Mase said that given the rising number of confirmed infections in the county and outbreaks in skilled nursing — as of Friday, there were 25 virus cases at such nursing centers — and residential care facilities for the elderly, it is becoming increasingly likely the county will end up on the state’s watchlist.
“This should give us all pause to know our own vulnerability here in Sonoma County,” she said Thursday, during her last public briefing before the holiday weekend, encouraging people to “stay put” and avoid travel outside the county.
Local, state benchmarks
In early May, the state established a program through which counties could petition to reopen more types of businesses and public venues than were then allowed according to the governor’s California reopening plan. At the time, health officials from many counties seeking faster resumption of business and industry submitted so-called “attestations“ that included a number of public health metrics they would use to gauge respective local efforts to stabilize the spread of the virus, or essentially to keep the curve of transmission flat.
For weeks, Mase used these local metrics she and her team compiled to measure the county’s ongoing virus containment efforts. Some of the county metrics were even more conservative than the ones now used by state health officials to identify struggling counties that go on the monitoring list.
For example, under Sonoma County’s original benchmark for cases per 100,000 residents over a 14-day period, anything over 25 confirmed cases per 100,000 people would prompt local health officials to consider implementing previous restrictions on public and workplace activity.
Meanwhile, the state set the benchmark at 100 cases per 100,000 residents for a 14-day period. Counties exceeding that 100 case rate would be flagged and ordered to again close certain businesses. On Saturday, Sonoma County’s case rate catapulted to 106 per 100,000 residents, its highest level and officially making the county out of compliance on this key state benchmark.
Counties also would be in trouble if they had a case rate greater than 25 per 100,000 residents over 14 days, plus a virus testing positivity rate greater than 8% of the population tested. Specifically, testing positivity is the average share of all COVID-19 tests reported positive over seven days.
While the case rate in Sonoma County has for more than a month been above that 25 threshold, testing positivity has stayed low at 2% to 3% for much of June and early July, with more than 51,500 people tested.
On Wednesday, the day before Contra Costa County was removed from the state monitoring list, that county logged a case rate of 74.9 per 100,000 residents, a testing positivity rate of 4.3%, a 13% decline in virus-related hospitalizations over a three-day period, ICU hospital bed availability of 53% of total ICU unit space and ventilator availability of 91%.
Monterey, which joined the state monitoring list Thursday, cited a case rate of 107.4 per 100,000 residents and a three-day hospitalization increase of 79.2%.
Local hospital, ICU beds
State requirements aside, Sonoma County is now falling short on several of its own metrics tracking suppression of the virus, including increasing hospitalizations and less availability of ICU beds for residents suffering from the sometimes deadly virus.
As of Thursday, the average daily percentage increase of confirmed COVID-19 cases over the past week was 6%, slightly more than the county’s 5% threshold. Also, only five or 7.5% of the county’s 67 ICU beds were available as of Saturday. Because the county has 82% of ventilators available at local hospitals, it’s still compliant with state requirements for hospital capacity.
However, Mase pointed out that local hospitals easily could add beds to ICU units. And with such small numbers of COVID-19 patients in hospitals, any numerical increase causes a large short-term percentage jump.
Dr. Chad Krilich, chief medical officer for St. Joseph Health Sonoma County, which operates Santa Rosa Memorial and Petaluma Valley hospitals, said there has been an increase in hospitalized COVID-19 patients. But the increase has been small and still very manageable.
Krilich said earlier in the pandemic that began in March the two hospitals would average a couple of patients suffering from the coronavirus in the hospital at any given time. Now the hospitals average about four patients.
“Overall in terms of the numbers of patients actually in the hospital, it is an increase,” he said. But Krilich noted COVID-19 patients still are only roughly 1% of the hospitals’ inpatient volume.