|Dr. Warne provided updates on the state of coronavirus in Contra Costa, noting improving trends over the last over the last month or two that have allowed the county to progress, along with other counties in the Bay Area, along the State's blueprint for safer economy. We have progressed so far from the purple to red tier.
The state uses two primary data points for determining where a county falls within the four-tier blueprint system in terms of reopening. One of the lead indicators is the case rate, which is measured in the number of cases per 100,000 people per day, averaged over a recent seven-day period. Contra Costa is solidly in the red tier and looking towards progressing into the orange tier. To do so, the metric that we need to need to meet is 4 cases per 100,000 in population. Our county gets extra credit because we do more testing than required by the State, so we a practically meeting this target now but we would need to do so consistently for two weeks to move to the orange tier. Contrast this to our peak of 19 in July and 9 in early September, so we’ve come down nearly 80%.
These gradual improvements are a testament to the strong efforts that everyone has made around social distancing and face coverings, following the restrictions. Also, it's a strong testament to our successes in rolling out more testing because the other key metric the state looks at as test positivity. The overall positivity rate in Contra Costa County is currently at 2.4%. Our target for moving into Tier three (orange) is <5, so we’re doing very well on that metric. We’ve come down substantially from our 10-15% positivity rate back in July.
In terms of testing, we’re not quite meeting our goal of 4,500 tests per day but at 3200 tests per day, we're well beyond the state’s minimum and higher than the state average. We have the capacity to test more people; our testing sites are open and have spaces available for quick appointments, so want we want to drive that number up even more because that's one of our key strategies for bringing down the virus.
We've also seen a flattening in daily hospitalizations, the 7-day average of which has been hovering around 35. The absolute number today is 17. Contrast that to six weeks ago when we were at 100.
We're also we're monitoring the cases in 22 long-term care facilities. Currently that is substantially down from our high of 49 back in August, so we're fewer cases in the facilities.
A caution, however, that as we open more, there is greater chance of a resurgence, so we need to maintain vigilance with social distancing, masking, hand hygiene, staying home if feeling sick, and getting tested.
The State has added a new metric called the Equity metric, addressing virus hot spots or disproportionately affected census tracts where case rates can be as much as 10 times greater than other areas. For the county to progress to a less restrictive tier, we need to demonstrate similar measures of success in hot spot communities as we do in the county as a whole. The state has given us a benchmark to ensure that we are promoting the same prevention and control measures every place. We’ve made progress this regard. Dr. Warne then listed the communities most impacted.
Dr. Warne described what has been able to be opened in the red tier. Elementary and secondary schools are allowed to reopen without a waiver but with plans developed by each public school district. Most are not expected to open in the immediate term. CC Health will continue to partner and provide support to the school districts.
He announced that we now have five weekend testing locations across the county. Drive through testing is available at West County, Martinez, and Pittsburg Health Centers by appointment. See the County website for more information. Weekend-only testing at Bay Point, appointments are optional. Testing is also available in North Concord, which also offers flu shots, by appointment and on weekends. Tests are free. No insurance is required.
Dr. Warne also cautioned about risk factors for virus resurgence: seasonal flu, winter weather, holiday gatherings. Seasonal flu can also be dangerous to vulnerable people. The best strategy against seasonal flu is flu shots. Free one-day flu vaccine clinics will be offered throughout the county. See the County website for more information.
Dr. Warne announced a heat advisory and public safety power shut-offs and reminded people to take precautions such as back-up batteries if they rely on electricity for health devices such as c-pap machines.
Dr. Warne address some of the questions that had been received prior to the meeting:
He apologized for the difficulty in navigating the testing phone tree; these problems have been corrected. He appreciated the feedback which assists CC Health to improve services.
He said that testing sewage is an excellent and novel idea for limited catchments, such as for a college dormitory or military base. Contra Costa is partnering with the City of Berkeley on a wastewater surveillance project with the Contra Costa Sanitation District.
On reconciling the latest CDPH guidance on public gatherings with County guidance, he said for any given question, whichever guidance is more restrictive applies. Make a plan for social gatherings with a stable group of no more than 12, who agree to limit their interpersonal contacts with others for at least three weeks. Gatherings are recommended outdoors. For example, the state guidance for social gatherings prohibits gatherings of people from more than three households, which is more restrictive than the county’s guidance.
Where the State has published conflicting guidance, Dr. Warne recommends that the most recent guidance should apply.
Regarding a homeowners’ association common house, social gatherings cannot be held in the common room but can be held outdoors. Outside conditions have no bearing on this guidance. Air purifiers likewise do not change the health guidance.
