• Kevin Hessel

Coronavirus roundup: Salons, gyms, indoor dining can start June 29 as county wins variance to move f

JUNE 23 — Marin public-health officials have announced residents can now join 12-person “social bubbles” and added that indoor dining, hair salons and barbershops, nail salons, hotels, motels and short-term rentals can resume operation this month, alongside gyms and fitness studios.

The indoor activities firing up June 29 will coincide with the reopening of additional outdoor activities as part of Marin’s sector-by-sector reopening of the economy amid the coronavirus pandemic. The guidelines to be issued this week will include the use of picnic areas and barbecues at public parks, as well as campgrounds, RV parks and other outdoor vehicle-based activities like drive-in movies, officials said.

The county has also announced guidelines for reopening schools in the fall, with kids in class five days a week.

Meanwhile, Tiburon saw at least two new COVID-19 cases, registering the town for the first time on the county’s geographic case maps, and Gov. Gavin Newsom issued a statewide mask order that includes a change in Marin: Kids ages 3-12 must now mask up.

Marin: 946 confirmed cases, 621 recovered, 18 deaths, six current hospitalizations per the Marin Department of Health and Human Services as of 4 p.m. June 22. Up from from 725 cases, 499 recovered, 17 deaths and nine hospitalizations the previous week.

California: 173,824 confirmed cases, 5,495 deaths, per the California Department of Public Health as of June 20. Up from 151,452 cases, 5,089 deaths the previous week.

U.S.: 2,275,645 cases, 119,923 deaths, per the U.S. Centers for Disease Control and Prevention as of 1 p.m. June 21. Up from 2,085,769 cases and 115,644 deaths the previous week.

World: 8,860,331 cases and 465,740 deaths, per the World Health Organization as of 1 a.m. June 22. Up from 7,823,289 cases and 431,541 deaths the previous week.

Marin pushes to move faster

The resumption of what health officials have deemed “high risk” indoor activities under the county’s sector-by-sector reopening of economic activity comes as Marin filed its COVID-19 variance attestation with the state, which allows counties that meet certain public-health metrics to reopen their economies faster than the state otherwise allows. Most sectors on the June 29 list would not yet be allowed to reopen in Marin without the variance.

As part of a seven-jurisdiction Bay Area coalition, Marin had become one of the nation’s first counties to issue a shelter-in-place order, which first took effect March 17. The state of California followed the next day, and both orders remain in place. As Newsom began allowing sectors to reopen, starting with construction and outdoor businesses in early May, the state’s 58 counties were allowed to individually prove they were adequately testing, could trace patient histories, had slowed the virus down and were prepared to respond to any hospitalization surge. With approval, the counties with variances could then begin moving ahead of the rest of the state.

Since then, the Bay Area coalition began to splinter as local public-health officials increasingly sought to tailor their reopening strategies to local data. But until last week, six Bay Area counties and Imperial County on the Mexico border remained the last seven to stick with the state’s pace, with the other 51 moving more quickly.

Signed by Marin Public Health Officer Dr. Matt Willis on June 17, the data on Marin’s 31-page attestation form, with another 112 pages of appendices, asserts that:

• Hospitalizations: At a peak of 10, hospitalizations had not exceeded the maximum of 20 in the previous 14 days.

• Stability: Test positivity — a percentage reflecting the number of new infections divided by the number of new tests — had not exceeded 6 percent in the previous 14 days, where 8 percent was the maximum. Marin was last above 8 percent in late March and dropped to about 2 percent from April 30 to about May 12, before the figure jumped up to about 6 percent by May 16. Test positivity has bounced between 4 and 6 percent since then. By comparison, Sonoma County’s rate is 1.5 percent and San Francisco’s is 0.7 percent.

• Test capacity: The seven-day testing average was 2.85 per 1,000 residents, exceeding the state’s minimum of 1.5.

• Contact tracing: Marin now has 41 contact tracers, or 15.9 per 100,000 residents, exceeding the minimum of 15 per 100,000. Marin is also training 50 more tracers.

The county was also able to demonstrate it had hospital capacity and supplies of personal protective equipment, could shelter vulnerable populations and had a containment plan.

