Mase said that, given the increasing number of confirmed infections in the county and outbreaks in skilled nursing, as of Friday, there were 25 cases of the virus in such nursing facilities and residential care facilities for the elderly, it is increasingly likely that the county ends up on the state watch list.
“This should give us pause to learn about our own vulnerability here in Sonoma County,” he said Thursday, during his last public meeting before the holiday weekend, encouraging people to “stay” and avoid traveling outside of the county.
State and local landmarks
In early May, the state established a program through which counties could request the reopening of more types of businesses and public places than permitted under the California governor’s reopening plan. At the time, health officials from many counties seeking a faster resumption of business and industry introduced so-called “certifications” that included a series of public health metrics that they would use to measure respective local efforts to stabilize the spread virus, or essentially to keep the transmission curve flat.
For weeks, Mase used these local metrics she and her team compiled to measure the county’s ongoing virus containment efforts. Some of the county metrics were even more conservative than those now used by state health officials to identify struggling counties on the monitoring list.
For example, based on the original Sonoma County benchmark for cases per 100,000 residents over a 14-day period, anything above 25 confirmed cases per 100,000 people would prompt local health officials to consider implementing restrictions prior to public and labor activity.
Meanwhile, the state set the benchmark at 100 cases per 100,000 residents for a period of 14 days. Counties that exceed that 100 case rate would be flagged and ordered to close certain businesses again. On Saturday, Sonoma County’s case rate catapulted to 106 per 100,000 residents, its highest level and officially caused the county to fail to meet this key state benchmark.
Counties would also be in trouble if they had a case rate greater than 25 per 100,000 residents for 14 days, plus a virus test positivity rate greater than 8% of the population tested. Specifically, the positivity test is the average proportion of all COVID-19 tests that tested positive over seven days.
While the case rate in Sonoma County has been above the 25 threshold for over a month, the positivity of the tests has remained low at 2% to 3% for much of June and early July. , with more than 51,500 people evaluated.
On Wednesday, the day before Contra Costa County was removed from the state monitoring list, that county recorded a case rate of 74.9 per 100,000 residents, a test positivity rate of 4.3%, a decrease of 13% in virus-related hospitalizations over a three day period, the availability of hospital beds in the ICU of 53% of the total ICU unit space and the availability of the ventilator of 91%.
Monterrey, which joined the state monitoring list on Thursday, cited a case rate of 107.4 per 100,000 residents and a three-day hospitalization increase of 79.2%.
Local hospital, ICU beds
State requirements aside, Sonoma County now fails to meet several of its own metrics that track virus suppression, including increased hospitalizations and decreased ICU bed availability for residents with the virus sometimes deadly.
As of Thursday, the average daily percentage increase in confirmed cases of COVID-19 over the past week was 6%, slightly more than the county’s 5% threshold. Additionally, only 5.5% of the county’s 67 ICU beds were available as of Saturday. Because the county has 82% of the fans available at local hospitals, it still meets state hospital capacity requirements.
However, Mase noted that local hospitals could easily add beds to ICU units. And with such a small number of COVID-19 patients in hospitals, any numerical increase causes a large percentage jump in the short term.
Dr. Chad Krilich, medical director for St. Joseph Health Sonoma County, which operates the Santa Rosa Memorial and Petaluma Valley Hospitals, said there has been an increase in patients hospitalized with COVID-19. But the increase has been small and still very manageable.
Krillich previously said in the pandemic that started in March that the two hospitals would average a couple of patients with the coronavirus in the hospital at any given time. Hospitals now have an average of four patients.
“Overall, in terms of the number of patients actually in the hospital, it’s an increase,” he said. But Krillich noted that COVID-19 patients still account for about 1% of the inpatient volume.
