Coronavirus roundup: Marin groomers can reopen; case surge due to contact testing; health order now
MAY 26 — Little Fluffy can now get a trim at the groomer, as long as your dog or cat is dropped off and picked up at curbside, sans collar and leash, in a no-contact system that allows you to depart before your pet is taken inside.
Pet groomers were among the five new sets of industry-specific guidelines quietly released by Marin County on May 22 in the slow march to reopen the economy amid the coronavirus pandemic. In at least one case, the rules for summer camps, Marin appears to be moving more quickly than allowed by the state.
The county’s Marin Recovers Industry Advisors task force issued its guidelines to allow pet groomers to reopen and recreational-equipment rentals to resume immediately, as long as operators first complete state-mandated COVID-19 Site Specific Protection Plans. The plans, which are required for all businesses as they reopen, primarily outline measures for sanitation and crowd controls and must be posted for customers and employees.
Further guidelines were issued for golf courses and racket clubs, outdoor recreational businesses and child-care services. Those programs were already allowed to operate with restrictions under previous shelter-in-place orders, so operators have a grace period until June 1 to complete their site-specific plans.
Among the child-care services getting new guidelines for June 1 were youth summer and sports camps, though it appears they have been allowed to open prematurely. On May 22, the same day the county’s new rules were posted online, Gov. Gavin Newsom said the state’s guidelines to allow counties to begin opening summer camps and summer schools would be announced “within a week or so,” suggesting no county — including those with California’s permission to move more quickly than the state — may yet do so.
County officials weren’t able to offer clarification by The Ark’s press deadline May 26.
Meanwhile, Marin public officials clarified that the most-recent regional public-health order, which took effect May 18, eliminated the May 31 expiration date and is now open-ended, so the more broad policy changes of previous extensions will be replaced with smaller, gradual easing of the order, such as those issued over the weekend.
Marin is still in the first phase of its own three-phase reopening plan. As with California’s four-stage plan, the final hurdle is widespread immunity, which will come in the form of herd immunity through broad exposure to the virus by the population or from widespread vaccination. Vaccinations aren’t expected for 12 to 18 months, so some form of the public-health order is expected to last at least that long.
Some coronavirus-related rules not outlined within the text of the May 18 public-health order, such as the countywide moratorium on residential evictions, retained their May 31 expiration date. The moratorium was extended 30 days, to June 30, in a vote by the Marin Board of Supervisors on May 26.
Marin: 417 confirmed cases, 14 deaths, per the Marin Department of Health and Human Services as of 5 p.m. May 25, the second consecutive week without a death. Up from 329 cases the previous week.
California: 94,558 confirmed cases, 3,795 deaths, per the California Department of Public Health as of May 24. Up from 80,430 cases, 3,302 deaths the previous week.
U.S.: 1,662,414 cases, 98,261 deaths, per the U.S. Centers for Disease Control and Prevention as of 1 p.m. May 26. Up from 1,480,349 cases and 89,407 deaths the previous week.
World: 5,304,772 cases and 342,029 deaths, per the World Health Organization as of 1 a.m. May 25. Up from 4,618,821 cases and 311,847 deaths the previous week.
County: Spike in cases due to contact tracing
Marin has seen a surge in new coronavirus cases over the past two weeks as counts have jumped from 28 new cases from 1,762 tests in the seven-day span ending May 12 to 65 new cases out of 1,768 tests the next seven days ending May 19. There were 81 new cases from 2,087 tests in the following six days ending May 25.
That’s a jump of one new case per roughly 63 tests to a new case every 26-27 tests over the past two weeks.
But Laine Hendricks, the county’s public information officer, said this is mostly due to stepped-up contact tracing.
As the county confirms new cases of COVID-19, the county’s public-health team performs an investigation to identify close contacts of that new patient and potentially tests those contacts.
Hendricks said that because the county is improving its ability to specifically seek out “those who had a meaningful exposure to the confirmed cases — not a quick, casual encounter,” the testing has been more targeted to those with known, high-risk exposure who are more likely to return positive test results, such as household members, intimate partners, caregivers and co-workers who share space for prolonged periods.
