State halts indoor dining in Marin amid coronavirus surge
JULY 6 — Less than a week after being given the green light to reopen, restaurants across the Tiburon Peninsula and the rest of Marin have again been forced to shut down indoor dining.
The California Department of Public Health mandate, which went into effect at 11:59 p.m. July 5, will last at least three weeks and was triggered when Marin spent its third consecutive day on a state watch list of counties seeing spikes in coronavirus cases and hospitalizations. While outdoor dining and takeout service is allowed to continue, Gov. Gavin Newsom says “strike teams” will be targeting restaurants and bars statewide that have refused to comply with health orders.
“Marin County Public Health is urging renewed diligence by everyone on adhering to the shelter-in-place order first established March 17,” public-health officials said in a July 5 press release. “Wearing facial coverings in public, washing hands often, adhering to social bubble guidelines and practicing social distancing are among practices that will help curtail the coronavirus outbreak and lead to more openings in economic sectors.”
Tiburon Peninsula: 16 confirmed Tiburon cases per the Marin Department of Health and Human Services as of 4 p.m. July 6, up from 14 the previous week. Belvedere and Strawberry each have an unknown number of cases between zero and 10, with the figure withheld by the public health department in an effort to protect patient privacy.
Marin: 1,483 confirmed cases, 1,036 recovered, 19 deaths, 34 current hospitalizations per the Marin health department as of 4 p.m. July 6. Up from 1,195 cases, 784 recovered, 18 deaths and 13 hospitalizations the previous week.
San Quentin State Prison: 1,378 cases and six deaths per the California Department of Corrections and Rehabilitation as of 3 p.m. July 6, up from 1,021 and zero deaths the previous week.
California: 271,684 confirmed cases, 6,337 deaths, per the California Department of Public Health as of July 6. Up from 216,550 cases, 5,936 deaths the previous week.
U.S.: 2,886,267 cases, 129,811 deaths, per the U.S. Centers for Disease Control and Prevention as of 1 p.m. July 6. Up from 2,545,250 cases and 126,369 deaths the previous week.
World: 11,327,790 cases and 532,340 deaths, per the World Health Organization as of 1 a.m. July 6. Up from 10,021,401 cases and 499,913 deaths the previous week.
Marin was among about 20 counties added to the watch list on July 3 as its 14-day case rate per 100,000 residents was 202.56 new infections, while its increase in hospitalizations was 30.8 percent and its intensive-care-unit bed count dropped to 7.2 percent, according to state data.
Counties land on the state watch list for having case rates of more than 100 new cases per 100,000 residents, an increase in hospitalizations of more than 10 percent and an ICU bed availability of less than 20 percent. According to the state, Marin meets its metrics for testing and ventilator availability.
Earlier last week, Marin saw new daily cases of 52 each on July 1 and 2, tied for Marin’s second-highest daily counts since the pandemic began. Officials also announced hospitalizations surged to 28 patients on July 2, in part due to the treatment of San Quentin State Prison inmates infected by a massive outbreak there. A Marin man in his 40s also became the county’s 19th COVID-19 death, the first younger than 50.
San Quentin’s figures are not included in Marin’s data for testing, cases, deaths, recoveries and cumulative hospitalizations, though they’re necessarily included for active hospitalizations in Marin facilities, as hospital treatment of inmates impacts Marin’s bed, intensive care unit and ventilator capacity.
In its report on Marin’s watch-list status, the state’s health department pointed specifically to the outbreak at the prison, as well as at increased workplace transmission and outbreaks in congregate settings and Hispanic neighborhoods.
In Marin, much of the coronavirus spread is in San Rafael’s Canal district, where there are high concentrations of high-density, low-income multigenerational housing — featuring an average of six residents per household — in which most workers are employed at essential jobs and cannot work from home. Of Marin’s 16-percent Hispanic population, some 77 percent of all cases are among Hispanic residents.
And just a day before Marin was placed on the state watch list July 3, 32 people — 15 residents and 17 staff — tested positive for COVID-19 at Marin Post Acute nursing home in San Rafael.
Dr. Matt Willis, Marin’s public health officer, has also attributed the surge in coronavirus cases to outbreaks at about a dozen businesses, including at Marin Sanitary Service, where 43 workers were diagnosed in mid June.
Indoor dining in Marin had been allowed to resume just last Monday, June 29, alongside the reopening of hair and nail salons, but the data leading up to that decision was already cause for concern.
On June 26, when the announcement to reopen was made, Marin health officials noted that the previous day had seen single-day highs at the time for new cases, at 54, for concurrent hospitalizations, at 12, and for intensive-care utilization, at five patients. Marin’s rolling seven-day percent-positivity average was also 7.2, the highest since March 31, after the county had seen a low of 1.4 on May 5 and a steady rise ever since.
Marin also had the highest effective reproduction rate in the state, at 1.44, a “rapid increase” in spread of the virus meaning that every two infected residents would give the virus to roughly three more people between them.
The data led Marin officials to hit pause on a number of new activities that were also set to reopen June 29, such as hotels, motels and short-term rentals for vacation and leisure; gyms and fitness studios; and personal services included nail salons.
However, Marin health officials did not respond to Ark inquiries as to why even a limited number high-risk indoor activities would still be allowed to reopen in the days ahead of the three-day Fourth of July holiday weekend, given the local data and the spike in cases previously seen in the days following the Memorial Day holiday weekend.
The indoor-dining shutdown will likely slow Marin’s plans for future reopenings. Had the county already moved forward with opening movie theaters, card rooms, zoos, museums and family entertainment centers like bowling alleys and miniature golf, as well as to wineries, breweries, bars, brewpubs and tasting rooms that don’t serve food, those sectors also would have been required to shut down for three weeks under the state’s July 5 order.
Most of those activities were on target to open later this month or in August.
According to the state’s health department, Marin must work with the state to mitigate the outbreak at San Quentin, improve infection-control and testing at residential-care and skilled-nursing facilities and must work with community-based organizations to increase testing, access to care and support for vulnerable populations.
Despite the instructions to work with San Quentin, Marin has no authority over health policy at the state prison, where Willis says his inquiries and recommendations were repeatedly ignored by the Department of Corrections both before and after the outbreak began.
San Quentin’s outbreak since a June 1 prisoner transfer from Chino has grown to a third of its inmate population with 1,400 cases and six deaths, while guards and some inmates are being treated at Marin hospitals. Willis said in a video statement July 1 that when active COVID-19 hospitalizations had hit 23 patients, 11 of those were prisoners. While that only represents about 10 percent of staffed, non-surge beds in Marin, intensive-care unit beds are nearing capacity.
Of Marin’s 25 total intensive-care beds, 24 were being used for treatments of all types July 1, not just for coronavirus, and eight of those were for San Quentin inmates being treated for COVID-19.
Kevin Hessel is The Ark’s executive editor. Reach him at 415-435-2652, on Twitter at @thearknewspaper and on Facebook at fb.me/thearknewspaper.