JULY 13 — Gov. Gavin Newsom has ordered more than 30 counties, including Marin, to shut down indoor businesses amid a surge in coronavirus cases and hospitalizations.
Marin has been on the state’s watch list since July 3, which started a three-day clock that triggered the closure of indoor dining when case numbers didn’t improve by July 5.
As cases and hospitalizations grew across the state last week and more counties landed on the list, Marin and other counties on the list have now been ordered to shut down hair salons, malls and offices of non-essential businesses.
Had they been open in Marin, the county also would have been forced to shut down indoor worship, gyms, nail salons and other personal-care services.
Broader orders were also issued statewide, though none directly impacted Marin. Indoor dining was halted last week, while bars and wineries that don’t serve food, as well as family entertainment, zoos, museums and cardrooms either never reopened in Marin or don’t apply here.
Marin health officials last week had already put further reopening of the economy on hold as the county saw three single-day records for new cases — including a swelling number in Tiburon.
For Marin, California health officials are specifically monitoring case and percent-positivity rates, for which the state targets are to either have fewer than 100 new cases per 100,000 county residents over a rolling 14-day window, or to have both fewer than 25 new cases per 100,000 residents over that same period and have fewer than 8 percent of tests come back positive over a rolling seven-day window. Marin’s failing both metrics, with a 14-day case rate of 222.4 per 100,000 residents and a seven-day positivity rate of 10 percent, as reported by the California Department of Public Health on July 13.
The outbreak at San Quentin State Prison is not included in Marin’s figures.
At the same time, Marin set a new single-day record for cases July 8 with 75, then 63 more cases July 9 and 66 July 11. The previous single-day records were 57 on July 3, then 73 on July 4. Officials note that with a rise in percent-positivity, the new-case records reflect an increase in community transmission and not just an increase in testing, which is exceeding 1,000 tests per day on a rolling-seven day average — with some recent days nearing 1,500 tests. Marin’s testing baseline is 500 per day.
County health officials say the only way to get back on track is for residents to practice health guidelines, including the wearing of face coverings when you leave your home, practicing physical distancing of at least 6 feet with people outside your household and frequently washing your hands.
“We have the freedom to control our exposures, to control our behavior and choices, and it’s time to double down on those things, because the last thing we need is another source of infections,” Dr. Matt Willis, Marin’s public health officer, said in an online community forum July 10.
Tiburon Peninsula: 20 confirmed Tiburon cases per the Marin Department of Health and Human Services as of 4 p.m. July 13, up from 16 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: 1,809 confirmed cases, 1,312 recovered, 28 deaths, 26 current hospitalizations — 18 community, eight San Quentin — per the Marin health department as of 4 p.m. July 13. Up from 1,483 cases, 1,036 recovered, 19 deaths and 34 hospitalizations the previous week.
San Quentin State Prison: 1,437 cases and 10 deaths per the California Department of Corrections and Rehabilitation as of 3 p.m. July 13, up from 1,378 and six deaths the previous week.
California: 320,804 confirmed cases, 7,017 deaths, per the California Department of Public Health as of July 12. Up from 271,684 cases, 6,337 deaths the previous week.
U.S.: 3,296,599 cases, 134,884 deaths, per the U.S. Centers for Disease Control and Prevention as of 1 p.m. July 13. Up from 2,886,267 cases and 129,811 deaths the previous week.
World: 12,768,307 cases and 566,654 deaths, per the World Health Organization as of 1 a.m. July 13. Up from 11,327,790 cases and 532,340 deaths the previous week.
The state’s shutdown of indoor dining in Marin came less than a week after it had been reopened June 29 alongside campgrounds and picnic areas — which were allowed to stay open — and now-closed hair salons as part of a sequential reopening about every two weeks. Officials hoped to match the virus’s 14-day incubation window so they could monitor for any potential surges in cases and hospitalizations from previous reopenings.
The county was also hoping to open gyms, nail salons and hotels on June 29, but it pushed off those sectors as cases began to rise. Those industries, alongside body-art shops and services for electrology, skin care, tanning and massages are all now on indefinite hold.
“This is a surge that we’re seeing in cases in Marin,” Willis said. “Really the most rapid period of acceleration started about mid-June, and this is a pattern we’ve observed throughout the region and the state.”
He noted, however, that even with a spike in cases and a rise in hospitalizations, the proportion of hospitalizations has actually decreased.
“As we have more cases, there tends to be a higher proportion of people who are younger and in the workforce who are healthier,” he said.
The largest single group of infections is among residents ages 19-34, at 31 percent, despite making up just 15 percent of Marin’s population. They represent just 11 percent of hospitalizations.
The number of cases in Tiburon also jumped to 20 cases at The Ark’s press deadline July 13, from 16 the prior week. With a population of 8,992, Tiburon’s overall case rate is 222 per 100,000 residents, compared with neighbors Mill Valley at 129, Corte Madera at 332 and Sausalito at 385 cases per 100,00 residents.
The 94901 ZIP code of San Rafael, which includes the Canal area, remains Marin’s biggest community hotspot, with 803 total cases, or 1,951 per 100,00 residents. The influx there is driven significantly by a high rate of essential workers living in high-density, multigenerational housing. The ZIP code represents 45 percent of all of Marin’s cases. Hispanics also represent some 78 percent of all cases and 49 percent of hospitalizations despite being just 16 percent of Marin’s population.
County officials say they’re working with community- and faith-based organizations in San Rafael’s and Novato’s Hispanic communities to provide multilingual information to residents, to step up testing, to use a local county-Marin Community Foundation fund that helps sick residents stay out of the workforce for up to 14 days, and to provide hotel rooms for those who need to isolate away from their families.
Some 80 percent of deaths in Marin are people in skilled-nursing and residential-care facilities.
“Most of those outbreaks have occurred because a staff member brought it into the facility,” Willis says. “In fact, all that we have been able to track — which makes sense because the community is otherwise being sequestered.”
Some 19 facilities in Marin have current coronavirus cases, representing 60 patients and 35 staff members.
Deaths are also highest among Marin’s senior population, with 92 percent of all deaths being residents over age 65. Some 67 percent of all deaths are residents over age 80.
Marin officials are also monitoring the outbreak at San Quentin, a state-run prison, where there have been more cases in the past month than in the rest of Marin since the pandemic began. Some 1,437 inmates have been infected and 10 have died. Though testing, cases, cumulative hospitalizations and deaths aren’t part of Marin’s coronavirus numbers, active hospitalizations are, as they impact the availability of hospital and intensive-care beds, as well as ventilators. While eight of Marin’s 26 hospitalized coronavirus patients are San Quentin inmates, six of nine total coronavirus patients in Marin’s ICUs are from the prison.
Back on June 24, the Marin Board of Supervisors wrote a letter to Gov. Gavin Newsom requesting an incident-command center and field hospital be established at San Quentin, and now both are in place. Willis, a member of the incident-response team, says a warehouse used as a job-training facility has been converted into a 220-bed field hospital and opened on the grounds July 10. Infected inmates are being moved there to help separate them from the rest of the prison population.
“This will protect their health and help prevent transfers to outside hospitals,” he said.
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.