Coronavirus updates: California puts most of state in purple tier, tightens mask order
The coronavirus crisis continues to intensify exponentially in the United States, and while California started its autumn surge from a lower baseline of activity than a large majority of states, its rates for new cases and hospitalizations continue to accelerate at alarming speeds.
The surge has been immense enough that, in an emergency move, Gov. Gavin Newsom and state health officials on Monday announced the most substantial rollback to the economic reopening process since early July.
Twenty-eight counties were demoted from the looser red, orange and yellow stages down to purple, meaning restaurants, gyms, places of worship and more must close in a vast majority of the state. Thirteen were already in the purple tier, including Sacramento and San Diego counties, which were placed there last week. The 41 total counties combine for more than 94% of California’s 40 million residents.
Newsom said in a Monday news conference that the state is “pulling an emergency brake” in response to the “fastest increase California has seen since the start of this pandemic.”
Additionally, nine counties moved to the red tier: Colusa, Del Norte, Humboldt, Marin, Modoc, Mono, Plumas, San Francisco and San Mateo. Calaveras and Sierra counties moved from yellow to orange. In those tiers, many businesses can stay open but must limit capacity.
In each of the three lower tiers, two counties maintained their tier assignments from last week: Amador and Lake stayed in red; Shasta and Inyo in orange; and Alpine and Mariposa in yellow.
The state made changes to the tier list, too.
Tiers can change day-to-day rather than on just a weekly basis, as data will be assessed continuously. And the state says it can move counties back more than one tier if necessary.
Counties previously had three days to implement the changes, but, because of “the extreme circumstances requiring immediate action, counties will be required to implement any sector changes the day following the tier announcement,” the California Department of Public Health wrote.
That means the 39 demoted counties have through Tuesday to make the necessary changes.
Most of the newly demoted counties had started in the purple tier and clawed their way to looser levels between September and early October due to improving coronavirus metrics. That’s been undone by widespread, spiking case and hospital rates in many parts of the state.
State mask mandate expanded
Accompanying the widespread demotions, state health officials on Monday tightened the face covering mandate. Masks are now required in the large majority of settings outside of one’s own home.
The primary change involves outdoor scenarios.
People can continue to be outdoors without a mask as long as there is no one outside of their household within 6 feet. But the rules now mandate that people who are outside “must have a face covering with them at all times and must put it on if they are within 6 feet of others” not in their household.
You still don’t need to wear a mask while driving alone or with household members, or while working in an office setting where you have a room or building to yourself.
Existing exemptions for those with certain medical conditions, the hearing impaired and those younger than 2 years old also continue to apply.
California by the numbers: Rates are soaring
The California Department of Public Health reported 9,875 new COVID-19 cases Saturday, officially shooting the state past 1 million lab-confirmed infections since the start of the pandemic. State health officials reported another 10,968 on Sunday, the most since Aug. 14, followed by 9,890 on Monday for a three-day total of nearly 30,000.
California has now averaged just over 7,000 new cases per day in the past two weeks. The daily rate was below 4,300 entering November, and it was under 3,150 two weeks before that on Oct. 18, state data show.
The growth is not a product simply of testing capacity, though that has recently seen a bit of a boost. Since mid-October, the two-week average for diagnostic tests returning positive for COVID-19 has gone from 2.5% to 4.6%, according to CDPH.
Test positivity is considered by health experts to be one of the most important metrics in tracking true spread of the virus. California has been below 5% positivity, which is what the World Health Organization recommends before economic reopening, since Sept. 3 but has seen the rolling rate rise an average of 0.1% a day in November.
The numbers of patients with COVID-19 in California hospitals and intensive care units have also surged sharply, exceeding 3,850 on Monday for first time since Aug. 30. Overall hospitalizations have leaped from a little over 2,500 on Nov. 1, a spike of 52% in two weeks. ICU cases went from just over 700 to over 1,030 in the same stretch, a 46% jump, according to the state health department.
Those growth rates are now slightly worse than the first two weeks of the summer surge, the June-to-August period that remains California’s worst stretch of the pandemic suffered to date. From June 15 to June 29, hospitalized COVID-19 cases increased 51% and the ICU total rose by 43%.
State Health and Human Services Secretary Dr. Mark Ghaly said in a Friday news conference that California is “absolutely” in another COVID-19 surge, given its climbing metrics. The case rate is now growing at about a 20% faster pace than it did in the outset of the previous surge, Ghaly and state epidemiologist Dr. Erica Pan said in a video presentation.
The surge has hit hard in the four-county capital region. Hospital totals have spiked substantially in the region, with Sacramento and Placer counties recording particularly sharp increases in recent weeks.
