COVID-19 State Policy Update 07.13.20

Coronavirus

Today, Monday, July 13, 2020Governor Newsom provided a live update on COVID-19. The Governor began by stating he would provide an update on the trend lines and address the increasing infection rate across the state and announcing new state orders to mitigate the increasing rate.

The Governor told the audience the trend lines are causing great concern, as the positivity rate continues to increase, as well as hospitalizations and ICU admissions. He reminded the audience the true measure of community spread is the positivity rate and the verification of that is the hospitalization and ICU rates, all of which are increasing in some rural counties at an alarming rate that is stressing the hospital system in those counties, such as Butte, Imperial, and Lake counties. He told the audience state experts are working with mutual aid partners to secure needed PPE and ventilators for those counties and working with FEMA to secure more ventilators for the state, as the state inventory of ventilators are being impacted. He also reminded the audience that the positivity rate leads the lagging data on hospitals, which means as the positivity rate increases, it is a forecast of increasing hospitalizations and likely ICU admissions. These data, he noted, drive the management of state assets from PPE to hospital beds and ventilators. 

The Governor told the audience, tomorrow Dr. Ghaly, Secretary of Health and Human Services will provide a presentation of the newly reformulated Testing Task force, including announcing two new co-chairs. The Governor noted the new task force will specifically address the testing desert issue, where some areas of the state do not have the testing capacity needed, including some rural and inner cities. Additionally, the task force will also focus on education and the need to keep children safe in an in-person learning environment—this includes working with the California Department of Education to develop safety guidelines. The Task Force has also been working on new guidelines for employers. The Governor told the audience there is no “either or when it comes to education. This is not something up for negotiation. Children must receive the appropriate education and this must be done in a safe environment that addresses all concerns for virus transmission.” Information regarding the reformation of his COVID-19 Testing Task Force and strategic plans to move forward to improve testing and community services in areas of the state identified as “testing and service deserts” will be presented tomorrow. 

New State Orders

The Governor reminded the audience the approach to stopping the spread of the virus, developed and implemented many weeks ago, was to work not on an “on/off switch when it comes to the stay-at-home order and opening sectors of the economy, but rather a dimmer switch, which allows for modification of the stay-at-home order as needed. The point of the dimmer switch is to point to monitor trend lines and utilize data, science, and experience to reopen different parts of the state. We have seen, as people are beginning to mix in different parts of the state it begins to manifest different conditions and as a consequence we wanted to be prepared for those conditions and based on the trend lines, the data, and the science we must modify our stay-at-home order—meaning not an all open or all closed, not a ‘shutdown’ but a dimmer switch, as we look at current conditions throughout the most populous state in the nation and our trend lines raise concerns.” 

As a consequence of the increasing positivity rate, the hospitalization and ICU increases, today we are announcing new conditions, as it relates to our stay-at-home order in California. Effective today, we are ordering all 58 counties to cease all indoor operations in the following sectors:

  • Restaurants and wineries and tasting rooms 
  • Zoos and museums
  • Family entertainment centers, such as bowling, theaters, and video game centers
  • Card rooms
  • All bars, brewpubs, breweries, and pubs must shutdown—no indoor or outdoor operations

Again, the Governor noted this order applies to ALL counties, not only those on the Monitoring List. He encouraged these sectors to develop and expand outdoor activity, as that is allowed under the order if the facility is able to maintain appropriate physical distancing, masks are required, and appropriate sanitization steps are taken, as required in the published guidelines for each sector. Below under Navigating the COVID-19 Site, you will find links to updated guidance for each sector. 

New orders for counties on the Monitoring List

For the 31 counties on the Monitoring list, the follow sectors must close all indoor and outdoor operations, while the county is on the Monitoring List. 

  • Fitness Centers and gyms (read more here).
  • Worship services (read more here)
  • Offices for non-critical staff (read more here)
  • Personal services, including salons, barber shops, and nail salons (read more here
  • Indoor shopping malls (read more here

The Latest on the Monitoring List

The Governor announced four additional counties have been added to the state Monitoring List: Placer, Sutter, Yuba and Sonoma, which brings the list to 30 counties. The Governor stated he also expects two additional counties to be added to the list in the next day or two, including Alameda County. Governor Newsom expressed concern over the growing positivity rate in the counties on the Monitoring List, as the counties on the list represent more than 80% of the state’s population. The Governor reminded the audience the Monitoring List is a dynamic process, as counties may come on and back off of the list, based on their ability to meet their attestation requirements and mitigate spread of the virus—this includes monitoring the trends in the county, such as reducing their hospitalization and ICU rates. “We anticipate in the coming days the addition of at least one additional county to the Monitoring List—Alameda County. As a reminder, when I spoke to you last week, we had 23 counties on the list and today we are at 30 and will likely grow to 31.”

