| |
Dr. Warne introduced himself and described his roles as a Deputy Health Officer serving in Contra Costa County’s Health Services and as a primary care doctor working in the West County Health Center.
According to the data dashboard (www.cchealth.org/coronavirus), COVID case rates are declining from the peak in January. On March 14 Contra Costa County moved from the purple tier to the red tier in the State’s restriction framework. Also, the State relaxed some requirements to move into less restrictive tiers after reaching a milestone in vaccinations administered. Red tier status allows:
- indoor restaurant service (25% capacity);
- fitness centers and gym re-opening (10% capacity); and
- retail store capacity expansion to 50%.
The County must wait at least 3 weeks before moving into the orange tier and must meet orange tier criteria for two weeks (adjusted daily case rate <4, test positivity rate <5%, equity metric rate <5.2%). Early April is the earliest the County could move into the orange tier.
County case rate is 7, adjusted by the State to 5.9, substantially lower than the peak rate of 62 in January. Test positivity rate is 2.2%, much better than the peak positivity rate of 11.1% at the end of December. The equity metric is 4.0%, measuring the test positivity rate in the lowest 25% of Census tracts in the Healthy Places Index and correlating to those areas with the highest rates of COVID. Total cases in the County are 64,358, rate is flattening. The county is diagnosing 80-120 new cases per day, significantly lower than 1,000 per day in early January.
Though there continues to be disparity in case rates by location throughout the county, the rate is going down across all communities. Most impacted communities are San Pablo, Pacheco and Bay Point (>200 cases per 100,000), followed by Oakley, Pittsburg, Richmond, Antioch and Discovery Bay (>150 cases per 100,000), then Concord, El Sobrante, Pinole, Martinez and Bethel Island (>100 cases per 100,000).
The County performs 4,000-8,000 tests daily, with over 1.2 million tests performed in total. There have been 727 deaths to date, with significantly fewer deaths recorded in February and March. 42 COVID patients currently in Contra Costa hospitals, 7-day average of 46 patients is significantly lower than over 300 in early January. 20% ICU bed availability rate; 10% of ICU patients have COVID. Outbreaks in congregate living facilities decreased dramatically, 13 facilities being monitored for outbreak activity down from 55 facilities in January. Vaccinations have been delivered to all facilities.
Dr. Warne said that although the three available vaccines (Moderna, Pfizer, and Johnson & Johnson) may have different efficacy rates from their research trials, they are all highly effective in the real world. Vaccination adds to existing layers of protection (masking, social distancing, avoiding large gatherings). Approximately 484,000 first doses have been administered to approximately 34% of eligible residents 16 and older (318,000 first doses), and approximately 18% of eligible residents are fully vaccinated (170,000 second doses). 8,000 – 12,000 vaccines are administered per day, 7-day average of 8,800 vaccinations.
The County is focusing on improving vaccination rates for Latino and African American populations. 94% of individuals aged 75 and older and 76% of individuals aged 65-74 have received at least one dose of the vaccine. There is capacity to administer more than 70,000 doses per week, and the amount of doses delivered is increasing - 13,000 additional doses from the Federal government this week. The County has cleared its backlog of eligible vaccine appointment requests.
He reviewed new guidance for fully vaccinated people (which is 2 weeks after receiving the final dose of vaccine), such as gathering in small groups indoors and no quarantine following asymptomatic exposure to COVID. A complete list of guidance for fully vaccinated individuals is on the county COVID webpage.
We are in Phase 1B of vaccination eligibility: individuals age 60 and over or with higher-risk health conditions, in congregate living facilities (group homes, shelters, jails, etc), transportation / logistics workers, education / childcare workers, agriculture / food workers, and emergency services workers. The County COVID webpage outlines how to schedule appointments through health care providers, Contra Costa County, the State (www.myturn.ca.gov) or private sector organizations such as CVS.
Three main variant mutation strains of COVID are being followed. UK variant is more transmissible and results in a more severe illness but is susceptible to the vaccine. 4700 cases of UK variant in the United States, 343 cases in California and 2 cases in the County last week. South Africa/ Brazil variant is not more transmissible, but it is not yet known if the vaccine is as effective on this variant. B-427/B-429 variant, or California/West Coast variant, has recently been classified as a variant of concern by CDC and is considered more transmissible. 169 cases of West Coast variant have been identified in the County. The County is participating in full-genome sequencing to track variants.
