the state gathered for July Fourth barbecues and parties.
“We’ve all forgotten about the tier system because we wanted to,” said Dr. John Swartzberg, clinical professor emeritus of infectious diseases and vaccinology at UC Berkeley’s school of public health. “We’re not in a very good place compared to where we were a month ago.”
California was one of the slowest states to reopen its economy during the pandemic and has one of the highest vaccination rates, especially among large states, with almost 52% of its population fully inoculated against the virus compared with 56% in New York, nearly 48% in Florida and 43% in Texas.
But like much of the United States, California is seeing rapid spread of COVID-19 driven by the highly infectious Delta variant, nearly all of it among those who haven’t been vaccinated.
On Monday, Napa, Santa Cruz, San Benito and Monterey counties became the latest to urge people who are both vaccinated and unvaccinated to wear masks while indoors in public places to slow the virus’ spread, joining most other Bay Area counties as well as Sacramento, Fresno and Yolo. Los Angeles made that an order Saturday.
According to the California Department of Public Health, the virus is spreading statewide at a 7-day average daily rate of 6.3 cases per 100,000 people among the unvaccinated, but at a rate of 1.1 per 100,000 people among the vaccinated. The department did not have those figures by county.
“Vaccines remain the best protection against COVID-19, including the highly infectious Delta variant,” the CDPH said in a statement Friday. “As we continue to see the real and aggressive impact of the Delta variant in rising case rates, we cannot stress enough how critical it is for eligible individuals to get vaccinated.”
California introduced its color-coded reopening blueprint last August amid a summer surge in cases after the state eased its March 2020 stay-home order to curb the coronavirus.
Under the original blueprint, counties in which the 7-day average of daily COVID-19 cases was 7 per 100,000 people or more were assigned the most restrictive purple tier.
At those rates, middle and high schools, and at some levels even elementary schools, couldn’t begin opening campuses to students. Bars were closed, and restaurants, theaters and gyms could only operate outdoors, where the virus doesn’t easily spread.
The blueprint allowed for progressively more gatherings and activities once counties’ case rates fell, putting them into the “substantial” red, “moderate” orange and “minimal” yellow tiers.
At the January peak of California’s deadly winter COVID-19 case spike, all but four rural counties were in the purple tier.
In March, as vaccines became more widely available and more people were getting the shots, state officials revised the tier metrics to account for the protection offered by immunization, making it easier for counties with high vaccination rates to move out of the restrictive tiers and reopen more businesses. Under the revised rules, the purple tier applied to counties with 7-day average daily case rates of 10 per 100,000 people or more.
On June 15, when the state ended its tier system, no California counties remained in the purple tier, and just one was in the red, while 29 were in the yellow tier.
The breathtaking pace of the virus’ resurgence already has led many local health authorities to at least recommend measures such as wearing masks indoors in public for all, vaccinated or not. But state officials for now have not changed their guidance, including allowing the vaccinated to go without masks inside.
Swartzberg noted that given how low infections had fallen since the spring, the sharp rise in new case rates still involves relatively small numbers. Statewide, the 7-day average daily case rate as of Sunday was 7 per 100,000 people, up significantly from 2 per 100,000 in early June but far lower than the 109.3 per 100,000 Jan. 9. And hospitalizations and deaths, which tend to lag new cases by a few weeks, remain on a downward slope. The 7-day average daily death rate as of Sunday was 0.01 per 100,000, down from 1.7 per 100,000 Jan. 9.
But given the Delta variant’s high transmissibility and rapid spread, even in the highly vaccinated Bay Area where many people continue wearing masks, new restrictions may be in order.
“The Delta variant’s transmissibility is so much greater than anything we’ve encountered,” Swartzberg said. “I think the Bay Area was wise in recommending masks indoors for everyone. If things continue on the trajectory we’re seeing, the Bay Area will probably have to mandate it and hope it’s sufficient to flatten the curve.”