“More testing means identifying more cases, and combined with contact tracing we’re able to catch those cases that would have gone undetected,” she said.
As part of the county’s first phase toward reopening the economy, officials are seeking to meet or exceed certain minimum public-health metrics before pressing ahead with more relaxed rules.
To date, the county has met only half its goals, for new cases and hospitalization rates, the ability for medical facilities to handle a surge and for the receipt of timely data from hospitals and labs.
The county said its testing capacity, its abilities to perform contact tracing, isolation and quarantine and the ability for all sectors to adopt industry-specific safety practices are still in progress.
The following indicators are a seven-day rolling average:
• New cases: 3.97 per 100,000 residents and decreasing as of May 25. Better than county and state goals.
• Hospitalizations: 3.29 and flat as of May 23. Better than county and state goals.
• Capacity: 1.26-percent occupied as of May 24, on a goal of less than 50 percent.
• Testing: 165.8 per day per 100,000 residents and decreasing as of May 23. Better than state goal of 150; Marin’s goal is 200.
• Contact tracing: 67.6 percent of cases were reached and their contacts identified within 24 hours; 81.9 percent of cases reached could safely isolate within 24 hours; 47.2 percent of contacts of cases have been reached; and 83 percent of contacts of cases could be safely quarantined. All metrics were below the county’s 90-percent goal.
• Personal protective equipment: All acute-care hospitals have a 30-day supply. However, the county Emergency Operations Center has received an equipment request from a facility within 14 days.
A look at Marin’s newest industry guidelines
For child-care facilities, the guidelines posted May 22 had few updates. Group sizes are limited to 12 children or fewer, shared equipment must stay within the group, group members cannot change for a minimum of three weeks and kids from the same household should be in the same group. Parents are to avoid carpooling and arrival times must be staggered.
Those same rules carry over to sports and summer camps. Kids also aren’t allowed to attend more than one child-care establishment, summer camp or sports group at a time, so a child cannot be enrolled in a new camp until they stop attending the previous one.
For outdoor-recreation businesses, groups must be limited to a maximum of 10, including instructors and staff, and businesses must collect the names and contact information of those participating in group activities, classes and tours to help with potential contact tracing. Participants must be screened for symptoms and should bring their own gear, but for outdoor-activity businesses and those renting equipment, equipment issued to a client can only be used by that client for the duration of the activity, until it can be sanitized.
For golf courses and racket clubs, business and transactions must take place outdoors, while indoor clubhouses, restaurants and bars must remain closed.
Additional golf course rules restrict play to Marin residents and to four people, unless members are from the same household. All high-touch surfaces must be removed, including flags, scorecards, pencils and ball washers. Carts are limited to single riders unless players are from the same household; those not providing their own carts must walk the course.
Additional rules for tennis that were clarified earlier last week were further implemented in the March 22 update, including limits to singles-only play for those outside the same household; those players must mark their balls and only serve and touch their own equipment.
Pet groomers may reopen once they develop site-specific plans. Pet drop-off and pickup must take place at curbside without the handling of collars and leashes in a no-contact system that allows the owner to leave before the pet is retrieved by the groomer. The exchange area must sanitized between pets.
All equipment must also be sanitized between pets, and recirculating bathing systems can’t be used. Pets that require more than two people to groom must be refused due to physical-distancing protocols, and payment should take place outdoors, over the phone or online.
Patchwork of rules in California, Bay Area
The Marin Recovers task force issued the new guidelines with the approval of the county’s public-health official, Dr. Matt Willis. Marin Recovers is a collection of more than a dozen working groups tasked with tailoring the state’s guidelines for local application as California reopens the economy sector by sector amid a coronavirus pandemic that has shut down or restricted all but essential services since a Bay Area shelter-in-place order first went into effect March 17 and California’s followed a day later.
But with California counties moving at different paces, even within the Bay Area, there is an increasing patchwork of localized rules.