None of the growing figures show any immediate signs of slowing down statewide or in the Sacramento area, a fact that is more concerning than the raw numbers themselves as what may be the most critical period of the health crisis fast approaches.
More than 18,250 California residents have already died of COVID-19 to date, according to CDPH, and it still may be days or a few weeks before spiking hospital and ICU rates start translating into higher daily death tolls.
Prepare for Thanksgiving — or no Thanksgiving?
In droves, health officials and government leaders have cautioned for weeks that the tail end of 2020 will come with numerous, substantial challenges in mitigating coronavirus spread. Colder temperatures will drive people indoors, where the risk of spreading the contagious respiratory disease is known to be significantly higher than outdoors.
Public health officials warn that Thanksgiving by its nature is one of the most worrisome holidays because it combines multiple high-risk activities in terms of COVID-19 spread — gathering, dining, sharing food and so on. Health experts are strongly recommending not to gather with people outside of your immediate household and to consider a virtual Thanksgiving — but if you do choose to celebrate the holiday with others in person, there are many modifications you should consider to make the gathering safer for all involved.
After November, a spate of winter holidays capped by New Year’s celebrations will tempt more rounds of family-and-friend gatherings.
And, if it proves to be a particularly bad flu season, hospital systems could suffer under the weight of a “twindemic.”
Health officials are trying to sound the alarm before hospital systems face imminent threat of hitting capacity, as is already happening in other parts of the U.S.
But people are already fatigued, tired from having their normal lives and traditions uprooted for the better part of a year. Californians will have been under the statewide stay-at-home order for eight full months as of this Thursday.
Will restrictions be enforced? How?
State and local health officials have largely attributed the recent surge to an abundance of private gatherings in which people let down their guard on mask use and social distancing around friends and extended family members.
Even if the sharp rise in cases is linked mainly to get-togethers in people’s homes rather than reopened businesses, spiking COVID-19 cases in a region — regardless of original source — make community transmission more probable.
This makes high-risk businesses and activities such as restaurant dining, where one must remove a mask to eat and drink, even riskier, health officials explain. Ghaly on Friday first likened the tier demotions and closures of non-essential businesses to an “emergency brake” in times of surge.
In practice, state officials can only directly enforce shutdowns for businesses and services that are licensed through the state. This includes bars and restaurants with liquor licenses; it also includes barbershops and hair salons, though indoor haircuts are still allowed at all tier levels following a rule change in late August.
That leaves the bulk of enforcement in the hands of local officials, and most counties and cities have been hesitant to order closures except in the most egregious of instances. El Dorado County, for example, cited a handful of restaurants and suspended their health permits over the summer after they “flagrantly” violated COVID-19 guidelines.
Sacramento County health officials on Tuesday will ask the Board of Supervisors to approve an ordinance that would let the county fine businesses refusing to adhere to state and local restrictions, with emphasis on bars, restaurants and gyms, as The Bee first reported last week.
Good news from Moderna as nation, world await vaccines
Biotech company Moderna announced Monday that the COVID-19 vaccine it is developing appears to be 94.5% effective, based on an interim analysis from its ongoing clinical trial.
It’s an astonishingly high number, and it comes one week after Pfizer Inc. said its own vaccine in late-phase trials may be more than 90% effective.
Dr. Anthony Fauci, the nation’s top infectious disease expert, called Monday’s figure from Moderna “truly striking,” the Associated Press reported.
The U.S. Food and Drug Administration has set a prerequisite of 50% effectiveness for any vaccine candidate to be considered for emergency approval.
Fauci has previously said that a safe, 60% effective vaccine would be a good outcome. If numbers like those from Pfizer and Moderna hold up, vaccines that are 90% or 95% effective would contribute immensely to ending the pandemic sooner rather than later, once they can be widely distributed.
Either or both of the Pfizer and Moderna vaccine candidates could get emergency-use approval by the FDA, likely in December or January. The authorization would allow for the vaccine to be deployed to the most vulnerable populations.
Newsom has said California’s first round of available vaccines will go to health workers. Emergency-use vaccines after that could go to vulnerable populations such as skilled nursing facilities. Newsom said Californians should expect it to take “many months” before a vaccine is widely available to the general public.
Sacramento-area numbers: 686 dead, over 45,000 cases
The six-county Sacramento region has combined for at least 686 COVID-19 deaths during the pandemic and has passed 45,000 total confirmed cases.
Sacramento County on Monday surpassed 30,000 total cases and reached 527 confirmed coronavirus deaths with seven newly reported since Friday. The county added a record-high 496 new cases Thursday, followed by 327 on Friday and then 1,162 for the period of Saturday through Monday, which is an average of 387 per day.