A $900 million plan outlines how Hayward is preparing its sewage plants, natural gas power plant and 1,899 acres of marshes and tidelands for a rising San Francisco Bay.
By 2100, we may need to let rising waters cover portions of today’s shoreline, once and for all.
“You’ve got to be forward-thinking,” said Al Mendall, who served on the Hayward City Council from 2012 until December. “As a layperson, it seems obvious to me that we’re going to have to consider some form of retreat at some point. Not just in Hayward, but all around the Bay.”
Before San Francisco Bay’s shoreline was recognized as an irreplaceable resource, it was where cities put garbage dumps, highways and industrial zones. Out of sight, out of mind.
That’s why the west edge of Hayward north of Highway 92 includes two sewage plants and the natural gas power plant that opened in 2013. The white toll booths of the San Mateo-Hayward Bridge shimmer in the haze of automobile exhaust. Two stumpy hillocks conceal long-closed dumps.
But there also are 1,800 acres of protected marshes and tidelands, along with the Hayward Shoreline Interpretive Center built in 1986. Even as new warehouses and research parks are built next to such preserves, populations of species like the snowy plover and salt water harvest mouse continue to increase.
Three pelicans rest in a channel near the Hayward Shoreline Interpretive Center last month. Carlos Avila Gonzalez / The Chronicle
It’s a juxtaposition that feels oddly timeless, but the placid scene can be deceptive. Already, several times each year, the combination of high tides and strong winds send sheets of water fanning across the trail from the interpretive center. Factor in the likelihood of significant sea level rise and the rare could become commonplace.
Sea level rise is fueled by higher global temperatures that trigger two forces: Warmer water expands oceans while the increased temperatures hasten the melting of glaciers on Antarctica and Greenland and add yet more water to the oceans.
Variations of this forecast — inconvenience followed by upheaval — are found all along the edges of San Francisco Bay. The difference is that Hayward worked out a detailed plan for what might lie ahead.
In February, Hayward’s City Council approved a set of strategies on how to adapt the shoreline zone to what climate change might bring between now and 2070. In some areas, the city would restore marshes or relocate trails. In others, new levees would shield industrial functions that cannot be moved, like the wastewater treatment facility.
John Blanchard/The Chronicle | GIS data from ART Bay Shoreline Flood Explorer, Hayward Area Shoreline Planning Agency, Scape and Hayward Regional Shoreline Adaptation Master Plan
The effort was led by Scape, a New York landscape architecture firm that has been active in sea-level-rise planning since Hurricane Sandy laid waste to coastal New York and New Jersey in 2012.
Unlike some bay settings — such as San Francisco’s heavily developed Mission Creek or Foster City, where a levee already protects homes — Hayward’s shoreline area offers room to maneuver. The area studied by Scape extends 3¼ miles from Highway 92 past the city’s northern border, while extending inland as much as 2 miles, past the power plant and research buildings to modest older homes.
San Francisco rises in the distance as cyclists ride through the Hayward Regional Shoreline last month. Carlos Avila Gonzalez / The Chronicle
Scape’s team of designers and engineers was selected in 2018 by the Hayward Area Shoreline Planning Agency, which includes representatives from the city, the East Bay Regional Park District and the Hayward Area Recreation and Park District.
The scale of the area captured the firm’s notice. So did the scale of Hayward’s ambitions.
“Plenty of cities and agencies are beginning to study risks. Hayward is one of the few places taking the next step and trying to offer solutions,” said Gena Wirth, who led the Scape team.
The 244-page plan lays out steps that can be taken in coming decades to stay ahead of the changes that would accompany daily tides 4 feet above current levels. Another 3.3 feet were added to account for the waves that could be triggered by a once-in-a-century storm.
“You want to look for how you can restore natural systems in a way that magnifies the overall benefits,” Werth said. “It’s all about establishing a vision and then breaking it down into bite-size components.”
