Sonoma County remains in California’s most restrictive pandemic reopening stage

Although two Bay Area counties are among a group of five areas statewide that Tuesday finally were able to resume more business operations, Sonoma County remained stuck after nearly six months in the most restrictive stage of the state’s four-part coronavirus pandemic reopening plan.

What that means is restaurants, wineries and brewpubs will have to continue with only outdoor and takeout service. And many retailers must stick with significant limits to customers allowed inside stores at one time. There are a slew of other commercial enterprises, including fitness centers and movie theaters, that also will be subject to continued restrictions.

The reason this county remains stuck in the purple tier, the bottom of the state’s color-coded reopening blueprint, is really twofold. Although it has been spreading less in recent weeks, COVID-19 continues widely circulating here and the county now has the relatively new challenge of being handicapped by a sharp drop in residents being tested for the virus as the public turned its attention in December to vaccine efforts, local health officials said Tuesday.

Before Tuesday, 51 of California’s 58 counties, where 40 million people live, were also in the purple stage, denoted by widespread virus transmission, with Sonoma.

To respond to the roughly 25% drop in COVID-19 tests conducted daily since late December, county health officials explained to the Sonoma County Board of Supervisors that they are redoubling efforts to encourage more residents to be tested, and much more frequently.

Plans are, for example, to set up virus testing sites where people gather, such as food bank distribution centers, churches and in neighborhoods hit hardest by the infectious disease that has killed nearly 300 county residents since last March. Testing at markets and workplaces also is being considered.

D’Arcy Richardson, the county’s director of nursing for pandemic response, told supervisors the testing decline is occurring across the state and nation, as more people focus on getting vaccinated against the virus. She said people are also “a little bit weary of going out and getting tested.”

“We're trying to boost our efforts to get out to where people are already going because they're not coming to us,” Richardson said. “We need to go out and find them where they already are.”

The drop in testing since the lethal winter coronavirus surge in December and January is contributing to higher overall test positivity rates for the county and in low-income neighborhoods, health officials said. Both testing measures are used by the state to determine when individual counties can reopen their communities more broadly.

Local residents only have to look to nearby Marin and San Mateo counties, which both exited the dreaded purple reopening stage Tuesday, to see the advantage of maintaining a robust daily COVID-19 testing volume.

The state’s median virus testing level — meaning half the counties exceeded the mark, while half didn’t — among all counties was 386 tests per 100,000 residents for the period between Feb. 6 and Feb. 13, the most recent data. Marin County reported 627 daily tests per 100,000 residents, while San Mateo County logged 820 tests per 100,000 of the population.

The state awarded Marin a significant “adjustment factor,“ based on how much it tested above the median, that knocked down its daily virus case rate from 10.7 to 7 per 100,000 residents, the maximum level to be able to advance reopening. San Mateo’s high testing volume got its daily new case rate cut in half, from 11.1 to 5.6 new virus infections per 100,000 residents.

By comparison, Sonoma County reported a daily case rate of 14.6 per 100,000 residents during the most recent seven-day period. That rate was adjusted slightly downward to 14, because the county’s daily testing volume for the period was 415, marginally above the state median of 386 daily tests per 100,000 people. Even with the small reduction in the daily virus infection rate, the county’s latest total remains double the maximum seven new cases a day it needs to be permitted by state health officials to move ahead with reopening.

Viewed another way, it’s easier to understand the virus testing challenge facing county health officials. Since the end of December, the volume of COVID-19 tests administered daily countywide has fallen from 3,400 to just under 2,100 tests a day, meaning 1,300 fewer residents are getting tested each day.

As tests conducted have declined, the number of locals vaccinated has increased sharply since shots started going into residents’ arms in mid-December. While more vaccinations certainly will protect the county from big spikes in virus transmission, the number of vaccine doses handed out doesn’t presently factor into the state’s community reopening plan.

“The vaccine will help ... to make a big difference in the overall health” of the county, Dr. Urmila Shende, the county’s vaccination chief, told county supervisors Tuesday. “But we are definitely going to have to continue testing to see where the cases are, and to make sure that we get a balance between developing herd immunity and tamping down infections in the community.”

Supervisor James Gore, who is president of the California State Association of Counties, thinks it’s time for state officials to switch to a less complex set of benchmarks to measure community success fighting the virus, and use those factors to determine when further business and public reopening can occur and which restrictions would be lifted.

For example, Gore said, one new reopening measure should be the share of residents older than 75 who have been vaccinated with both COVID-19 shots. The county has prioritized that vulnerable group, and now 65% of them have gotten first inoculations and 11% are fully immunized.

“A lot of the people who were getting tested consistently before are getting vaccinated now,” Gore said. “The baseline has completely changed across the state and all these counties in terms of what they’re testing. So, we are pushing for and getting a lot of traction with them (state health officials) moving toward a reopening plan based on vaccinations.”

Until the state makes any changes to its Blueprint for a Safer Economy, officials gauge virus containment weekly in each county in the state on three metrics: average daily case, or infection, rate per 100,000 people; overall share of virus tests that are positive; and the share of positive tests in counties’ poorest neighborhoods. And COVID-19 testing volume over or under the state median level each week either serves to delay or boost chances for counties to reopen more business and public activities.

County Health Officer Dr. Sundari Mase on Tuesday underscored the critical nature of robust testing, noting that the state can adjust daily virus case levels downward sometimes as much as 50% when counties report high testing volumes.

The state’s reopening process places counties into four tiers, according to the level of virus spread. The most restrictive purple tier indicates widespread transmission, red designates substantial, orange shows moderate and yellow means minimal spread.

There are two ways for counties to advance to the next less restrictive stage. One is to drive down all three metrics the state uses to thresholds in place for the next reopening stage. Another avenue allows counties to move to the next reopening tier, if they can get both virus test positivity rates to meet the requirements set for two steps ahead.

“The other way to get into the red tier is to get that case rate into the red tier, which means that we need to test more so that we can get that adjustment factor,” Mase said.

To finally accomplish that, Mase and other public health officials spelled out in the most broad terms for county residents when they should be tested. Their bottom line was that having virus symptoms or being exposed to someone who contracted COVID-19 are obvious signals for immediate tests. But they said anyone who routinely goes out in public and mingles with people should put themselves on a testing regimen.

“Anyone who is out in public interacting with people outside their household on a regular basis should get tested on a regular basis so they know their status,” Richardson said. “Many people experience only mild symptoms and may not even be aware they have COVID, but can pass it on to others who may not be so lucky.”

The county’s nursing director for the pandemic battle elaborated on what regular testing could look like for certain residents.

“(Those) who are in contact with people outside their households should get tested every two weeks or every month, depending on the populations you are around and whether there’s anyone vulnerable in your household,” Richardson said. “The point is to find cases early to avoid transmission, and regular testing is the only way to do that.”

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