Dr. Warne responded to questions that were received in advance of the meeting:
- Why is Type 1 Diabetes not a condition for possible eligibility to receive a vaccine? Dr. Warne explained that the State determines conditions covered. Individuals should contact their healthcare provider, because vaccine providers with access to health records have discretion to vaccinate individuals with comparable health conditions.
- What is the status on getting homebound seniors and their caregivers vaccinated? Dr. Warne responded that as healthcare workers, caregivers could be vaccinated starting in Phase 1A. More than 36,000 vaccine doses were administered to Contra Costa residents and staff working in skilled nursing facilities. Mobile teams reached out to over 70 senior housing complexes, where 97% of residents have first dose, and 47% are fully vaccinated. Planning is underway to reach out to homebound seniors.
- Why is 3 feet distance not allowed for student spacing when the CDC has recommended that 3 feet is sufficient? Dr. Warne stated that CDC has not yet recommended 3 feet as sufficient, although CDC representatives are considering it. State rules are 6 feet spacing between students but allows 4-6 feet spacing when 6 feet spacing is attempted but not possible.
- Under red tier guidelines, are rotary or other service clubs able to resume meeting indoors? Not at the present time. Such meetings continue to take place remotely although new guidance on outdoor events and meetings is expected from the State on April 1.
- What are the rules for garage sales? Follow the same guidance as retail stores.
- Will the County continue to manage vaccination appointments after www.myturn.ca.gov takes over? The State is planning to transition vaccine allocation management and appointment management to a third-party administrator, Blue Shield, which has been delayed. The County does not yet know if it will continue to manage appointments independently or fully transition to the State-run system. Individuals should sign up with both systems.
Lynn Mackey provided an update on school re-openings with the County’s red tier status, noting that the decision to re-open is determined by individual school boards. All County school districts reported that that every educator was offered a vaccine and was able to make initial appointments. 3-feet spacing model would allow schools to fully re-open. She also noted that County schools report every COVID case to the County and follow OSHA reporting regulations.
The following individuals spoke during the Public Comment period:
- Mike McDermott asked if Contra Costa County will expand vaccine availability to age 50 and over, expressed appreciation for his recent positive vaccination experience at the Miller Wellness Center, and noted that the median age of residents correlates with higher vaccination rates in cities. Dr. Warne said the County is considering expanding eligibility to 50 and over. Chair Andersen stated that she has been told this expansion will happen very soon, possibly in next week.
- (415) 640-3569 from Richmond asked several questions: 1. Which [special] districts are currently being tested for COVID? The County is not publishing tests results. Could the new testing instrument for water/sewage be used in Contra Costa County? Dr. Warne responded that testing through water/sewer districts is conducted via independent research projects and although it is a useful measuring tool, the County has no authority over the data collected.2. How is the $40 million mentioned in the February meeting being applied? 3. CO2 levels are a good indication of overall air quality. Is the County providing assistance to schools or other locations to purchase air filter machines? Dr. Warne noted there are many methods to reduce spread in schools, including ventilation and air filter machines, and believes ventilation will factor into schools’ mitigation plans. Superintendent Mackey noted that the county has been helping County schools navigate Cal-OSHA and the State Health Department ventilation guidance. 4. Is the County participating in the National Association of County and City Health Officials (NACCHO) Preparedness Summit? Dr. Warne is not familiar with this summit, but the County works closely with NACCHO, the California Conference of Local Health Officers, and the Association of Bay Area Health Officers. The caller also stated that the listed CVS locations are all in East County. Dr. Warne responded that there are not many CVS stores located in West County. Chair Andersen stated that the Board and the Health Department have rioritized placing vaccination sites in disadvantaged communities to help address vaccine equity.
- Dan Sharoni asked to speak with Lynn Mackey about the continued importance of testing and how he can help keep schools open. Superintendent Mackey provided her contact information via the moderator.
|