Sonoma County on watch as most of California advances into COVID-19 shutdown

A second pandemic shutdown began this week for most of the Bay Area and more than 33 million Californians, the latest effort to curb record-shattering COVID-19 transmission rates that health authorities say threaten to overwhelm hospital facilities and staff.

Sonoma County, with a rising infection rate and new cases topping more than 1,170 over the past seven days, remains on the sidelines of that shutdown, though for how long remains unclear.

That’s because regionwide capacity at intensive care units in the Bay Area stood 10 points above a key threshold ― at 25.7% on Monday ― and has hovered in that range since Gov. Gavin Newsom announced his new regional approach Thursday. It requires more closures and restrictions on businesses should regionwide capacity drop below 15%. Five Bay Area counties, including Marin, opted not to wait last week and advanced their shutdown to this week.

“The bottom line is that, because we are not seeing the dramatic increase in case rates experienced throughout much of the state, we have decided not to join the five counties and the city of Berkeley that have chosen to immediately implement the state’s regional stay-at-home order,” Sonoma County Health Officer Sundari Mase said during her regular Monday afternoon briefing.

Twenty-two other counties in the San Joaquin Valley and Southern California came under the new requirements as of 11:59 p.m. Sunday, after the number of available intensive care beds in the region fell below 15% of total capacity.

Mase said that she had experienced no pressure to reconsider, even amid substantially increased case numbers, but said she expected more public discussion during her briefing of the Board of Supervisors on Tuesday morning.

What happens next is hard to project, given shifting conditions, both in terms of the effect of increased restrictions in neighboring counties and the ongoing conduct of local residents, Mase said.

Absent any immediate prohibitions in the Bay Area, state officials had predicted the region would reach the 15% tipping point between mid- and late December — after the rest of the state was predicted to do so. That still could be the case, as COVID patients who require hospitalization or even care in the ICU usually are infected for two or three weeks first, so those who stand to be admitted later this month likely already are among the county’s burgeoning caseload. It rose by 88 on Sunday and 183 on Saturday. The report for Monday was not immediately available.

But with Santa Clara, San Francisco, Alameda, Contra Costa and Marin counties already adopting new restrictions, it could take longer for the surge to impact regional ICU capacity to the point that it hits the state threshold, Mase said.

“It just depends on whether the other counties getting a little bit more restrictive right away will impact that, and that’s also hard to predict,” she said. “That mid-December may have been a good forecast, but now we have to see.”

Sonoma County public health personnel also are coordinating with the state to work out discrepancies in reporting of local ICU availability that further clouded matters last week. The confusion stems from the difference between “staffed” ICU beds and a larger number of “licensed” beds that officials say has resulted in significant under-reporting of county capacity for months.

County reports on its own website and those sent from local hospitals to the state did not accurately represent that capacity, with different problems affecting each. The county’s website overstated ICU occupancy because some of the patients shown as utilizing those beds in daily reports stretching back to at least May did not require that level of critical care and could have been moved to open space for someone who did.

The county has taken down hospital capacity information from its COVID-19 website while it resolves the matter, but state data updated Sunday showed Sonoma County with 57 hospitalized COVID-19 patients, including 15 in ICU, an increase of six from the day before. The county has 77 ICU beds and, according to the state, had 12 available as of Sunday, a capacity of 15.5%.

County officials also are imploring residents to take every action possible to slow the transmission of coronavirus by staying home when possible, avoiding unnecessary contact with others, observing social distancing and wearing facial coverings.

“The next few weeks are really going to be a make-or-break time for us,” said Paul Gullixson, the county’s communications manager. “We hope not to have to go to a stay-at-home order. We really want people to buckle down now and do what they can to stay safe.”

Sonoma County, since March, has posted 13,369 COVID-19 cases and 160 COVID-related deaths. Nearly 11,000 people have recovered, according to county statistics.

With the first, limited round of vaccines expected to be distributed in a matter of weeks, Newsom rolled out his new regional restrictions last week as a “bridge” through the winter surge until a Californians can be inoculated on a wide-scale basis.

In regions that fall below 15% ICU capacity, the measures call for closure of all restaurant service except takeout and delivery; personal care services like haircuts, nail salons and massage; customer business at wineries, breweries and distilleries; and stays at hotels and other lodging, except for essential travel or COVID isolation purposes. Retail stores are allowed to operate at 20% capacity or less and grocery stores at no more than 35%.

The restrictions are mandatory for three weeks and are to remain in effect after that until four-week projections of ICU capacity equal or exceed 15%.

Also Monday, Newsom announced that the state has been working with Google and Apple to develop a free, voluntary, opt-in mobile app through which participants can be notified of potential exposure to COVID-19 through contact with other program participants.

The CA Notify app is anonymous and has been tested at seven University of California campuses. It uses Bluetooth technology to exchange random codes that allow someone who tests positive for COVID to notify via the app those who have been within 6 feet for 15 minutes that they should be tested, speeding up the contact process and allowing people to quarantine before they expose others.

The system will start sharing information on Thursday. Interested users can download the CA Notify app for iPhone or Android from the Google Play Store. More information is available at CaNotify.ca.gov and Covid19.ca.gov.

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

Editor’s Note: This story has been updated to correct the available capacity of ICU beds.