Mask mandate could remain in Sonoma County into new year
In a PowerPoint presentation for last week’s board of supervisors meeting, Sonoma County health staff prepared a slide showing the county’s status on the three benchmarks that define local masking rules.
Those three criteria are low rates of coronavirus transmission and hospitalizations, and high rates of vaccination.
The county was 0-for-3.
Dr. John Swartzberg looked at the data and concluded that people in Sonoma County will likely be living under an indoor mask mandate at least into January.
He thinks that’s a good thing.
“Sonoma could be kind of a poster child where I think these metrics might work,” said Swartzberg, a clinical professor emeritus at UC Berkeley’s School of Public Health.
For contrast, he pointed to Marin County, which on Nov. 1 dropped the mandate after meeting the benchmarks agreed upon earlier this year by seven Bay Area counties.
“You could even say it forced them to limit the mandates earlier than I imagine the health officer wanted,” Swartzberg said. “An argument could be made that setting up the criteria can be very valuable at one end of the spectrum, like in Sonoma, because it doesn’t allow you to remove the mandate before it makes sense. It can be problematic if it forces them to open too soon.”
Throughout the pandemic, Sonoma County Health Officer Dr. Sundari Mase, her staff and the officials who hired them have attempted to walk a tightrope between health and free choice.
They leaned toward health on Aug. 2 when, faced with the ascendance of the more transmissible delta variant of the virus, they joined Marin, San Francisco, Alameda, Santa Clara, Contra Costa and San Mateo counties in mandating facial coverings in a wide range of indoor settings, including retail stores, gyms and movie theaters.
More than 3½ months later, we’re still in mask mode.
That’s because we aren’t hitting the agreed-upon benchmarks.
To get there, transmission rates must be no higher than 50 new cases per week per 100,000 residents, for at least three consecutive weeks. Hospitalizations must be judged by the health officer to be low and stable. The vaccination requirement can be met one of two ways. The first is a vaccination rate of at least 80% of the entire population. The second is that the requirement will automatically be met eight weeks after COVID-19 shots became available for kids aged 5 to 11.
The last value is the easiest to gauge. While county leaders haven’t given up on reaching the 80% vaccination mark, it looks unlikely that Sonoma County would get there before the end of the year. About 74% of the county’s eligible population is immunized at this point.
“We can be hopeful for the 80%, but we definitely have a date for the eight weeks,” Mase said.
And that date is Dec. 24, Christmas Eve.
Getting the transmission rate in line could prove trickier. Sonoma County has been hovering above the threshold for months now. As of Friday, according to Kate Pack, the county’s lead epidemiologist, Sonoma was right around 68 new cases per week per 100,000 residents. That number has held fairly steady for several weeks, she said. And remember, even if the county were to drop below 50, it has to stay there for 21 days.
And controlling the spread of the coronavirus won’t get any easier during the upcoming holidays. In fact, it was about 10 days after Thanksgiving last year that Sonoma County, and the rest of California, began its plunge into the deadly winter surge.
“People will get together and travel,” Mase said. “The good news is we’ve got a high percentage of people vaccinated. And that might make a difference. And we don’t have a new delta (variant). Again, there’s no crystal ball, we have to wait and see. But we have some things in our favor.”
Of the three criteria for dropping the mask mandate, the one that comes with no numerical guidelines is the hospitalization rate. Swartzberg calls it “purposely vague.”
It’s loosely defined because health care systems vary so much between counties, Mase said. Hospital capacity is a fluid concept, too, because it includes things like possible shortages in staffing and PPE. It also involves looking beyond the county boundaries, since hospital groups like Kaiser Permanente, Sutter Health and Providence commonly transfer patients within their systems based on bed space.
“Certainly, we want to look at the number of COVID hospitalizations, and ICU cases,” Mase said. “But we also look at the overall hospital census, because we are seeing more deferred care. So patients are coming in with worse presentations of whatever condition they have.”
As of Friday, 27.8% of Sonoma County’s ICU beds were available. “We don’t have much wiggle room,” Pack said.