California’s regional stay-at-home order lifted as state’s COVID numbers improve

With California’s coronavirus infection and hospitalization numbers showing signs of rapid improvement from high winter peaks, state health officials on Monday morning lifted the regional stay-at-home order, which had been in place for most of the state since early December.

The end of the order allows for wider business openings across three geographic regions that combine for 91% of California’s population: the Bay Area, San Joaquin Valley and Southern California.

The California Department of Public Health in a news release announced that four-week intensive care unit projections show ICU availability in all three regions above 15%, allowing the order to end effective immediately.

As for the state’s other two regions: Greater Sacramento already exited the stay-at-home order earlier this month due to improving projections for ICU availability; and the sparsely populated Northern California region had never fallen below 15% ICU availability since the system was introduced in early December, and it therefore never triggered the restrictions.

“Together, we changed our activities knowing our short-term sacrifices would lead to longer-term gains,” Dr. Tomás Aragón, CDPH director and state public health officer, said in a prepared statement. “COVID-19 is still here and still deadly, so our work is not over, but it’s important to recognize our collective actions saved lives and we are turning a critical corner.”

The state also announced that the “Limited Stay at Home Order,” which instituted a 10 p.m. to 5 a.m. curfew on non-essential businesses and activities, expires with the lifting of the regional order. In practice, few jurisdictions had enforced this curfew.

The CDPH news release says COVID-19 is “far from over,” but that there are “positive signs that the virus is spreading at a slower rate across the state.”

The state’s rolling two-week average for new lab-confirmed cases has fallen from about 40,500 to about 30,000 in the past 11 days, with the test positivity rate crashing from 13.4% down to 9.4%, according to state data updated Monday.

The statewide total for patients hospitalized with confirmed COVID-19 has fallen from a peak of nearly 22,000 on Jan. 6 to a little over 17,400 by Monday.

ICU numbers are declining more slowly, but have trended consistently downward for about two weeks. On Monday, the ICU patient total fell below 4,400 for the first time since Dec. 29.

Decreases are coming broadly across most well-populated counties in the state, CDPH data show.

Deaths, which lag behind these other data indicators by a few weeks, continue to come at a rapid pace. The state has reported an average of 504 COVID-19 deaths per day over the past two weeks, a tenfold increase from early November and more than triple the worst period during summer’s surge.

To date, California has reported more than 3.13 million COVID-19 cases and at least 37,118 deaths from the disease.

What does lifting the regional stay-at-home order mean?

When Greater Sacramento exited the regional order two weeks ago on Jan. 12, most of its 13 counties returned to the purple tier, which is the tightest of the four stages in that reopening framework but not as restrictive as the regional order.

CDPH and the Newsom administration confirmed in Monday’s formal announcement that the entire state is indeed moving back to the color-coded, tiered reopening system. This means the move out of the stay-at-home order will allow restaurants to reopen for outdoor dining and several other types of businesses including barbers, and hair and nail salons to resume operations.

As of an update last week, 54 of California’s 58 counties — combining for 99.9% of the state’s residents — were still in the purple tier. Across the Bay Area, San Joaquin Valley and Southern California, all but Mariposa County are in purple. Tier assignments are updated weekly on Tuesdays.

Why was the order lifted with ICU space low in some regions?

CDPH has said in previous updates that regions will be released from the stay-at-home order when projections looking four weeks ahead show their aggregate ICU availability at or above 15%.

CDPH had also said the order would be lifted statewide only once all five regions were simultaneously projected to meet or exceed the 15% mark, as is now the case.

State health officials had made note of some of the factors it takes into account for its mathematical projections on ICU space, but has not made the actual calculations available or posted precise percentages for these projections, including in Monday’s announcement that the order has ended.

Since Greater Sacramento departed the order nearly two weeks ago, the state continued to say simply that the region remains “at or above (the) threshold.”

The state does regularly update the region’s current, reported ICU availability. Southern California remained at 0% as of Saturday, while the San Joaquin Valley has escaped zero availability and is now at 1.3%. The Bay Area has boomed up to 23.4%, after having dipped into single-digits earlier this month. Greater Sacramento was at 11.9% and Northern California at 41.2% as of Saturday’s update.

Vaccine pace picks up a bit, but struggle remains

California over the weekend reported some substantial gains in how many COVID-19 vaccine doses it has administered. The total grew from about 1.8 million Friday to over 2.3 million by Sunday for a gain of more than 520,000 shots in two days, according to a CDPH dashboard.

But it remains unclear what portion of each day’s growth came from actual new shots administered those days, as opposed to vaccine providers like hospitals and county health offices reporting shots given previously within the past few weeks.

