Coronavirus roundup: ‘It’s going to be weeks’ more on watch list, Marin health official says

JULY 27 — Marin’s coronavirus case rate remains nearly 2½ times what’s required to be taken off the California watch list — a list that mandates more than 30 counties roll back economic activity and halt any new reopenings, including in-class instruction. Health officials warn the local freeze won’t be lifted any time soon.

“It’s going to be weeks if our numbers continue as they are,” Marin Public Health Officer Dr. Matt Willis told the Marin Board of Supervisors at its July 21 meeting.

Meanwhile, hospitalizations and deaths remained stable, as did diagnosed infections in Tiburon and Belvedere, though Strawberry now registers for the first time on the county’s geographic breakdown with exactly 10 cases. With a population of 5,427, its overall case rate is 184 per 100,000 residents, compared with 26 cases in Tiburon, for a rate of 289 per 100,000 residents, and with 14 cases in Belvedere, or 736 per 100,000 residents, which remains the highest rate in Southern Marin.

Marin last week also lifted its ban on the use of reusable shopping bags, while new citation rules to enforce individual and business compliance with coronavirus safety mandates are now in effect.

Tiburon Peninsula: 26 diagnosed Tiburon cases, 14 Belvedere cases, 10 Strawberry cases per the Marin Department of Health and Human Services as of 4 p.m. July 27. Unchanged for Tiburon and Belvedere. Strawberry previously had an unknown number of diagnosed cases between zero and 10, with the figure withheld by the public health department in an effort to protect patient privacy.

Marin: 2,609 diagnosed cases, 2,147 recovered, 40 deaths, 17 current hospitalizations — 12 community, five San Quentin — per the Marin health department as of 4 p.m. July 27. Up from 2,288 cases, 1,699 recovered, 31 deaths and 32 hospitalizations the previous week.

San Quentin State Prison: 537 active cases in custody and 19 cumulative deaths per the California Department of Corrections and Rehabilitation as of 4 p.m. July 27, down from 922 active cases and up from 12 deaths the previous week.

California: 460,550 diagnosed cases, 8,445 deaths, per the California Department of Public Health as of July 26. Up from 391,538 cases, 7,694 deaths the previous week.

U.S.: 4,225,687 cases, 146,546 deaths, per the U.S. Centers for Disease Control and Prevention as of 1 p.m. July 26. Up from 3,761,362 cases and 140,157 deaths the previous week.

World: 16,114,449 cases and 646,641 deaths, per the World Health Organization as of 1 a.m. July 27. Up from 14,348,858 cases and 603,691 deaths the previous week.

Lingering on the watch list

Marin first landed on the state’s coronavirus monitoring list on July 2, starting a three-day clock to either improve certain criteria or face a rollback on economic activity. When the surge in new cases and hospitalizations didn’t improve by July 5, Marin was forced to shut down indoor dining, which had only resumed a week prior. As the number of counties on the watch list grew to more than 30, Gov. Gavin Newsom on July 13 ordered a further rollback on all watch-list counties, which in Marin applied to indoor malls, non-essential offices and hair salons, though officials later clarified that salons can continue certain outdoor operations.

Then, on July 17, Newsom said counties will have to be off the watch list for 14 days for in-class instruction to resume at schools, which in Marin was slated for late August, though Willis and the county Office of Education had already suggested in-class instruction not begin until Sept. 8.

The Reed Union School District board on July 27, after The Ark’s press deadline, was set to announce a plan to begin distance learning on Aug. 20 and follow later with in-class instruction.

When that can happen remains unclear. As of July 27, the county was still seeing nearly 250 new cases per 100,000 residents over a rolling two-week average, when the state’s maximum is 100.

The county continues to meet the state’s goals for daily testing volume, hospital capacity and stability in the rate of new hospitalizations, but it has been failing two overlapping standards for elevated disease transmission. To be removed, Marin must either have fewer than 100 new cases per 100,000 residents over two weeks or have both fewer than 25 new cases per 100,000 residents over two weeks and testing positivity below 8 percent over one week.

Testing positivity is the proportion of new cases per new test, rather than per capita, and with other data can potentially indicate changes in community spread regardless of fluctuations in testing volume. Marin’s data portal shows a 14-day average, rather than the state’s seven-day metric, which at The Ark’s press deadline had jumped up to 8.7 percent — up from just 1.8 percent in early May, when only essential and outdoor businesses were allowed to operate. While the state was still reporting that Marin meets the below-8-percent goal, its case rate is still too high to pass either objective.

“We’re seeing significant transmission of the virus in certain communities in Marin County, we’re doing a lot of testing and we’re ascertaining a lot of cases where they exist, and that’s really driving the numbers,” Willis said.

Contact tracing and increased testing can combine to boost both new cases and test positivity, as health teams tracing exposure histories for those diagnosed with the virus will order tests for close contacts who had high-risk exposure, such as members of a household — even if those contacts are

asymptomatic. That means the county can increasingly focus its testing on, and then identify, cases that may have otherwise gone undetected, but it also means those people can be isolated until they’re no longer contagious to help stem further spread.

The highest transmission rates remain in overlapping segments of the essential workforce and in San Rafael’s and Novato’s Hispanic communities, all of which trend younger and healthier, which is keeping hospitalization rates down even as so-called index cases bring the virus home to multigenerational family units.

Sometimes, however, transmission is less innocent.

“It’s painful when we see clusters of cases that are based on bad decisions, and we see this sometimes — an indoor party where our contact tracers will determine a cluster of 10 cases was rooted in a particular event that was illegal under the order and unwise in terms of our understanding of how the disease is transmitted,” Willis said.

The fastest-growing populations for infections by age group remain 19- to 34-year-olds, at 31 percent of all cases, followed by 35- to 49-year-olds, at 27 percent. Those 18 and younger are now the third-fastest-growing group, outpacing 50- to 64-year-olds and those 65 and older.

Hospitalizations continue to trend older, with 43 percent being residents older than 65. When including those over 50, that jumps to 67 percent. Deaths trend even older, with 66 percent of deaths being residents older than 80, or 94 percent when including all residents over 65. Willis says about 75-80 percent of deaths have been of people in residential-care or skilled-nursing facilities.

“The message is for all of us to do our part to reduce transmission in our community in the ways we know we can — covering our faces, maintaining physical distancing — those are very real correlates,” he said. “Those are the drivers of incidents that are going to prevent us from moving forward” with reopening the economy.

Reuse those reusable bags

County health officials have updated the countywide shelter-in-place order to allow customers to take reusable bags to stores — as long as customers carry them or leave them in the cart, then bag their own groceries.

Reusable bags had been banned from stores since March 31 as a precaution against the spread of COVID-19, as they’re a high-touch item. However, “recent studies have shown that virus transmission through reusable bags is a much lower risk than originally believed, and the risk is even lower if shoppers are the only ones to touch the bags,” county officials said in a July 22 press release.

New citation rules in effect

As expected, the Board of Supervisors on July 21 approved a new uniform, non-criminal citation framework for enforcing the county’s coronavirus public-health orders.

The urgency ordinance allows jurisdictions to fine individuals $25-$500 for violating public-health orders such as face-covering and physical-distancing mandates — a lesser penalty than the misdemeanor charge and $1,000 fine, jail time or both that has been on the books since April 17.

A new task force is also following up on tips from residents about businesses violating COVID-19 health rules — which can be submitted to SIPviolation@marincounty.org — and potentially issue citations of $250 to $10,000.

The fines would depend on the risk to public health, previous warnings and lack of a good-faith effort to comply, with consideration of a business’s increased revenue generated from not complying with the requirements.

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.