Under California’s second stage of a four-stage plan to reopen the economy — which on May 8 kicked off a sequential rollout of low-risk workplaces, so far including curbside retail, schools, summer camps, child care, outdoor businesses and now pet groomers — counties may move slower, may pace the state or may move more swiftly within Stage 2 if they meet certain public-health metrics, such as a maximum number of new coronavirus cases and hospitalizations per capita and a minimum number of contact tracers.
Marin is moving forward cautiously, in concert with Alameda, Contra Costa, San Francisco and Santa Clara counties, as well as the city of Berkeley. However, Bay Area counties such as Napa and Sonoma are among the 47 of California’s 58 counties that won approval from the state to move ahead more quickly and, for instance, allowed restaurants to reopen seated dining service ahead of the Memorial Day holiday weekend.
Newsom typically announces the state’s plans in televised press conferences that garner significant media attention, but Marin so far has quietly released its updates going into weekends and with little or no fanfare.
In a surprise announcement May 15, the county said parking lots to parks, open spaces and trails could reopen May 18 at the discretion of managing agencies and municipalities. Though the public had been given notice that the county’s curbside-retail guidelines would be issued May 15, no notice went out once the guidelines were actually posted. Quietly included with the guidelines was an all-new public-health order, which wasn’t announced by the county until after it took effect May 18.
Then, last week, the public wasn’t given advance notice about which Marin rule updates were coming next. And while the new guidelines were posted to the marinrecovers.com website May 22, a press release announcing the changes didn’t come until the next day — the Saturday of a three-day holiday weekend.
Hendricks, the county spokeswoman, said by email May 24 there was a glitch in sending press releases for the guidelines as planned, which she said she discovered the following morning and then sent out immediately.
“The last two announcements just happened to be Friday, but the conversations on these reopening guidelines are happening often,” she said. “As the industry groups, public health and legal counsel reach consensus, the approved guidelines are posted. I would anticipate more announcements happening on any day of the week, not just Fridays.”
Hendricks said municipalities are typically notified ahead of the release of new economic-sector guidelines so they can offer support to local businesses and agencies — but Tiburon officials say that’s not quite the case.
“We typically have a sense of the general direction things are headed, but we learn the exact details essentially when everyone else does,” Town Manager Greg Chanis said by email May 25.
Tiburon Police Chief Mike Cronin said there’s a weekly phone conference, “but it doesn’t get too specific.” He wasn’t notified in advance that groomers, for instance, were allowed to reopen, or to what extend parking-lot restrictions would be relaxed for open spaces.
“We didn’t know they would continue to maintain restrictions on West Marin beaches. That’s important because it limits people’s choices and forces them to look elsewhere, like Tiburon,” Cronin said by email May 26.
“They’re trying to make sure the information becomes public in an even fashion, I think, rather than from multiple sources at different times,” Cronin added. “That can be a real issue, and even the way they are doing it now results in confusion, especially when people hear a snippet on TV or the radio and make choices based on that limited, incomplete and sometimes misleading information without reading the order or at least the FAQs.”
Hendricks said that regardless of the timing of the orders, all businesses already have the tools to be ready when guidelines are announced.
“A business must complete (the site-specific plan) before reopening, regardless of what day of the week the guidelines were posted,” she said. “All businesses can start to build their protection plan now to begin to prepare for reopening, and then as their industry-specific guidelines are issued and they’re given the green light to reopen, they are already one step ahead in the preparation process.”
In several cases under the unified regional health order the county appears to have inadvertently moved more swiftly within Stage 2 than the state allows.
The latest example is the summer-camp rules, but as part of the health order that took effect May 4, Marin allowed broad child-care and educational programs to begin in small groups during a time that California was still restricting child-care services only to essential workers; the state was still in its Stage 1 stay-at-home order that allowed only essential services. Broader child-care programs weren’t allowed by the state until Stage 2 began on May 8.
Meanwhile, car washes were also allowed under the Bay Area order beginning May 4, but Newsom didn’t announce those were allowed to open until the second step of Stage 2, beginning May 12.