None of this is easy — or cheap.
The combined price tag for everything in the plan tops $900 million, and there is no funding yet. But the recommendations are split into 26 projects of varying size — the idea being that pilot programs and smaller initiatives can kick off within the next few years, building momentum for larger projects in later decades.
“We have a lot of work ahead of us, definitely,” said Erik Pearson, the environmental services manager for Hayward’s Public Works department. “This is something we can use as a guide.”
The approach is applauded by scientists and officials wrestling with the challenge of a future in which the old danger — developers wanting to fill in the bay — is replaced by the need to keep the bay from reclaiming the low-lying lands at its edge.
“The level of sophistication and thoughtfulness is rare,” said Jessica Fain, the head planner of the Bay Conservation and Development Commission, a state agency created in 1967 to watch over the health of the bay. “There’s a range of solutions spelled out, and also a real dedication to pursuing them.”
This includes what potentially is the most controversial solution of all.
After it describes various natural methods to enhance and protect the shoreline, the plan devotes two pages to “managed retreat.” Or as Scape puts it, “a management strategy for retreating from vulnerable coastal areas” and “adapting to sea level rise over time.”
In one design scenario, Scape went so far as to study moving the Interpretive Center from the south end of the area, near Highway 92, to the top of one the hillocks that hide a former dump. Besides protecting the center from flooding, this option “maintains visibility of the structure and offers expansive views of the Bay.”
Al Mendall, who served on Hayward’s City Council from 2012 until last year, has been an advocate for Hayward’s planning efforts along its shoreline. Carlos Avila Gonzalez / The Chronicle
The final plan doesn’t include this move. But it emphasizes that if sea level rise matches current projections, the relocation of buildings and services “would likely be needed … long-term.”
That topic rarely is discussed, except in coastal areas that routinely flood or suffer dangerous levels of erosion. But Hayward officials inserted it deliberately.
“It’s important to mention that the concept exists” within the larger discussion, Pearson said. “At 4 feet, it doesn’t make sense to look at retreat. But at some point after that, it may be the best approach.”
Experts familiar with bay’s potential reach welcome the willingness of Hayward and the design team to acknowledge this.
“We need to stop thinking, ‘This is going to be here forever,’” said Letitia Grenier. She leads the resilient landscapes program at the San Francisco Estuary Institute, which advised Scape on the Hayward shoreline’s environment. “That’s not the way the world works. We need to learn to live with that.”
Will Travis, who was the executive director of the bay commission when it released its first sea level projections in 2007, has a similar view.
“The hard decisions will be what not to protect,” he said. “How you prioritize where to put your (limited) resources.”
The plan went to Hayward’s City Council on Feb. 16. It passed on a 5-0 vote.
Mendall, the former council member, was excited to see the council act in unison — and with no public opposition.
“We wanted something doable, not pie-in-the-sky,” he said. “It’s a tool for the next generation to preserve and protect the shoreline.”
An aerial view of the Hayward Regional Shoreline. In addition to restored marshes, it includes wastewater storage ponds and a field of solar panels. Carlos Avila Gonzalez / The Chronicle
CREDITS
REPORTING – John King
EDITING – Mark Lundgren
VISUALS – John Blanchard, Carlos Avila Gonzalez, Guy Wathen, Alex K. Fong, Drawings animated in Mental Canvas
COVID cases up more than 20% in Bay Area, California since June 15 reopening
San Francisco Chronicle, by Catherine Ho, July 1, 2021
A worker walks along Stockton Street in San Francisco on June 15, the day California lifted most of its pandemic restrictions. Stephen Lam/The Chronicle
New coronavirus cases have jumped more than 20% in California and the Bay Area since the state’s June 15 reopening — a sign that even as residents embrace a return to normalcy, the virus can still spread among unvaccinated people and will likely linger for months to come.
