As most of California has moved into Phase 3 reopening, the state is once again seeing COVID-19 cases and hospitalizations increase dramatically.
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The Department of Public Health has a watch list of counties that are being monitored for worsening coronavirus trends. In each case, the state is working with local health departments to identify the source of the problem and provide assistance as needed.
If a county is on the watch list for two weeks or more, the state will order the reopening to be delayed, Governor Gavin Newsom said at a news conference Monday.
The following counties are currently on the state “directed commitment” list:
Contra Costa County: East Bay County is being monitored due to an increase in hospitalizations that correlates with the reopening. Contra Costa is being asked to improve messages about the importance of wearing masks and testing, prepare the surge capacity of hospitals, ensure that nursing homes have adequate protective equipment, and educate people about tracking of contacts.
Fresno County: Fresno is in trouble for “elevated disease transmission,” especially in skilled nursing facilities and at Avenal State Prison. (While the prison is in Kings County, some of its employees live in Fresno and have brought the virus to the community.) Controlling outbreaks at those congregated facilities is key to removing Fresno from the list, DPH says.
Glenn County: Increased social gatherings, a church gathering, and a Mexico commuter are driving further transmission in Glenn County. In response, the county needs to speed up testing, contact tracing, and speed up how they handle suspicious cases.
Imperial County: DPH attributes the problem in Imperial County to two factors: “US citizens crossing the Mexican border seeking medical attention” and inadequate hospital staff. The county is being asked to increase testing, contact tracing, transporting patients to hospitals in other counties, and to create more alternative care sites.
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Kern County: Disease transmission and hospitalization are on the rise in Kern County. The state says it is due to outbreaks in nursing homes and state jails, as well as patients coming from Kern County hospitals outside the city. The county is being asked to increase the testing and public awareness of the protection team to control that the spread of the outbreaks does not go further.
Kings County: Not only is there high disease transmission and increasing hospitalization in Kings County, but hospitals are also approaching their capacity in a worrying way. An outbreak at Avenal State Prison has spread the virus to the entire community, and Kings County hospitals have admitted patients from other areas. Action items include controlling the prison outbreak as well as ensuring that hospitals are adequately equipped to treat patients and protect staff.
Los Angeles County: One reason why Los Angeles County has nearly half of the state’s COVID-19 cases is because of its large population and the fact that it is doing a lot of testing. Still, the county is being asked to closely monitor positivity rates as an indicator that community transmission is on the rise. They are also evaluating each resident and staff member at the county’s 235 skilled nursing facilities.
Merced County: Merced has seen outbreaks that date back to work environments and large homes, particularly in the Latinx community, the county says. To mitigate the situation, the county will increase multilingual messages about the importance of facial testing and coatings. They will also work to make companies safer so they don’t have to close.
Orange County: Hospitalizations are on the rise in Orange County due to increased meetings, transmission in the workplace, and congregated housing facilities. The county will be “collaborating with cities and the business community to increase public messages about the importance of social estrangement, not meet, and demand face coverage,” as well as increase testing.
Riverside County: The state has identified five factors that contribute to an increase in cases in Riverside County: outbreaks in prisons and nursing homes; large public protests in which people did not wear face covers; patients coming from Imperial County for treatment; patients who come from northern Baja California for treatment; and an increase in social gatherings. In addition to increasing testing, the county is told to educate residents about the importance of wearing face covers.
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Sacramento County: “Community broadcasting due to holiday gatherings between large families” has placed Sacramento County on the state watch list. The county is being asked to increase public messages about social distancing and facial linings and to increase testing in hotspot communities.
San Bernardino County: The increase transmissions here are largely attributable to large gatherings, workplaces, nursing homes, jails and prisons, and patients transferred from Imperial County. The county needs to speed up testing, contact tracing, and “work with laboratories and employers to increase response time from diagnosis to isolation.” Residents must also do a better job of wearing face covers to mitigate the spread.
San Joaquin County: The problem in San Joaquin County is an increase in hospitalizations and an increasingly limited hospital capacity. Suspected of this is the increase in social gatherings combined with broadcasts in the workplace, the state says. In response, the county is told to “increase public messages about the importance of personal protection measures and the risks involved in mass meetings in multiple languages.”
Santa Barbara County: The increase in meetings in the northern part of Santa Barbara County is accused of an increase in transmission. Reducing community broadcast and increasing contact tracking should help, the state says.
Santa Clara County A recent increase in hospitalization put Santa Clara County on the watch list. “Although the percentage change in hospitalizations shows an increase, the increase in the absolute number of hospitalized patients is low relative to the population size in Santa Clara County and low relative to the number of hospital beds available in the county, “says DPH. The county is working with hospitals to identify whether patients are local or from other jurisdictions, as well as increasing public service announcements in multiple languages about the importance of covering their faces and avoiding mass gatherings.
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Solano County: A large outbreak among farmers working in the Sonoma and Napa vineyards (but living in Solano County) is in part responsible for an increase in COVID-19 cases here. The county says those cases are in “many dozens.” Other cases also date back to family and social gatherings on weekends. The county is told to educate workers about social distancing using Spanish translators and to work with companies to ensure that working conditions are safe.
Stanislaus County: Stanislaus County is experiencing an “increase in outbreaks and clusters related to family reunions, businesses (in and out of the county) and health care facilities.” Health officials believe that people may not be following the guidelines for facial coverage and social distancing. The county is also being asked to increase rapid contact tracing to isolate positive cases more quickly before they spread widely.
Tulare County: Tulare County is interesting because not only do they report more coronavirus transmission, but also “increased hospitalizations and ICU use have been linked to multiple conditions in addition to COVID-19.” Preventing outbreaks in nursing homes and raising public awareness are two elements of action for the county.
Ventura County: The increase in cases in Ventura County has resulted in an increase in hospitalizations. Authorities believe the increase comes from broadcasts in large gatherings, overcrowded housing, essential workplaces, and nursing homes. They also believe they are detecting more cases since they opened more test-driving facilities. Action items for the county include: improving contact tracing, making sure nursing facilities have protective equipment, and continuing to send messages about social distancing and hygiene.
This story will be updated as counties are added and removed from the list. You can find more information at the California Department of Public Health.
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