Sonoma County falls short of state’s new COVID-19 equity metric

Sonoma County is falling short of a new state requirement aimed at reducing the disproportionate impact of COVID-19 on minorities and disadvantaged communities, the latest evidence of the deep toll the coronvirus pandemic is taking on Latinos in the county.

The county is among four Bay Area counties that do not meet the new health equity requirement imposed by the state this week. Twelve of the state’s 35 largest counties have missed the mark, which applies to counties with populations greater than 106,000.

But Dr. Sundari Mase, Sonoma County’s health officer, said addressing COVID-19 disparities will ultimately benefit the broader community and could even help the county move faster through the state’s reopening plan.

“The health equity metric is going to help us and other counties move in the right direction,” Mase said.

Since the beginning of the pandemic, Latinos in Sonoma County have been hit harder than other racial or ethnic groups by the coronavirus pandemic, though local health officials have had some success reducing COVID-19 disparities.

In early summer, Latinos accounted for as much as 77% of all COVID-19 cases, though they only comprise about a quarter of the county’s population. Latinos now comprise 54% of cases, according to the latest county public health data.

The health equity metric, which took effect Tuesday, is the newest benchmark used in the state’s four-tier, color-coded reopening plan, which assesses counties on a weekly basis and determines to what extent they can reopen businesses and other activities.

The goal of the new requirement is to encourage counties to implement public health strategies that reduce the rate of virus transmission in minority and disadvantaged neighborhoods. State health officials say closing that gap will become crucial as counties move into less restrictive tiers that allow more movement and mixing in the general population.

“We’re incentivizing counties to reduce those infections across every neighborhood,” Dr. Erica Pan, acting state health officer, said Tuesday during a state press briefing announcing the new measure.

Under the new requirement, a county must show that test positivity in its most disadvantaged neighborhoods does not significantly lag behind the county’s overall test positivity. Test positivity is the share of all COVID-19 tests that detect the presence of the virus.

“The counties with the lowest disparities or least differences are going to move more quickly through the colored tiers,” Pan said.

The state defines disadvantaged neighborhoods as the bottom quartile of the California Healthy Places Index, a composite measure of socioeconomic opportunity. Census tracts in each county are divided into quartiles based on that index.

A county falls short of the health equity metric if test positivity in its disadvantaged neighborhoods meets the requirement for the next least restrictive tier.

In Sonoma County, the test positivity for the bottom quartile of all local census tracts is 8.1%, while the county’s overall test positivity is currently 5%. The county must bring test positivity down to 8% or less to exit the purple tier, the most restrictive in the state’s reopening plan, and enter the red tier.

The more elusive of the state’s benchmarks is the rate of transmission, or the number of new daily cases per 100,000 people. To get into the red zone, the county must bring its average daily transmission rate down to 7 or fewer cases per 100,000 people. It is currently 10.7 cases per 100,000.

Counties must meet all three metrics — equity, test positivity and transmission rate — for two weeks to advance in the state’s reopening plan.

However, counties that do an exceptional job of eliminating disparities in minority and disadvantaged neighborhoods can advance by meeting only two of the three requirements — a dynamic that could allow Sonoma County to bypass a metric that has been difficult to meet.

While the county has had success in significantly reducing its overall test positivity, it has been unable to exit the purple tier and meet the requirements of the next least restrictive tier because of a high case rate.

Just before the Glass fire, the county had gotten its case rate down to 8.4 cases per 100,000 and a test positivity of 4%. Because of the county’s robust testing, the state adjusted the local case rate to 7.8 cases per 100,000, barely missing the red tier requirement of 7 or less.

Kathryn Pack, health program manager for the county’s epidemiology team, said Wednesday the new healthy equity metric might actually improve the county’s chances to reopen sooner.

The new rules allow for “accelerated progression” where a county can advance to a less restrictive tier if test positivity for its bottom quartile meets the threshold for the tier that is two tiers less restrictive than the current. Counties can do so even if they don’t meet the case rate requirement for the next tier.

Sonoma County would be able to advance to the red tier if its overall test positivity were 4.9% or lower and 5.2% for its disadvantaged neighborhoods. The county would still have to show a decreasing case rate, but it wouldn’t have to bring it down to 7 or less cases per 100,000 people.

Pack and Mase said public health staff are aggressively focusing on testing Latinos and doing outreach in their communities and neighborhoods. They said targeting those most impacted by the virus will ultimately benefit the broader community and allow businesses to reopen sooner.

You can reach Staff Writer Martin Espinoza at 707-521-5213 or martin.espinoza@pressdemocrat.com. On Twitter @pressreno.