After three consecutive days on the Monitoring List, counties are subject to the new order (for at least three weeks), which includes ceasing all indoor dining in restaurants, closing bars, and no alcoholic beverages may be sold without an accompanying meal. Also, ordered closed under this order are museums, zoos, theaters, and family entertainment centers. New guidelines are provided for those sectors impacted by the order and include gyms and places of worship (read more about monitored counties here); (find the Monitoring List here). 

The new order applies to counties on the Monitoring List for 14 days or longer and requires the closure of bars and indoor operations must cease at dine-in restaurants (find guidance docs here), museums, zoos, family entertainment centers, movie theaters, and card rooms (read more here). Counties on the Monitoring List for three consecutive days, must close bars upon order of the local public health director (read guidance for bar closures here). New guidance documents were also published for other organizations where people gather in larger numbers, including gyms (guidance docs here) and places of worship (guidance docs here). Find guidance documents for all other sectors here.

The Numbers

The Governor stated it is critical to focus on not just the number of positive tests, as that does not tell the story of what is happening with the virus in the community—"only the 7-day positivity rate, coupled with the hospitalization ICU rate really tells the story of what is happening—these are the data we need to watch and base our decisions on regarding the stay-at-home order.”

Currently, there are 8,358 cases, since the last reporting period; however, the 7-day average is 8,211 cases this tells us the upward trend has grown to a point of concern. For a contemporary comparison, last week’s 7-day average was 7,876, so you can see we are trending upwardsThe 7-day testing rate is 107,287. The percentage of people testing positive—the positivity rate is 7.5% over the past 14 days and 7.4% over the past 7-day reporting period.”

The Governor reported the state conducted 138,000 tests yesterday and the teams continue to work on growing the testing rate. He noted it is critical to constantly monitor the trends, as they tell an important story and indicate what actions must be taken to control the spread of the deadly COVID-19 virus. Just a few weeks ago, the positivity rate was 4.9%, then it grew to 6.1% and now at 7.4% it represents a 21% increase from 6.1% to 7.4%. The hospitalization rate, which again he reminded the audience is a lagging indicator, has increased 28% over the past two weeks, which is only a little better than the 50% increase from a week ago. He noted this is a modest reduction but represents 8.7% of our hospital bed capacity. He reminded the audience the positivity rate is a forecast of what the hospitalization and ICU rate will do in the next two weeks—and at this point it is trending upward to a point of serious concern, as the experts do not want to see a continuing increase in hospitalizations, which could lead to stress on the system. He reported there are 73,867 beds in our hospital system and a total of 44,577 patients hospitalized at this time and 6,405 COVID-19 positive patients hospitalized. ICU admissions stand at 1,833 COVID-19 positive patients statewide; however, the Governor noted, this is a 20% increase over the past two weeks—we are at 16% of our total ICU bed capacity and in some counties the ICU bed inventory is stressed and has required some mitigation measures, such as moving some ICU patients to other counties where there are more beds available. He offered Imperial County as an example of a stressed ICU bed inventory.

There are 10,187 ventilators available, which is down from our consistent number of over 11,000 ventilators. “We have consistently been above 11,000 ventilators for weeks, so this increase in the use of ventilators has us concerned and we are watching closely, as this situation can worsen quickly. We continue to draw down from our inventory and have already been in touch with FEMA to secure more ventilators, if needed.” Governor Newsom reminded the audience these are all aggregate numbers, and as he has noted many times, we do not live in the aggregate, but rather “we live somewhere in the state and there are parts of the state in need of ventilatorsWe are starting to see in some rural parts of the state an increase in the ICU rates, which is also generating some concern.”

Let me be specific, in Placer, Butte and Imperial Counties ICU capacity is now limited—the rate is south of 20% of capacity which is requiring the assistance of mutual aid. We share assets and equipment. Lake County is another county of concern. When you start to see a little supply constraint, it draws our attention, which leads us to hit the dimmer switchI must remind all of you, this virus is not going away anytime soon. I hope all of us recognize that if we are still connected to some notion that the virus is going away on summer months or takes weekends off, this virus has done neither. In some parts of the country with very hot and humid climates (not just the dry climates) we are experiencing increases in the positivity rate, hospitalizations, and ICU admissions. Increases in community spread. It is time to recognize COVID-19 is not going away anytime soon.”

The Governor reminded the audience that until there is vaccine or more effective therapeutics, it is peoples’ actions that will stop the spread of the virus. He noted he is very proud of California’s role in developing vaccines and effective therapies, as the state is leading the nations in many respects, including advanced trials which are taking place. “Our ability to form effective partnerships with universities, federal labs, and the private sector and the ingenuity taking place in many of these areas is resulting in a lot happening in this space.”  The Governor added that the state has an Advisory Group that promises some rays of hope in the area of therapeutics, which he noted is very important because the reality is that when we look to the scale needed for an effective vaccine to be administered, including procurement, distribution, and needed quantity, to do justice to the state and the nation, we are a ways off from that being a reality. In the immediate term, he noted, we must rely on effective therapeutics to mitigate the mortality rate. He told the audience he is inviting members of the Advisory Group to make a public presentation of their work in the coming days. 

