Marin County relaxes some coronavirus rules to better align with state

Though a statewide reporting error has led to incomplete local data, and Marin remains on the state watch list that triggered a rollback of activity and froze some new economic reopenings, county public-health officials are pressing forward with new local guidance that further relaxes the coronavirus shelter-in-place order.

Dr. Matt Willis, Marin’s public health official, said the coming changes for hotel and short-term rental stays and recent updates to group sizes for child care and youth camps and to outdoor options for personal-care services would more closely align the county with activity previously OK’d by the state despite Marin’s watch-list status.

Tiburon Peninsula: 44 diagnosed Tiburon cases, 16 Belvedere cases, 13 Strawberry cases per the Marin Department of Health and Human Services as of 4 p.m. Aug. 17. Up from 36 in Tiburon, no change in Belvedere and 12 in Strawberry the previous week.

Marin: 3,552 diagnosed cases, 3,169 recovered, 58 deaths, 13 current hospitalizations per the Marin health department as of 4 p.m. Aug. 17. Up from 3,152 cases, 2,775 recovered and 56 deaths and down from 16 hospitalizations the previous week. Two-week testing positivity was 9.3 percent as of July 30, the last reported date. Marin’s R-eff was 0.97 as of Aug. 17, according to the California COVID Assessment Tool.

California: 628,031 diagnosed cases, 11,242 deaths, per the California Department of Public Health as of Aug. 16. Up from 561,911 cases, 10,359 deaths the previous week.

U.S.: 5,382,125 cases, 169,350 deaths, per the U.S. Centers for Disease Control and Prevention as of 1 p.m. Aug. 17. Up from 5,023,649 cases and 161,842 deaths the previous week.

World: 21,549,706 cases and 767,158 deaths, per the World Health Organization as of 1 a.m. Aug. 17. Up from 19,718,030 cases and 728,013 deaths the previous week.

Marin moves to align with state

Willis told the Marin Board of Supervisors last week the county intends to issue guidance to reopen hotels, motels and short-term rentals for leisure use effective Aug. 24, as long as the county’s two-week-average new-case rate remains below 200 per 100,000 on Aug. 21.

Willis on Aug. 13 said Marin’s new-case rate was 160 per 100,000 residents.

Short-term rentals are banned in Tiburon and Belvedere, but The Lodge at Tiburon and the Waters Edge Hotel in downtown Tiburon, for instance, would be allowed to reopen to tourists and other travelers. Since May 29, a county order has restricted use of hotels and short-term rentals to essential workers and those who need to isolate or quarantine away from home.

California has allowed hotels to reopen across the state since June 12, but the choice to keep them closed in Marin was a local one. Willis said with high case rates and Marin being a tourist destination, open hotels would encourage travel into the community. He warned, however, that it’s possible the state could include hotels and other short-term leisure stays in a future rollback.

Effective this week, beginning Aug. 17, Marin officials have reduced the county’s restrictions on child-care and youth programs, allowing group sizes to grow from 12 kids to 15 and letting children participate in up to two programs at a time.

Kids still cannot change activity groups for a minimum of three weeks, programs can only take place outdoors, participants must stay 6 feet apart and face-covering rules for ages 2 and older still apply.

The youth guidelines apply to sports including basketball, football, gymnastics and dance studios — but officials said sports without enough distancing still are not permitted. Instead, those sports must stick to individual skills development and conditioning.

Adults still may only take part in one “social bubble” of 12 at a time, and all members of a household must be in the same bubble. The social-bubble rule seeks to relax shelter-in-place guidelines for non-essential activities, but other restrictions still apply: activities are still to take place outdoors, with 6-foot physical distancing and the use of face-coverings.

Marin health officials said the new youth guidance allows for more flexibility through the rest of the summer and fall.

“We appreciate the importance of group activities and exercise for our children both physically and socially, but at the same time, we have to take measured precautions to reopen safely for our entire community,” Willis said in a press statement. “We also know that child-care and youth programs will take on a new meaning this fall with schools starting back in a virtual environment.”

And just after The Ark’s press deadline last week, officials on Aug. 10 announced that nail salons, massage therapy, esthetic services, cosmetology and skin-care services could reopen for outdoor business, effectively immediately. The move put those industries in line with hair salons, which had briefly been allowed to reopen for indoor service before being shut down again July 13 by Marin’s watch-list status. Outdoor salon services, however, were allowed to continue.

“The recent decision to move hair salons outside showed that personal services can be managed effectively outdoors,” Willis said. “We’ll continue to monitor our local and state data and make adjustments for the safety or our community and economy.”

Local businesses slow to embrace relaxed rules

Despite the new guidance for outdoor personal-care services, only a handful of impacted businesses on the Tiburon Peninsula last week had found ways to take advantage of the change.

Eva Claiborne, who has a skin-care clinic at 86B Main St. in Tiburon, embraced the outdoor-only restriction by creating a cabana with privacy curtains. She moved a massage table outside, where she does facials on clients while they’re reclining.

But around the corner, Nail Connections Spa on downtown Tiburon Boulevard was closed, and there was no sign of activity outside. The lights were off, and a sign on the front door read “By appointment only.”

At Era Salon in Strawberry, nail-care workers in gloves and masks were attending clients at two mini-stations set up outside, with Plexiglas stands between each.

