Sonoma County has biggest one-day jump in coronavirus cases; peak expected in late May or early June

Sonoma County disclosed 16 new cases of coronavirus Wednesday, the largest single-day increase since the pandemic began, as the county's top public health officer said she expects COVID-19 cases to peak locally between May 28 and June 2.

That range of dates, a period when up to 1,500 residents could be hospitalized simultaneously with the respiratory disease caused by the virus, is based on preliminary modeling and Public Health Officer Sundari Mase cautioned she “would feel incredibly inaccurate in trying to predict a specific date” when the pandemic would strike hardest.

“We'll probably see our peak maybe two to four weeks later than those counties,” Mase said Wednesday in a media conference call.

With the 16 new cases, 83 people in Sonoma County have COVID-19 and 52 have recovered. A man in his 60s died last month from complications of the illness. The tallies are almost certainly an undercount because of testing shortages and many people carrying the virus are likely without symptoms.

Earlier this week, Mase did a rough calculation of the number of ultimate total of COVID-19 cases in the county. That figure, 7,500, was derived from current county data that shows about 1 in 5 confirmed coronavirus cases results in a hospitalization.

Though Mase expressed confidence in the impacts of sheltering in place, tracing contacts of people infected with COVID-19 and proper social distancing, she floated the idea of elevating the current recommendation to cover one's face when out in public to the level of a mandate.

“We are going to revisit the idea of facial coverings in terms of whether that should be more of an order rather than a guidance,” Mase said.

On Wednesday, Mase said the county's preliminary modeling does not show how many of the 1,500 people expected to be hospitalized at the local peak of the epidemic will require treatment in an intensive care unit or will need ventilators. She said the first phase of modeling is too rudimentary to show how many will die.

“That's what our modeler is working on right now,” she said. “I asked the team to specifically look at the difference in acuity … ICU beds versus med/surge beds versus a need for ventilation in an ICU setting. So we'll have those data I think soon.”

When asked during the press conference how long after the peak the shelter in place order would be extended, Mase said it depends on “what that curve looks like for our outbreak.” She said public health workers will be closely tracking the decline of the outbreak, both in terms of fewer hospitalizations and cases over a period of time.

“Again, it doesn't mean shelter-in-place has to be in for a very long time,” she said. “What it means is that we need to look at the impact of these other measures that we're putting in place.”

Efforts such at contact tracing, identifying quickly those who have the virus and removing them from the community, and self-isolation are all effective tools reducing the number of cases that occur at a given time.

“I'm hoping even that we might see some modification in that curve that we have as a model with these measures,” she said.

Sonoma County has performed at least 2,915 tests, and has been receiving roughly 200 tests per day. Mase couldn't say how many people would have to be tested on a daily basis to have a better idea how the virus is spreading locally.

She noted that county officials were looking to additional modeling data to determine “what level of testing we'd need to achieve, to have a better idea of the level of infection the community.”

Mase said she hopes the results of the new modeling will be ready by early next week.

“The more data we get, the more we can say about what's going to happen,” she said, adding that “The best case scenario is we don't have a surge at all, but I doubt that (will happen).”

One out of every 6 of the 16,957 confirmed coronavirus patients in California has been hospitalized, and about 40% of those hospitalized, or 1,154, have been placed in an intensive care unit, according to the state Department of Public Health. To date, 20 people in Sonoma County have been hospitalized with COVID-19.

Gov. Gavin Newsom, in a daily briefing broadcast over social media Wednesday, announced that California would buy $1.4 billion worth of personal protective equipment used by hospital workers, allowing the state to buy 200 million masks per month, including 150 million N95 masks coveted by nurses.

The Santa Rosa Fire Department announced Wednesday that an employee in its operations division has tested positive for COVID-19, with at least 10 others testing negative and eight others either quarantined, ill, awaiting test results or waiting to be symptom-free for 72 hours.

The city, through spokeswoman Adriane Mertens, declined to disclose the rank or position of the employee but said the person “is a first responder within the Fire Department and not a civilian employee.”

“This is an isolated case and has not presented any exposure to the Department or community,” Mertens said in an email.

Anticipating a surge, Sonoma County made a deal with Sonoma State University to create 580 makeshift patient beds at the Rohnert Park campus' recreation center and student housing. This “alternative care site” is for patients who don't need acute medical care, Mase said.

The move will dramatically expand the county's emergency stock of hospital beds as officials seek to avoid the grim scenes emerging from an overwhelmed New York City, where a park is being considered for temporary burials and National Guard troops have been photographed loading bodies into Enterprise rental vans. Mase credited the county's shelter-in-place order, a version of which has been effective since mid-March, with a massive reduction in expected coronavirus caseload and said the strict rules would help keep the local health care system above water.

“The modeling shows us that if we were not sheltering in place, we would expect to have five times more cases than we're expecting currently in Sonoma County,” Mase said.

Mase said the county was working with local heath care providers to prepare for a surge and would look to add more hospital beds - currently, there are not enough in Sonoma County to meet the anticipated surge.

But, Mase noted that hospitals have “surge plans” in place to deal with excess demands on the health care system and expressed confidence that, combined with extra capacity at SSU, “we will have enough beds.”

Responding to The Press Democrat's questions about staffing at local hospitals that have cut back on non-coronavirus procedures, Mase said she had not heard of any local hospitals having to cut any workers.

Hospital surge plans already account for additional health care workers, and the county may be able to help hospitals with staffing needs, Mase said.

She noted that state officials have “already been a big help” by adjusting some rules and that county officials were considering how best to use the Medical Reserve Corps, a volunteer program that bolsters the health care system during public health disasters, for which Newsom has called for more participants.

“Many are over 65, but there are options like having them care for people are non-covid in hospitals, while doctors who are under 65 could care for covid patients,” Mase said through a spokeswoman via email.

Of the nine people under 18 in Sonoma County who are confirmed to have COVID-19, Mase confirmed that four contracted the disease through contact with someone they know but declined to share additional information. Details about the other five cases were not available Wednesday night.

Responding to a community question on a webinar, Mase also said that people do not need to wear gloves when they leave their homes for essential activities but should instead focus on washing their hands, using hand sanitizer and wearing facial coverings when they leave home.