Sonoma County unlikely to end stay-home order Jan. 9, health officer says

Sonoma County is unlikely to end its current stay-at-home order when it is set to expire the night of Jan. 9, Health Officer Dr. Sundari Mase said during her final public briefing of 2020.

As coronavirus spreads locally at the highest rate of the pandemic while parts of the state are struggling to provide enough hospital beds for patients, it’s no shock that Mase is less than optimistic about reopening in a week and a half.

“I don’t predict that,” she said Wednesday. “Because we’ve already had a wave of gatherings for Thanksgiving that led to cases. We’ll probably see an increase from Christmas as well, traveling as well as gatherings. And New Year’s is coming as well. Jan. 9 is really right around the corner for us. So I don’t anticipate that we’ll be out of the state order on Jan. 9.”

That order, announced by California Gov. Gavin Newsom Dec. 3, ties the ability to gather in backyards and eat outdoors at restaurants to a region’s ICU bed availability. On Dec. 10, Sonoma and 10 other Bay Area counties preemptively adopted a collective stay-at-home order as the region approached the 15% availability threshold established by Newsom.

It’s hard to gain an accurate read on ICU capacity, a measure that can be fluid based on staffing and contingency plans. But the most up-to-date data from the California Department of Public Health shows Sonoma County with 20 available staffed ICU beds as of Tuesday. The county is licensed for 77 ICU beds, though that number can be lower based on available staffing.

Twenty available beds would put local hospitals above the 15% mark. But Mase said the overall Bay Area availability rate is at 7.5%, giving Sonoma and the other 10 counties little chance of escaping what many refer to as a “lockdown.”

“Realistically, the regional ICU capacity won’t be at 15% for at least several more weeks,” Mase said.

While Sonoma County hospital officials insist there are no current shortages of beds or staffing at their facilities, most of the metrics have gotten considerably worse since Mase issued the local order three weeks ago. In the 19 days following her announcement on Dec. 10, the county reported 3,170 new coronavirus cases, or 16.8% of all cases since the start of the pandemic. The daily average since Dec. 10 has been 242. Before then, Sonoma County exceeded that number just two days in seven months.

Even the good news is being tempered. One positive note through most of December has been the absence of fatality clusters at local skilled nursing centers and other congregant living sites for seniors. But as the county acknowledged Wednesday, that doesn’t mean the virus isn’t infiltrating local nursing homes again.

Kate Pack, health program manager of Sonoma County’s epidemiology team, said that since Dec. 8, 44 elder care facilities have reported at least one case among staff or residents, with 24 categorized as outbreaks — defined as three or more cases among staff, or one COVID-positive resident if the infection is determined to have been acquired on-site. Pack cited a total of between 243 and 249 cases here during the month in senior homes, including 137 in Santa Rosa and 59 in Petaluma.

According to the California Department of Social Services, there were 59 active cases among staff and 42 among residents as of Tuesday at Sonoma County residential care facilities for the elderly. That data is similar to, but doesn’t precisely align with, statistics from the state’s Department of Public Health, which notes 34 active cases among residents at Santa Rosa Post-Acute, 12 at Broadway Villa Post Acute in Sonoma and a lesser amount (the department doesn’t specify for numbers smaller than 11) at Cloverdale Healthcare Center, Park View Post Acute in Santa Rosa, Petaluma Post-Acute Rehab and Vineyard Post Acute in Petaluma.

“Overall, it’s an upward trend,” said Pack, who noted her team has identified positive coronavirus cases in about a quarter of the county’s long-term elder care facilities this month.

The trend stokes fears of a return to the dire conditions of the summer, when the county recorded 56 COVID-19 deaths in August alone. Over the course of the pandemic, right around two-thirds of all such fatalities in Sonoma County have come at elder care facilities.

The situation here, already worrisome, is made more so by the scenes coming from Southern California, where doctors at one medical center, Martin Luther King Jr. Community Hospital in Los Angeles, are treating patients in outdoor tents, in a conference room and in the campus chapel. Shortages in equipment that pumps oxygen to rooms led at least five Los Angeles County hospitals to declare an “internal disaster” Sunday. They were turning patients away.

While noting the gravity of those events, Mase does not believe it bodes future calamity for Sonoma County.

“We have really compared ourselves with other Bay Area counties, predominantly, because we’re right next to them,” she said. “We haven’t seen earlier what was seen in Southern California, like Imperial County. That never hit us here in Sonoma, with having to transfer COVID-positive patients out of our county because of our health care capacity being overwhelmed.”

Mase thinks that might be explained, in part, by Sonoma County’s early adoption of shelter orders — a move she helped put in motion again this month.

“So hopefully, again, we’re in front of that process. In other words, we’re ahead,” the health officer said. “I’m hoping that we won’t see what LA and other parts of Southern California are seeing as a result.”

Not everyone is thrilled with the idea of following more restrictive measures into some indefinite future beyond Jan. 9, of course.

Sonoma County Supervisor David Rabbitt acknowledged the need for safety during “a horrible contagion among us that can kill way too many people.” But he was confused when Mase joined other Bay Area county health officials in revising her order before the state required her to, and he wonders why it’s ICU capacity that has triggered the shutdown, when that metric is stable in this county. Mostly, Rabbitt wants more transparency from county staff.

“We just want people to stay home, to reduce contact,” Rabbitt said. “Well, then say that. I just hate not giving people the truth about why we’re asking them to stay home. Don’t say getting a haircut is the worst thing in the world, or that it’s worse than standing in line at Costco. If it were up to me, we’d have no hard closures.”

Mase began her Zoom session noting that just about everyone is looking forward to the end of 2020. That’s one point on which Rabbitt agrees with her.

“I think I’ve spent the entire year being frustrated,” he said. “I know I’m not the only one.”

You can reach Phil Barber at 707-521-5263 or phil.barber@pressdemocrat.com. On Twitter @Skinny_Post.