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New Sonoma County COVID-19 plan to focus on reducing cases among disadvantaged to reopen economy

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Initiatives being developed by Sonoma County officials to revive the local economy and restore public life specifically target the needs of disadvantaged communities as a means of reducing COVID-19 transmission, Sonoma County Health Officer Dr. Sundari Mase said Wednesday.

Though the multi-pronged campaign may have some elements that impact the broader population — especially if it works — planned interventions are intended primarily for those whose income or socioeconomic status put them at particular risk of exposure to the virus or prevent them from taking necessary measures to avoid passing it on, once they’re infected, Mase said.

The plan is to build on existing outreach and support for communities with disproportionately high rates of coronavirus infection and, in doing so, win permission from the state for expanded economic activity.

Sonoma County is now among 10 of California’s 58 counties with extremely restricted business operations because of statistical metrics by which it is considered to have “widespread’ coronavirus transmission. Neighboring Mendocino County is another. Each county has languished in the “purple” color-coded tier since Aug. 31, when the new system was introduced, even as other Bay Area counties have advanced into the more permissive, or “red,” tier.

“Many in the community, I understand, are frustrated by the many challenges facing Sonoma County in its efforts to open schools and the economy safely,” Mase said during a public briefing. “The primary drivers are socioeconomic disparities — the pressure (on) essential workers and those living on limited income to go to work despite safety concerns. Without sick leave or job security, these workers simply cannot afford to miss a shift. “In addition, lower incomes cause people to share transportation. More people are housed in less space, and there are fewer child care options.”

As a result, county health officials are working with the Board of Supervisors and other administrators to develop a package of options that would reduce COVID-19 transmission, targeting those in the lower socioeconomic quartile.

They include ramped-up outreach and testing among populations especially hard-hit by the virus, financial incentives that make it possible for people to stay home from work when they are sick and vouchers enabling them to stay in hotels near home so they can isolate while they’re contagious.

Details are being worked out, and it’s not clear when different initiatives will be rolled out, though both board Chair Susan Gorin and Vice Chair Lynda Hopkins have underscored the urgency of the situation, saying that county officials are authorized under the long-declared health emergency to take steps where appropriate on appropriate strategies that other counties have found effective.

“Real-time, I think is how we’re operating,” Hopkins said.

The nascent effort emerged in part from the state’s announcement last week of a new “health equity metric” by which California counties are to be assessed to determine if they are ready to move from one level of economic activity to another, Mase said.

The “health equity metric” measures how many positive tests are occurring among those in the county who have limited soioceconomic opportunity.

Along with number of COVID cases per 100,000 population over a seven-day period and what’s called the seven-day “testing positivity rate” — the percent of tests that come back — it’s used by the state to determine how safe it is for a county to expand movement and intermixing of people within a county.

Sonoma County has recorded 8,558 confirmed COVID-19 cases and 128 deaths since March.

It’s current case rate is 13 per 100,000, above the 6.9 allowed for a transition to tier red, with a positivity rate of 5.1% and 7.5% for disadvantaged individuals in the lower quartile.

Both are below the 8% threshold that would allow the county to move to a more permissive category if not for its elevated case rate, Mase said.

But even with the high case rate, getting the health equity metric level below 5% for two successive weeks would allow the county to shift tiers, “so this is what we’re striving for,” she said.

Officials have some federal CARES Act dollars and contingency funds to help finance the new initiatives and are hoping to work with business owners with a stake in resuming greater business activity, but it remains unclear how soon different strategies will in place.

It’s also impossible to predict how soon the desired impact on COVID metrics will be observed, given the fact that increased testing will likely drive up positive test numbers in the short term, Mase said.

Recent wildfire evacuations affecting more than 30,000 residents are likely to have some effect on local cases, as well, she said.

Hopkins said she sees diverse effects of the virus and ensuing business closures on people around the county. She contrasted people “who are extremely privileged and can work at home” with those “whose lives are on the line” because of where they work and others “who have created a beautiful, unique small business that they love, that their customers love and they’re worried it’s going to disappear forever.”

“I think we’re all very committed to do what we can to help flatten the curve and decrease those numbers so we can reopen some of those businesses,” she said.

You can reach Staff Writer Mary Callahan at 707-521-5249 or mary.callahan@pressdemocrat.com. On Twitter @MaryCallahanB.

Track coronavirus cases in Sonoma County, across California, the United States and around the world here.

For more stories about the coronavirus, go here.

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