Contact Tracing 

The Governor noted there are now more than 10,000 people on the ground throughout the state conducting contact tracing and urged people to be honest with contact tracers, if they receive a call, as this is the only way to identify where and why the virus is spreading. He reminded people again that is our behaviors that are driving the increasing positivity and hospitalization rate. He stated it is important to avoid mixing with people outside of your home and it is family and friend gatherings are causing the increase and then those people go to restaurants, stores, places of worship, gyms and further spread the virus when they do not wear a mask. He noted this is common sense but unfortunately, he stated, “it is clear there are people who are not using common sense and that is leading to this deadly virus spreading across the state.”

Closing remarks

The Governor closed by reminding the audience it is the mixing with people outside of their homes that is partially responsible for driving up the positivity rate and spread of the virus. He noted the need for common sense and to follow the state order of wearing a mask or face covering when outside your home and when you cannot be at least 6’ away from others. “The impact of the spread of the virus is more favorable when outside than mixing with a group of people for an extended time inside where there is little or poor air circulation. We’ve seen based on contact tracing examples not only in California but other parts of the nations and the world, a concentration of the increase in the positivity rate where people are not following the guidelines. What more evidence do you need than to see the nations that have taken bold action to require masks have seen a corresponding reduction in the spread of the virusDo not be fooled by fewer deaths on some days, as we have seen a number as low as 6 but more often the rate is closer to 100 and has been over 100. This virus is a very deadly disease and it is now putting a strain on our hospital system and our ICUs. Please wear your mask, follow the guidelines. Do your part to help stop the spread of this deadly virus.”

Q&A

The first two questions focused on education and the reopening of schools and if it is safe to have in-person education when the Governor is taking action to pull back in other areas. The Governor responded by referring the reporters to the published guidelines for education and noted with more than 1,000 independent school districts throughout the state with varying conditions, it is up to each to determine how to proceed. He offered San Diego County as an example where they have already decided to proceed with distance learning, as the county has seen increasing rates of infection and has been on the state Monitoring List for several days.

Another question focused on testing availability and long wait times for results. The Governor stated this will be addressed tomorrow with Dr. Ghaly’s presentation. 

The next question focused on some confusion over the state Monitoring List being updated and some city officials in Alameda county stating they will defy the state’s orders. The Governor noted Alameda County is one of the counties coming onto the list and he hopes city leaders will follow the guidelines. State officials will work with county health and elected leaders by providing technical assistance to help the county mitigate the circumstances that led to them being added to the Monitoring List.

The next reporter asked the Governor to explain why protests are listed in the banned activities. He responded, after some clarification, that this refers to “indoor activity.”

The final question was about additional federal assistance the Governor is seeking and what the federal government is providing. The Governor noted the federal government has provided 190 healthcare experts to assist with decompressing some of the stresses on our hospital and staffing. The calls include governors sharing best practices and the COVID-19 Task Force providing expertise and advice to states. 

With that the Governor thanked everyone for their time and attention.

Wildfire evacuation protocols

on new protocols and plans to keep fire crews and the public safe from COVID-19 during wildfire season and community evacuations (Read more here). 

Key milestones – COVID-19 numbers – as of today (7.13.20)

The Governor noted the most important measures of the trajectory of the virus are the Positivity rate and the 7-day average; in some cases, only the 14-day average is available. 

  • 7,040 deaths, up by 23 overnight or +0.3% (72 people died Saturday); 14-day total 1,104 up 18.6% 
  • 329,162 positive cases - up by 8,358 +2.6%; 14-day total 109,910 up 50.1%
  • The state’s positivity rate continues to increase; the 7-day positivity rate is 7.7%; and the 14-day positivity rate is also 7.4%. It was 4.9%, just weeks ago.
  • 5,544,365 tests conducted; 1-day total 137,766; 14-day up 1,482,673 or 36.5%.
    • Latinos continue to have the highest percentage of positive cases at 55%; Caucasians 18%; Asians 6%, and Blacks 4%.
  • Hospitalizations for COVID positive is 6,485 up by 163 or 2.6%; 14-day rolling average is 5,838. Suspected patients with COVID-19 is 1,410, up by 122 or +8.0%; 14-day rolling average is 1,519.
  • The majority of hospitalizations are in LA County 2,103; followed by Orange County 674; San Bernardino 587; Riverside 513; San Diego 389; Kern 238; Fresno 203; San Joaquin 202; Stanislaus 188; Sacramento 175; Alameda 150; Santa Clara 129.
  • ICU – COVID positive patients in ICU is 1,833 up by 26 or 1.5%; the 14-day rolling average is 1,717. Number of suspected COVID-19 in ICU 228 up by 18 or 11.2%. Available beds statewide is 4,178.
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