As recently as May 7, when Newsom announced Stage 2 would begin the following day, officials across the Bay Area, including Hendricks and Willis, the county’s public-health officer, were publicly asserting counties could have stricter but not more lenient rules than the state — and that the stricter rules would take precedence. But the state had already announced counties could earn variances that allowed them to move faster beginning May 8. Where approved, county rules can, in fact, be more lenient with state permission, with the lenient local rules taking precedence.
Hendricks deferred to Willis on how affected sectors are supposed to sort out whether they can proceed with reopening, why these several rules were allowed early in Marin and whether Newsom’s frequent announcements are catching local public-health officials off guard in trying to carefully craft and implement local plans. Willis did not respond by The Ark’s press time.
Newsom OKs worship, protests, in-store shopping, hair salons
Hendricks did not say which sectors would be next to reopen in Marin, but Newsom said May 26 the state is moving toward its Stage 3 plan to reopen high-risk workplaces.
A day earlier, he announced that all counties — at their own pace — may restart in-store retail shopping, and he gave all counties the green light to allow houses of worship to reopen and for political protests to proceed. The state guidelines on worship and protests limit attendance and participation to 25 percent of an area’s capacity or 100 total people, whichever is fewer.
President Donald Trump has called houses of worship essential services and last week ordered them to be opened immediately nationwide, but a three-judge panel of 9th Circuit Court of Appeals on May 22 sided with Newsom in a suit brought by a San Diego church, ruling 2-1 to uphold the temporary ban on in-person services as not being selective or “motivated by religious belief.”
In his May 26 press conference, Newsom said the counties that have received explicit state permission to move forward more quickly than the rest of California can start reopening hair salons and barbershops — but only when the stylist and client can both wear face masks, for services such as cuts, coloring, weaves and braids. Shaves, facial waxing, threading and facials are not yet allowed.
The state’s rules for casinos and card rooms are expected June 8.
Stage 3 is also to eventually include gyms and move theaters, as well as sporting events without live audiences, which Newsom previously said could return as soon as June 1.
Stage 4 represents a full reopening of the economy, including concerts, conventions and sports with audiences — but that, officials say, will require widespread immunity to the coronavirus, either through herd immunity or a vaccine. While the White House is pressing to develop a vaccine by year’s end, most experts still suggest it’s 12-18 months away.
• Newsom on May 22 announced California Connected, a contact-tracing program and public-awareness campaign. Public-health workers calling individuals who have tested positive for COVID-19 or been exposed to someone with the virus may receive a call from a contact tracer, identified on caller ID as “CA COVID Team,” or receive a text or email. The state hopes to deploy 10,000 contact tracers, and so far 800 have been trained or are in the process.
• The CDC is recognizing a pediatric inflammatory disease connected to the coronavirus as “multisystem inflammatory syndrome in children,” or MIS-C, the agency announced May 14. The disease had previously been described among some doctors and researchers as “pediatric inflammatory multisystem syndrome,” or PIMS.
Children generally have mild symptoms of infection from COVID-19, but there is a possible link between the virus and the syndrome, characterized by inflammation of the blood vessels, found in children and teens who have current or recent infections. The syndrome can lead to fatal aneurysms if left untreated.
The first reports came from the United Kingdom in April, were seen in New York in early May and have since been reported in 20 states, including in California. The syndrome is also being reported in young adults, with a 20-year-old being treated in San Diego and a 25-year-old in New York.
• A peer-reviewed study published May 22 in The Lancet medical journal of 96,032 hospitalized coronavirus patients across six continents — the largest to date — found those who were prescribed hydroxychloroquine and chloroquine, as well as those drugs paired with an antibiotic, “were each independently associated with an increased risk of in-hospital mortality.” The researchers suggested the drug not be prescribed to coronavirus patients outside further controlled clinical studies.
On news of the study, the World Health Organization on May 25 temporarily suspended its global clinical trials to review safety data.
President Trump said last week he had begun taking the controversial drug under his physician’s supervision.
The drugs are still generally accepted as safe for patients with autoimmune diseases and malaria.
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.