Chair Andersen invited Lynn Mackey to provide an update on how schools are approaching reopening. Yesterday was the two-week marker where schools can consider reopening. People’s feelings are split evenly on the wisdom of reopening. She has been meeting regularly with the school boards and health department. As of today, 27 private/charter schools opened under the waiver system to good effect. Schools can only open if they are able to follow the state guidance. This is much more difficult than may appear. There are many guidance documents, regulatory agencies, and health recommendations to follow. To open, they must be able to follow social distancing in the classrooms. Schools are crowded with high student:teacher ratios. There are requirements to stagger lunch hours and recesses. Some of these requirements will be impossible to meet until more students can congregate. Most schools are discussing hybrid models, staggering instruction so that students receive the same number of minutes of instruction on every day. They are examining other jurisdictions that have already opened. There are many different hybrid models. She encouraged listeners to consult the website for their school board. All the school districts are still negotiating with their teachers’ unions around safety protocols.
The County office has worked with social service agencies to provide subsidies to at-risk student situations to provide safe access to learning. Most school boards have decided not to bring students back before January, which is the normal semester break. Some have decided not to bring students back until the County is in the yellow tier.
- Mike McDermott asked if the County will harmonize its guidance on church services with the state orange tier guidance, which allows up to 200 people or 50% of capacity, whichever is lower. He also asked for clarification about church offices and meeting rooms. Dr. Warne replied that the County’s health order is aligned with the State blueprint. However, the county reserves the right to be more restrictive if circumstances warrant it. Church offices fall under general office guidance. Under the red tier, they must operate remotely. Under the orange tier, they can operate indoors with modifications and encourage telework. Meetings should not be done in person when they can be done remotely.
- Richard Giessner, a Rossmoor resident, asked about the use of atrium pools that are classified as indoor pools. He said the pools are important for therapeutic purposes related to daily activities. They are hoping to have these pools reclassified as outdoor pools to increase capacity for therapeutic use and exercise. Dr. Warne said the Rossmoor indoor pools have been thoroughly evaluate by CCHealth and the retractable walls are not enough to turn them into an outdoor space. Chair Andersen asked if there is a provision for pools used solely for therapeutic services. Dr. Warne could not provide a definitive answer at this time but would take this question back to the County’s health team. He noted that indoor gyms can open at only 10% capacity and require masking, which cannot be done in a pool, so those are considerations. The good news, however, is that indoor pools can open when the County moves to the orange tier.
- Yehudit Lieberman said she sees people eating together in restaurants and so doesn’t understand why people from two households cannot use the same meeting room if wearing masks. Dr. Warne explained that the requirements for indoor eating are State requirements and permit people from the same household to sit together for a meal indoors. Gatherings across households fall under social gatherings, which are only permitted outdoors.
- Barbara Csider described trying to get urgent medical care and ultimately needing emergency surgery and having to endure this alone because no personal support was allowed. Dr. Warne explained that each health system determines how it will operate to minimize risks, which is moving in the direction of a combination of in-person and telecare visits. CC Health doesn’t prescribe how each system will operate. The State has been revisiting its visitor policies, which will continue to develop in the ensuing weeks as, hopefully, the numbers go down.
- Jared Thomsen, church pastor, asked for clarification on when a mask is and isn’t required when outdoors. Dr. Warne clarified that if you are outdoors among your own household and you are socially distancing from others, then you do not need to wear a mask. However, for outdoor church and social gatherings across households, even with social distancing, masks are required.
- Stella Wotherspoon asked at what tier would state guidance for schools no longer apply. If the County were to regress back to purple tier, what operations guidance would be provided to schools by the county? Dr. Warne responded that the State guidance applies at all tiers. The least restrictive tier doesn’t get us back to normalcy. If we move back to the purple tier, there are not additional State restrictions applicable to schools; however, school districts might choose to apply additional restrictions.
- David Shi Chun Wu asked if Dr. Warne’s responses would be different if the county moves to the orange tier. Dr. Warne explained that social gatherings guidance will likely not change when we move to the orange tier, but the State guidance is evolving so things may change.
- A caller asked how many tracers we have per 100,000 residents, if the BAAQMB will be asked to step up pollution controls such as web scrubbers. He said there were studies that correlated COVID rates with pollution. Vice Chair Mitchoff address wet scrubbers, saying there is an established process for approving them. She invited the caller to Zoom into the Air Board meetings.
- Attie Maddox, a Rossmoor resident, said the pool is in the same complex as the gym, which is fully enclosed. Whereas the pool is in an atrium. She feels it would be safe to open the pool.
- Juliet Don said the San Mateo County resumed allowing having customers serve their own beverages if they clean surfaces and use social distancing. She wanted to know if Contra Costa would allow this. Dr. Warne’s advice is to follow the State guidance.