Marin's monthlong coronavirus lockdown begins noon Dec. 8

Marin County and five other Bay Area jurisdictions will voluntarily implement a new regionalized stay-at-home protocol announced this week by Gov. Gavin Newsom, with the local lockdown running noon Dec. 8 through at least Jan. 4.

As daily new COVID-19 cases, hospitalizations and deaths surge to record numbers around the nation, public-health officials from Marin, Alameda, Contra Costa, San Francisco and Santa Clara counties, as well as the city of Berkeley, announced Dec. 4 they would not wait for intensive-care-unit bed availability to drop below 15 percent, the trigger for the new state-mandated regional restrictions.

“Although Marin has fared better than some other counties in our region over the last few weeks, we know it is only a matter of time before rising case and hospitalization put pressure on our hospitals too,” Marin Public Health Officer Dr. Matt Willis said. “We must act now, and must act together to ensure all hospitals in the Bay Area have the capacity they need to care for our residents.”

Under a framework intended to slow a surge of infections that is already overwhelming some Bay Area and Central Valley hospitals, California counties on Dec. 3 were assigned to one of five regions. The Southern California region hit the 15-percent threshold the following day, the San Joaquin Valley Dec. 5; both are already under state-ordered lockdown. Marin is part of an 8.5-million-resident Bay Area region that includes the traditional nine counties, plus Santa Cruz and Monterey. As of The Ark’s press deadline Dec. 7, Marin had 24 percent ICU bed availability and the 11-county Bay Area region had 26.9 percent availability, according to Marin health officials.

However, while Marin and state public-health officials are publicly reporting seemingly exact percentages of bed availability to support the need for further economic restrictions, they have been unable to explain or provide the data being used to calculate the percentages that trigger the lockdowns — specifically the total number of adult ICU beds in Marin, the Bay Area and the state.

Hospitals are required to report the number of available staffed beds on a daily basis. On its coronavirus dashboard, Marin until last week had provided only ICU bed use by COVID-positive patients, but it has now added staffed bed availability in Marin and the percent available in Marin and the Bay Area.

The county does not publicly publish data for total adult ICU beds — the figure required for the percent-available calculation after accounting for unstaffed beds, or beds that may be in place but cannot be used due to individual hospital staffing capabilities, as well as beds already in use by COVID-positive and non-COVID patients.

Multiple Marin public-health and media-relations officials either did not respond to repeated requests for the complete data or stated they did not have access to that data for Marin, the Bay Area or the state.

“The capacity issue has come up many times before during the pandemic, and I have been unable to get a firm answer,” one Marin official said. “We are reliant on the hospitals releasing the data, and not all are keen on being so detailed.”

A representative of the California Department of Public Health Office of Public Affairs responding anonymously by email from a generic username also could not provide current bed counts for the state, Bay Area or Marin. The office referred The Ark to a county-by-county hospital-data spreadsheet dated April 13 — eight-month-old figures from less than a month into the original March stay-at-home order, before counties statewide took on massive expansions of bed capacity. The state did not respond to several follow-up requests seeking current data.

As of The Ark’s press deadline, no county or state official had provided the figures used for the calculations despite repeated requests.

The stay-at-home order is similar to the one issued in March, allowing essential travel and outdoor activity but generally barring gatherings with those outside your household except in certain circumstances, such as outdoor worship and protest, school attendance and child care.

Restaurants will be limited to takeout and delivery only, retail will be reduced to 20-percent capacity, worship events and political protest must be moved outdoors, and hotels and offices can only be open for “critical infrastructure” workers. Sports can continue but without a live audience.

Schools that are already open to in-class instruction, such as those in the Reed Union School District, will be allowed to remain open, but those that haven’t, such as in the Tamalpais High School District, must remain closed unless granted a waiver by the state.

Closed entirely will be personal-care services, including hair salons and barbershops; indoor gyms and fitness centers; bars, breweries, wineries and distilleries; indoor and outdoor playgrounds, indoor recreational facilities and overnight camping in campgrounds; museums and zoos; and all entertainment venues, such as movie theaters, amusement parks, casinos and card rooms.

While the six participating Bay Area jurisdictions will keep the order in place into January, the state could still order the entire 11-county Bay Area region into the lockdown for a minimum of three weeks if regional ICU bed availability drops below 15 percent.

If availability remains below 15 percent after that period, the order will be extended and regions will be re-evaluated on a weekly basis. Once availability improves above 15 percent, individual counties will again be reassigned to California’s color-coded four-tier blueprint for reopening the economy.

Under that blueprint, Marin is currently in the red tier for substantial transmission of the virus and is one of just six counties in California not in the most-restrictive purple tier for widespread transmission. While Marin has the second-lowest per-capita transmission rate in the state, Willis, Marin’s public-health officer, has warned the current rate of spread and potential fallout from Thanksgiving travel and gatherings and Black Friday shopping would soon put the county in the purple tier and roll into late-December holiday gatherings, compounding the surge into the new year.

Newsom warned of the same, saying the state is on the verge of a “surge on top of a surge.”

The 52 counties now in the purple tier, which include all 10 other counties under the state’s Bay Area grouping, represent more than 99 percent of California residents. Those residents are already subject to tighter restrictions and a limited stay-at-home order from 10 p.m. to 5 a.m.

Test positivity in California has doubled to more than 7 percent in the past month, with an average of about 15,000 new cases per day. The state reported a record 30,075 new cases Dec. 5. In Marin, 14-day test positivity soared to 3.9 percent, and the county has averaged 29 new cases per day for the seven days ending Nov. 30, compared with 10.7 new cases per day the seven days ending Oct. 31.

According to public-health officials, about 12 percent of all cases require hospitalization, and about 30 percent of hospitalizations — or roughly 3.5 percent of all cases — require use of an ICU bed or ventilator.

The U.S. Department of Health and Human Services reports California has 7,183 ICU beds, though that figure varies by the hundreds based on the source. In addition to non-COVID patients, as of Dec. 7 there were 2,470 COVID-positive patients in California ICU beds, with 1,714 beds available — the lowest number since late July — according to the California Department of Public Health. Based on federal bed data, that would mean the state has about 24-percent ICU bed availability.

Of 20 coronavirus hospitalizations in Marin as of Dec. 7, six patients require ICU beds, with 15 left countywide, according to the state. With 24-percent bed availability, that suggests Marin has roughly 63 total adult ICU beds. Again, however, complete Marin, Bay Area and state data was not available at The Ark’s press deadline.

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.