Marin would not have met the incidence rate of fewer than 25 new infections per 100,000 tested. The county’s new-infection rate continues to rise and remains one of California’s highest, with a 14-day rolling average of 124 new cases per 100,000 residents, more than triple the rate of roughly 38 each in San Francisco and Sonoma counties.

Marin public-health officials say hospitalizations and deaths remain key indicators on whether to continue reopening, and those figures have remained relatively flat. Of 59 total coronavirus hospitalizations, six patients were in Marin hospitals at The Ark’s press deadline June 22. Eighteen people have died overall, with 13 of those older than age 80 and just one younger than 65.

Tiburon cases significant

Tiburon registered at least two new COVID-19 cases last week, bringing the town total to 12 and giving residents a clearer picture of the virus’s prevalence in the community.

Marin’s Department of Public Health breaks down the number of cases by community across Marin, but in jurisdictions with 10 or fewer cases — including Belvedere and Strawberry — officials say they withhold the actual case count to help protect individual patient privacy.

Until last week, Tiburon had an unknown number of cases between zero and 10, so the number of new cases could be greater than two.

With a population of 8,992, Tiburon’s 12 total cases gives the community an overall rate of 133 per 100,000 residents. By comparison, neighboring Mill Valley has 15 cases and a rate of 107 per 100,000 residents, while Corte Madera has 17 cases and a rate of 182 per 100,000 residents. Sausalito has 18 cases, at a rate of 257 per 100,000 residents.

“Clearly it is in the community’s best interest to keep this number as low as possible, and we encourage all Tiburon residents and visitors to abide by the current requirements related to social distancing and the use of face coverings,” Greg Chanis, Tiburon’s town manager, said by email June 21.

Marin’s overall COVID-19 surge is driven mostly by an outbreak in San Rafael, where there are 434 total cases, or 1,054 per 100,000 residents.

Public-health officials say the outbreak there is concentrated primarily among Latinos in the lower-income Canal area, where many residents perform higher-risk essential jobs and live in high-density, multigenerational housing, all of which facilitate the spread of the virus. Some 73 percent of all Marin cases and 36 percent of hospitalizations are among Latinos, who represent 16 percent of the county population.

Granular hospitalization, deaths data

The countywide case breakdown by geographic location is part of Marin’s COVID-19 surveillance dashboard, which has also been updated with a more granular look at the impacted age groups for total cases, hospitalizations and deaths.

Marin has the oldest population in the Bay Area, with about 22 percent of residents age 65 or older, versus about 16 percent in San Francisco and Solano counties and about 20 percent in Sonoma and Napa counties, for example, according to 2019 data estimated by the U.S. Census Bureau. But county statistics previously only broke down data by ages 0-18, 19-34, 35-49, 50-64 and 65 and older.

The new breakdown updates 65 and older to 65-79, 80-94 and 95 and older.

Rather than 17 of 18 deaths being among residents ages 65 and older, the update reveals that 72 percent, or 13 of Marin’s coronavirus deaths, are actually among residents 80 and older, despite the age group representing just 5 percent of the Marin population and 4 percent of all infections. Of those, four deaths were those ages 95 and older.

The five remaining deaths include four residents ages 65-79 and one aged 50-64. No one younger than age 50 in Marin has died of COVID-19.

The number of infections that require hospitalization, however, shows a broader range across age groups, with nearly 60 percent of all those hospitalized younger than 65, and half of those younger than 50.

The largest group, at 30 percent, is ages 50-64, followed by 27 percent ages 65-79 and 14 percent ages 35-49.

The county does not indicate whether those who were hospitalized or died had underlying medical conditions that put them at greater risk, and it does not break down the 569 recoveries by demographic group.

Getting social in ‘bubbles’

The rules for 12-person social bubbles were issued June 21 and took effect the next day, for the first time expressly allowing people to interact outdoors with people who do not live in the same household.

“A lot of effort has gone into finding ways to reopen our local businesses and economy, but the friendships and social lives of our residents are just as crucial to our community’s stability during the COVID-19 crisis,” Willis said in a June 21 press release. “This model will allow each of us to begin to engage with people from outside of our household unit as safely as possible.”

Social bubbles require a stable group of up to 12 people who remain within the group for outdoor social activities for at least three weeks. People are only allowed to be in one social bubble at a time — though kids can be in a second bubble related to child care or a sports camp, and a third bubble if they split time living in two different households.