Statewide, new cases crept up from about 900 on June 15 to nearly 1,100 on June 30, according to seven-day averages of new daily infections. In the Bay Area, cases ticked up from 187 to 225 during the same period, according to Chronicle data.
State and local health officials had predicted a rise in new cases after June 15, when California lifted nearly all pandemic restrictions on public life. Case rates are still considered low, at fewer than 3 new infections per 100,000 people statewide and in the Bay Area. In January, during the worst of the winter surge, there were nearly 100 new cases a day per 100,000 people statewide.
In the Bay Area, the biggest jump in new cases is in Alameda County, which has seen a 55% increase since June 15. New cases are up 22% in San Francisco, 27% in Contra Costa County and 35% in Marin County, according to Chronicle data.
In some counties, though, the number of new cases is relatively small. San Francisco went from averaging 11 cases a day to 13. Marin went from four cases a day to five.
COVID-19 hospitalizations are also increasing statewide and in the Bay Area, but at a slower rate than new cases. The number grew 11% statewide and 9% in the Bay Area from June 15 to 30, according to state data.
Deaths are largely flat statewide and dropping in the Bay Area. There is usually a lag time of several weeks between new cases and hospitalizations and deaths.
The rise in new cases can be attributed to three factors: the reopening, the fact that nearly a third of people eligible to be vaccinated have not received a shot and the spread of the more contagious delta variant, said local health officials and infectious disease experts.
Most of the new cases are among people who have not been vaccinated, including young adults and teenagers, and in areas that have lower vaccination rates, health officials said.
“It’s a good argument that the vaccine is helping to protect residents,” said Dr. Nicholas Moss, health officer for Alameda County. “And people who have not had the opportunity to get vaccinated yet, we strongly encourage to do that.”
In neighboring Contra Costa County, the city of Antioch — which has significantly lower vaccination rates than the county overall — accounted for 25% of new cases over the past two weeks, even though it has just 10% of Contra Costa’s population, said county Health Officer Dr. Chris Farnitano.
unvaccinated people in Contra Costa are 16 times more likely to get COVID than vaccinated people, according to county data. The COVID vaccines also do a better job of preventing serious symptoms in the handful of vaccinated people who do test positive.
“With the lifting of the business restrictions, more people getting out and doing things, a lot of people not wearing masks, it’s kind of a recipe for increased infections in people who are unvaccinated,” Farnitano said.
unvaccinated people mingling indoors is especially concerning, now that most venues go by the honor system when it comes to masking, said Dr. George Lemp, a former University of California epidemiologist.
“The problem is because they’ve changed the mask mandate, particularly indoors, there’s no way for proprietors of stores or any other facilities to know whether a person who’s maskless indoors is vaccinated or not,” Lemp said. “The large crowds of people who are unvaccinated who gather together indoors in places like Disneyland and other venues around the state are going to spread coronavirus to each other.”
The Bay Area as a whole has one of the highest vaccination rates in the country, led by San Mateo and and Marin counties, where more than 80% of eligible residents are fully vaccinated. More than 70% of residents are fully vaccinated in Santa Clara, San Francisco and Contra Costa counties. But even in those highly vaccinated counties, there are pockets where vaccination rates are less than 50%.
The spread of the delta variant prompted Los Angeles County health officials to urge even vaccinated people to resume wearing masks in indoor public spaces — one of the pandemic restrictions that the state lifted June 15. Local counties have not issued similar advice, but health officials say the growing number of delta infections could mean that the Bay Area’s already impressive vaccination numbers may have to get even better to check the disease’s spread.
“Delta might be transmissible enough, infectious enough, that you just need to push your vaccination rates a little higher,” said Moss of Alameda County. “A more transmissible virus is more likely to get to those susceptible (unvaccinated) people. And even just a small increase in the ability of the virus to pass from one person to another, when you multiply that over millions of people, you can start to see these changes in the pandemic.”
Catherine Ho is a San Francisco Chronicle staff writer.
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