Sonoma County supervisors health officer’s back decision to opt out of early stay-home measures

Sonoma County supervisors said they would stand by their appointed health officer’s decision to opt out of a preemptive move made by five neighboring counties to impose new stay-at-home measures before the entire Bay Area is forced into a second shutdown to preserve hospital capacity.

The support from the Board of Supervisors came even as local case rates continue to rise, along with hospitalizations, and as newly fixed state standards showed Sonoma County had a lower share of its staffed ICU beds available than anywhere else in the greater Bay Area.

Supervisors said they trust Dr. Sundari Mase’s assessment of the county’s COVID-19 caseload and treatment capacity, and unanimously embraced her decision to “watch and wait” before adjusting public health measures designed to slow the spread.

“We’re comfortable with the decision so far,” Chairwoman Susan Gorin said Tuesday.

But Mase, during a regular pandemic briefing, told supervisors that maintaining the county’s status could cut both ways, depending partly on how it’s affected by restrictions in other Bay Area counties.

While a regional approach to safety measures would limit the county’s ability to tailor rules to target local transmission issues, Mase said, having fewer restrictions in place than neighboring counties could draw more diners and other consumers to Sonoma County, encouraging the kind of unwanted travel that risks higher spread.

Additionally, if the additional business closures and restrictions in the five lead counties have the desired effect — reducing COVID-19 infections — it could slow the region’s approach to the trigger point for a mandatory second shutdown, Mase said. Remaining ICU capacity across the Bay Area stood at 24.5%, while the state’s trigger for a regional shutdown is below 15%.

“I think we’re in a dire situation where we need to make a decision as to whether we’re wanting to track this more closely — whether we want to move forward to more restrictive measures before a regional stay-at-home order goes into effect,” she said. “These are the things we need to consider right now.”

Mase also took time to explain an ongoing source of public confusion in recent days, arising from a discrepancy in the way the county was reporting ICU capacity and the state was assessing it. Going forward, Mase said, the state will assess each county’s available intensive care capacity based on staffed beds, rather than licensed ones. As a result, Sonoma County’s reported capacity will be lower — at an average 10.5% of ICU beds available over the past week, well below the regional trigger for a second shutdown.

“We are the lowest in the region in terms of ICU bed availability,” Mase said to the board.

No daily figures for ICU bed occupancy in Sonoma County were available from either the county or state on Tuesday, when total cases stood at 13,439, including 70 new confirmed infections Monday. The rolling seven-day number of new cases was 1,120, nearly twice what it was in mid-August, the last local spike. The death toll remained at 160 on Tuesday.

As the pandemic enters its tenth month amid soaring transmission rates around the nation, the local case rate had doubled, to 21 new cases per 100,000 people, an upward trend “that is very worrisome,” Mase told supervisors.

“We’ve had a lot of cases — that’s really what the take-home message is — in this past week. More than we’ve seen, ever, this week.”

Mase’s comments came during a 2½-hour briefing that touched on multiple facets of the county’s pandemic response and the new framework announced by Gov. Gavin Newsom last week to slow a statewide surge and preserve hospital capacity.

Statewide, more than 33 million Californians reside in counties that already have imposed the new restrictions, including bans on outdoor dining at restaurants, closures of bars, wineries and breweries, shuttering personal services like hair and nail salons, and capacity limits at retail stores and groceries.

San Francisco, Santa Clara, Marin, Alameda and Contra Costa counties were the first to act under that guidance, electing to advance early into a second shutdown rather than wait for their cases to get even worse.

Mase said she discussed the option to join those counties with supervisors last week as well as local hospital administrators before coming to her decision to wait.

She again engaged supervisors on that decision Tuesday, but the board took little opportunity to weigh in on the call or publicly discuss its implications. Instead, supervisors devoted more time in the briefing on plans for additional local stimulus aid, public health messaging on the pandemic and planning for the arrival of vaccines.

Supervisor James Gore went furthest among the board members at the meeting, telling Mase and her staff at one point that he appreciated the care and caution with which they approached the latest shutdown decision.

“I want to thank you guys for, on this one, waiting and seeing rather than being the first out of the gate and just tying into the other place,” Gore said.

Supervisor David Rabbitt said, “Dr. Mase, I told you I have your back, and if you tell us that we need to go into something more, I totally support you. If there’s something in between, I totally support you.”

In a later interview, Supervisor Lynda Hopkins, the board’s vice chairwoman, said she appreciated having a locally driven decision and said she trusted Mase’s acumen and judgment.

“I support Dr. Mase’s decisions, which is that she’s going to be tracking the data closely,” she said in an interview. “I think that she would come forward with a recommendation if she felt a sense of urgency to take action.”

Supervisor Shirlee Zane said in a text exchange she supported Mase’s decision, “given what the previous shutdown has cost this community in terms of businesses, jobs, schools, housing.”

But she also said she thought further restrictions in the county were inevitable.

“We have yet to see the surge from Thanksgiving, and if that happens next week, then I expect that she will shut down,” Zane said. “There will be no hospital beds and no other choice. We seem to be heading there now.”

Staff Writer Tyler Silvy contributed to this report. You can reach Staff Writer Mary Callahan at 707-521-5249 or mary.callahan@pressdemocrat.com. On Twitter @MaryCallahanB.