“(We) know people are already congregating outside their households in more risky ways,” Willis said. “This model provides guardrails so small gatherings can occur in a safe way, especially as we move into the summer season.”

All the other typical rules apply: People should wear face coverings, stay 6 feet apart, wash their hands and isolate or quarantine if sick or exposed to the virus.

Indoor activities

On June 22, Marin Recovers issued its guidelines for high-risk indoor activities to resume on June 29, which can proceed under Marin’s variance.

• Indoor and outdoor dining: While outdoor dining was already allowed, the new changes impact dining indoors and out — in particular group seating. The rules now allow up to 10 people to sit at table, even if they’re not from the same household, as long as they asked to sit together. Restaurants should encourage takeout and delivery and prioritize outdoor seating. Partitions should be installed at any service stand, such as host stands, cash registers and bars. Tables must be placed at least 6 feet apart.

For the complete guidelines, visit marinrecovers.com/restaurants.

• Hair salons and barbershops: Customers must book appointments in advance to limit waiting lines, and businesses should conduct symptom screenings over the phone when confirming appointments. Children and others should not accompany the client, and magazines, newspapers and self-serve beverages should be removed. Staff and clients must wear face coverings and are encouraged to wear eye protection.

• Nail salons: Businesses cannot allow multiple services at the same time, such as a manicure and a pedicure. Face coverings are required at all times, and workers must also wear disposable gloves and should also wear eye shields; plastic partitions should also be considered. Nail-polish displays should be replaced with color palettes that are cleaned after use.

For the full guidelines, visit marinrecovers.com/personal-services.

• Gyms and fitness studios: Marin Recovers Industry Advisors is recommending the state’s guidance. Patrons should be temperature and symptom screened on arrival and asked to use hand sanitizer and face coverings where possible. Touchless check-in should be implemented with plastic barriers at reception. Equipment must be spaced 6 feet apart, and gyms should consider special hours for high-risk patrons. One-way signs should be installed, available lockers should be limited and saunas and steam rooms must remain closed.

For the full guidelines, visit marinrecovers.com/personal-services.

• Hotels and motels: Large meeting spaces must remain closed, and other public spaces should be reconfigured to allow distancing. Guests should be symptom-screened on arrival and asked to use hand sanitizer and face coverings. To adhere to enhanced cleaning, venues should limit early arrivals and late checkouts; venues should also consider leaving rooms vacant 24-72 hours after each guest. Indoor pool use is not allowed.

• Short-term rentals: In addition to the above, rental operators can only rent out unoccupied units — no room rentals in an occupied residence. Guests should be able to self check in and out, and must be a household unit with no outside visitors.

For the complete guidelines, visit marinrecovers.com/hotels-motels-hospitality.

Guidelines for schools

The county’s Public Health Department also released guidelines for safely bringing students back to campus full-time in the fall that include having both teachers and students wear face masks, separating kids into stable cohorts and conducting daily health screenings for signs of exposure to the coronavirus.

The 30-point plan, which was developed with the county’s Office of Education and released June 18, is designed as a roadmap to help schools return to site-based instruction for the 2020-2021 school year after the pandemic abruptly shut down campuses in mid-March. All Marin County schools, including those within the Reed Union and Tamalpais Union High school districts, were forced to send students home and transition to a distance-learning program through the end of the school year in June as public-health officials scrambled to contain the virus’ spread.

Though public-health officials previously indicated students would likely need to split time between in-person and distance-learning in the fall, the guidelines pave the way for schools to have all students on campus for full school days five days a week — though it remains to be seen how districts will use the guidelines to formulate individualized plans for their own schools. The Tamalpais Union High School District, for instance, announced to parents last week it was planning to start the school year with a hybrid plan that splits on-campus time with distance learning.

“The goal is to see children and staff return to the classroom and to do that as safely as possible,” said Willis, the Marin County public health officer, in a release. “We’re partnering with our leaders in education to think creatively following these guidelines. Classrooms will look different than they did last year, but they’ll be open.”

The new rules require teachers and students, from transitional kindergarten up through high school, to wear face coverings while in the classroom and on campus, except where contraindicated.