Sorted by date of test collection rather than reporting date, 532 Sacramento County residents provided specimens on Nov. 9 that returned a positive result. A day later, last Tuesday, the county had 430 new cases by episode date. Both figures exceed the prior all-time high of 403 set July 20 at the peak of the statewide summer surge.
The county now estimates there are close to 4,900 currently active cases in residents. Though a rough estimate, that figure has boomed from roughly 3,500 last Wednesday, and is now well above the previous record of over 3,600 set during the summer surge. The rapid growth indicates that the rate of new cases is now far outpacing the typical recovery period for the virus, a concerning sign.
While Sacramento County is testing more people than it was in the summer, countywide test positivity rate skyrocketed from 3.1% to 4.6% in just the first week of November. The local health office COVID-19 dashboard does not yet have positivity data available for the second week of the month.
Hospitalizations are soaring as well. There were 172 patients hospitalized with coronavirus in Sacramento County and 48 in ICUs as of Monday, state data show. Both match the county’s highest figures since early September.
Ten deaths have now been confirmed for the first 10 days of November. The county’s October death toll stands at 54.
Yolo County has reported 3,863 total infections and 70 deaths from COVID-19, reporting six new deaths since last Thursday, including two Monday. The county added 49 cases Monday after reporting 56 on Sunday.
Yolo had 15 patients in hospitals with COVID-19 as of Monday. Six are in ICUs.
Placer County has reported 5,397 cases during the pandemic, adding 263 for Saturday through Monday, or about 88 a day over the weekend. Placer reported one additional death for 64 all-time. The county has reported five fatalities since Thursday.
Placer reported a massive spike in hospitalized cases: The county said Monday 70 patients are in hospital beds with confirmed coronavirus, 66 of them in hospitals “because of COVID,” up from 43 and 41, respectively, on Friday. Ten are in ICUs, eight of them specifically being treated for the disease, double the four who were getting COVID-19 intensive care treatment heading into the weekend.
The numbers diverge sharply from the state data, which as of Monday showed only 53 hospitalized and six in ICUs within Placer County. No explanation was immediately available for the difference, though it is not uncommon for changes in hospital data maintained by the state and by the county to lag one another by a day or so.
Placer on its dashboard says its test positivity rate was 5.5% for the week ending Nov. 7, the most recent span with data available. The rolling seven-day average surged a remarkable 1.5% in just five days and is now at its highest point since early August.
El Dorado County is one of a few California counties with a single-digit death toll, with just four fatalities since the start of the pandemic. Health officials have reported a tally of 1,701 cases after adding 64 Monday in a total that covers the weekend. The county reported a single-day record 37 cases Friday.
El Dorado has three hospitalized COVID-19 patients as of Monday, all in ICUs.
Sutter County health officials have reported a total of 2,399 people positive for coronavirus and 12 deaths. The county added 80 new cases Monday, a new daily record, after reporting 58 Sunday, 75 Saturday and 52 Friday. Sutter reported one new death Monday, but it’s not clear why the total of 12 fatalities didn’t change on the county’s website.
Eleven people infected with COVID-19 were hospitalized as of Monday, and two people were in intensive care, according to county health officials.
Yuba County officials have reported a total of 1,598 COVID-19 infections and 10 deaths. The county reported 36 new infections Monday. Yuba had four patients infected with COVID-19 hospitalized, with one in an ICU.
World numbers: 1,320,000 dead
The United States surpassed 11 million lab-positive coronavirus cases less than one week after hitting the 10 million milestone, according to data compiled by Johns Hopkins University.
Coronavirus activity in the U.S. continues to lead the world. The nation now has reported more than 247,000 deaths and is on pace to hit a quarter-million within a week.
The global totals are 54.8 million infected and over 1.3 million dead as of Monday afternoon.
Following the U.S. in death toll are Brazil at about 166,000, India at 130,000, Mexico at 98,500, the United Kingdom at 52,000, Italy nearing 46,000, France at over 42,500, Iran at nearly 42,000 and Spain at more than 41,000. Next are Peru and Argentina at over 35,000 dead, and Colombia at just over 34,000. More than 33,000 have died in Russia.
By total confirmed infections, India follows the U.S. with more than 8.8 million, and Brazil is next at almost 5.9 million. Russia has overtaken France, with both closing in on 2 million. Spain, the United Kingdom, Argentina, Italy, Colombia and Mexico all have between 1 million and 1.5 million cases.
This story was originally published November 16, 2020 at 9:49 AM with the headline "Coronavirus updates: California puts most of state in purple tier, tightens mask order."