One of the owners of the family-owned and family-operated nail business, who declined to give her name, said the salon opened the stations to help clients but that the change isn’t paying the bills.

At SkinSpirit clinic and spa at The Strawberry Village Shopping Center, no work was going on outside. Employee Heather Janssen said that, regardless of what the county allows, her industry’s licensing board would not allow it. The clinic is only doing medical work that is exempt under the rules, and that work is done inside under strict protocols dictated by their license.

StretchLab at Strawberry Village had set up a large tent and outdoor tables, and its trainers were working one on one with clients outside.

Certified massage therapist Tim Mehoves of Strawberry said he was laid off from the Cavallo Point Lodge in Sausalito and would have difficulty providing massage therapy at his own studio in Mill Valley, as it can be cool and windy and the outdoor space would lack privacy, quiet and comfort. He said his unemployment has run out and that by the end of September he may have to move out of Marin or out of California.

He expressed frustration with people who don’t wear masks when they walk around Strawberry, Tiburon and Mill Valley, saying they don’t seem to realize that if people don’t wear masks, the coronavirus will linger — and so will the economic impacts due to prolonged restrictions.

Watching the watch list

Marin has been on the state’s coronavirus monitoring list since July 2, which started a three-day clock to either contain the spread or face a rollback on economic activity. For Marin, that led to a July 6 shutdown on indoor dining, which had only resumed the week prior. A week later, Gov. Gavin Newsom further shut down watch-list counties, which in Marin affected indoor malls, offices and indoor hair salons. Outside a waiver program for elementary schools, schools must also remain shut down until a county is off the list for 14 consecutive days.

To be removed, the county for three consecutive days must fall below 100 new cases per 100,000 residents over a rolling two-week average. That’s about 19 cases per day.

“I’m encouraged by seeing our hospitalization rate be the lowest it’s been in almost two months and that the … transmission rate has also been much lower,” Willis said last week. Some 13 COVID-19 cases currently required hospitalization Aug. 17 compared with an average day exceeding 20 for July. Marin’s hospitalization rate is also the lowest in the Bay Area.

“We may be off the monitoring list sooner than I would have predicted a week ago, but if we’re at 160 (cases per 100,000 residents) now, it’s still a long way to 100. And so it will be weeks at best, but perhaps not months,” he said.

While Marin officials say the county has 160 new cases per 100,000 residents, the state says Marin’s rate is 260.4 per 100,000, illustrating disparities caused by what California officials have described as a “technical glitch” in its statewide reporting database.

California appears to have made several preventable errors. The state did not have enough computing capacity to handle all reporting data from outside labs, which caused a July 25 server outage, while it also failed to renew a software security certificate required to allow one of the state’s largest labs to transfer data to the state database for five days. The state’s public-health director has since resigned over the errors.

By the time they were caught, California had a backlog of some 250,000 to 300,000 unprocessed health records, mostly COVID-19 results. Processing them required manual checks to ensure no data was duplicated, which was expected to be completed this week.

The system failure has had a ripple effect, as the incomplete data reported to the public was artificially low and didn’t indicate the full magnitude of the case surge already underway since June; California now has more than 625,000 diagnosed cases, the most in the U.S. For people casually tracking cases day to day or week to week, the backfill of delayed results could be perceived as massive case spike occurring in real time.

Public-health officials across the state said that because the data is incomplete, the trends themselves are generally accurate but specific metrics — such as those used to determine watch-list status — may not be.

Marin officials earlier this month said they had already noticed discrepancies between the state’s data and their own, which the county largely gets directly from the labs, so Marin placed warnings on its pandemic-surveillance website that its recent figures are incomplete, at least back to July 14.

As the county’s confidence in the state-supplied data deteriorated, the county last week froze reporting of some its most critical data, including case rates and testing-positivity. Officials said they suspect they haven’t received a complete picture of all negative test results, for instance, which would artificially inflate testing-positivity percentages.

In the affected period, Marin’s testing positivity — the proportion of new cases per new test rather than per capita — hit a two-week rolling average of 10.6 percent on July 29 before the county shut down the reports, up from a low of 1.6 percent on May 13. The county’s overall high is 10.9 percent on March 18 — two days after Marin and five other Bay Area counties, alongside the city of Berkeley, issued the nation’s first shelter-in-place order to limit activity, travel and business.

The World Health Organization recommends rolling two-week testing positivity drop below 5 percent to resume further economic activity, a level Marin has exceeded since June 20. California’s watch-list metric is 8 percent, but only when paired with new-case rates of 25 or fewer per 100,000 residents. Marin appears to have exceeded 8 percent only since the state data was undermined, so that figure could be artificially inflated as well.

Willis separately pointed to Marin’s aggregate effective-reproduction number on the state’s California COVID Assessment Tool as a potential indicator of transmission in the county. Marin’s R-eff is 0.97 as of Aug. 17, based on a combination of six other predictive models, including Johns Hopkins, Harvard and Stanford universities and the University of San Francisco. The number represents the average number of people each infected person will pass the virus to. A number over 1.0 means there is increasing spread, and below 1.0 means there is decreasing spread. The Bay Area’s overall R-eff is 1.09.

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. Deirdre McCrohan contributed to this report.