For elementary-school students, the guidelines focus on creating stable cohorts of kids that will be maintained throughout the school day for the entire quarter or semester. While public-health officials previously suggested cohorts could be limited to 12 kids — as they currently are for summer camps allowed under the county’s shelter-in-place order — the school guidelines allow each cohort to be made up of a standard class size of kids.

The groups will use a synced schedule for arrivals, classes, lunch and recess to help prevent mixing of classroom cohorts, and frequent hand-washing will be built into the students’ daily routines.

In middle and high schools, where students are typically switching classes and classrooms throughout the day, larger cohorts can be formed with students from more than one classroom as long as accurate attendance data for students and teachers is maintained daily.

Teachers are allowed to visit or instruct more than one cohort of kids as long as they follow physical-distancing protocols and wear a mask, and they must document each visit to a classroom of kids that isn’t their primary cohort.

Classrooms will also need to be reconfigured to follow physical-distancing protocols, with students staying 4-6 feet apart from each other and teachers staying 6 feet away from students. Desks should also be arranged to face forward rather than in small groups.

There will be no more meals in the cafeteria, as the rules say lunch should be eaten in classrooms or outside. The guidelines also suggest schools think creatively in repurposing outdoor areas, gyms and multi-use rooms for instruction to facilitate physical distancing.

Large gatherings, such as school assemblies, will continue to be off-limits, and the sharing of electronic devices, clothing, books, games or learning aides should be limited.

Schools are also expected to implement plans for intensified cleaning, including regularly disinfecting frequently touched surfaces.

Staff and students will undergo daily health screenings to determine if they are showing symptoms or could have been exposed to the virus; a sample daily health screening for students linked in the guidelines leads to a four-question survey asking, among other things, if a child lives with or has had contact with anyone who has shown symptoms of or tested positive for the virus in the past 14 days.

The guidelines also say school staff will be tested for COVID-19 at the start of the school year and then “no less than once every two months” while noting testing may expand to include students with advance permission from their parents.

Local school districts will now be tasked with using the guidelines to come up with a plan to reopen their own campuses.

Reed district Superintendent Nancy Lynch earlier this month said the district was working on a few different models of instruction for the 2020-2021 school year, which begins Aug. 20, and she expected to be able to bring a plan to the district board for discussion by the end of June or early July.

Meanwhile, Tara Taupier, the superintendent of the Tamalpais Union High School District, said in an email blast to parents last week that the district plans to have a hybrid learning system in place when school resumes on Aug. 19 that would have students on campus at least two days a week while continuing some distance learning from home.

Taupier said the district hopes to have its reopening plan complete and ready to share with parents and students by the end of June.

In other developments

• Newsom last week announced that face coverings are now mandatory statewide in most public settings, rules that generally reflect those that have been in place in Marin since April.

People must wear them inside public spaces or while waiting in line to enter, when seeking health care, when using public transit including ride-hailing services and in common areas of buildings. Workers must wear masks in areas where the public is or likely will be present, around others, or any place food is being prepared or packaged for sale.

The biggest change is for face coverings for children: Marin’s rule said kids 12 and younger are exempt, but California’s stricter rule only exempts kids 2 and younger to reduce the risk of suffocation.

Face coverings are not required for the hearing impaired or those communicating with them, or for those with medical, mental-health or developmental disabilities that prevent people from wearing them. They’re also not required while eating or while recreating outdoors, as long as physical distancing of 6 feet can be maintained.

• The number of coronavirus cases at San Quentin State Prison has soared from 26 to 304 in the past week. The outbreak began when California Department of Corrections and Rehabilitation on June 8 confirmed that prisoners at the California Institution for Men in Chino had not been tested for weeks before nearly 200 prisoners were transferred by bus to other facilities. Chino had the deadliest prison outbreak in the state and on May 30 moved 121 prisoners to San Quentin, 14 of whom tested positive after they arrived.

• Some 43 workers at San Rafael-based Marin Sanitary Service have tested positive for COVID-19, according to the Marin Independent Journal. The entire staff of 288 has been tested.

• Marin’s unemployment rate for May was 10.3 percent, down from 11.2 percent in April and 2 percent a year ago, according to the California Employment Development Department.

Assitant Editor and education reporter Emily Lavin contributed to this report. 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.

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