Data reporting has been one of numerous factors in California’s vaccine rollout frustration, as The Bee reported last week. And state health leaders maintain that California is only expected to distribute about 400,000 to 500,000 doses per week — which works out to, at most, around 71,000 shots per day — for at least several more weeks.

California is reportedly considering reorganizing vaccine priority in a way that would base the order primarily on age, not job category.

With supply limited, the state has tried to find a delicate balance of vaccinations between essential workers and populations that are most vulnerable to the virus like the elderly.

Top state health officials, including Health and Human Services Secretary Dr. Mark Ghaly, have acknowledged that the balancing act itself is slowing the rollout.

The federal Centers for Disease Control and Prevention, which on Sunday listed a lower total of about 2.2 million shots administered in California, reports that about 1.84 million of those shots have been first doses and 356,000 have been second doses. Both Pfizer and Moderna’s vaccines are two-dose regimens, designed to be taken a few weeks apart.

The 2.2 million dose total works out to 5,568 shots given per 100,000 residents, which ranks California 12th worst among the 50 states, according to the CDC. That’s still far from ideal, but the state had been seventh worst in last Friday’s update.

Placer County resident death investigated

Placer County’s local health office and the coroner’s division of the Placer County Sheriff’s Office in a joint statement Saturday announced that a resident died last Thursday, several hours after receiving a vaccine and about one month after testing positive for COVID-19.

The cause of death has not been determined, and “multiple local, state, and federal agencies” are investigating, the statement said. The county has not disclosed any information about the deceased victim’s age or background, and it did not say whether the vaccine administered was of the Pfizer or Moderna brand.

Numerous medical experts and science agencies, including the CDC and CDPH, have concluded based on data from large clinical trials that Pfizer and Moderna’s COVID-19 vaccines are safe and effective. Both were granted emergency use authorization from the Food and Drug Administration in mid-December.

Some health leaders have cautioned, especially as the COVID-19 vaccine is being given primarily to older populations, that some percentage of recipients will die shortly after getting their dose, but of unrelated causes, and that this will lead some people to conclude — inaccurately — that the vaccine caused the death.

“You get one chance to make a first impression,” said epidemiologist Dr. Michael Osterholm, a member of President Joe Biden’s transition advisory board, in a CNN story focused on anti-vaccine misinformation. “Even if we come back later and say, ‘No, (the deaths) had nothing to do with vaccination, it was coronary artery disease,’ the damage has already been done.”

The Placer County Sheriff’s Office posted the joint statement on the recent death to its Facebook page. The post has been flooded with more than 2,500 comments and it has been shared close to 3,000 times on the social media site.

Many of those comments shared concerns that posting about the death before any information about its cause has been officially determined will evoke unnecessary concern about the safety of the vaccine and undermine public confidence in it, to Osterholm’s above point.

The Sheriff’s Office responded, in numerous replies to Facebook comments, to these concerns by saying that it posted the statement to be transparent.

Even with no link confirmed between the vaccine and the fatality, news of the Placer County death has already spread widely. Local, national and international media outlets picked it up rapidly over the weekend.

Death toll in six-county Sacramento area approaches 1,700

The six counties that make up the bulk of the 13-county Greater Sacramento region — Sacramento, El Dorado, Placer, Sutter, Yolo and Yuba counties — have reported more than 130,000 combined positive cases and at least 1,682 virus deaths.

Sacramento County has confirmed 83,530 cases since the onset of the pandemic, and at least 1,185 of those residents have died of COVID-19.

The county added 1,464 new cases and increased the death toll by 28 on Monday for the three-day reporting period that includes the weekend, for averages of about 488 infections and nine deaths per day.

By date of death occurrence, December was by far Sacramento County’s deadliest month of the pandemic. County health officials have confirmed 372 deaths for the month — an average 12 a day. The death toll more than doubled that of August, the previous worst month, in which 181 county residents died of the virus.

Local health officials now say at least 133 county residents died of the virus between Jan. 1 and Jan. 19. That figure is still very preliminary as death confirmations can take weeks to be made official.

Virus hospitalizations in Sacramento County have trended on a steady decline while the ICU patient total remains elevated but may also be showing early signs of dropping. The overall patient total fell from 401 on Saturday to 374 by Sunday, staying near that at 377 with Monday’s update.

The ICU total, which hit a record-high 130 last Tuesday, is down to 107 as of Monday’s update. The state now reports 68 available ICU beds in Sacramento County, 15 more than on Sunday.

Placer County health officials have confirmed a total of 17,675 infections and 188 deaths, last reporting 91 cases and two fatalities Friday. The county also reported two deaths Thursday, and four on Wednesday.

State data on Monday showed 114 hospitalized in Placer, down from 118 on Sunday. But 27 are still in ICUs, a decrease by one in the past eight days, with only six ICU beds left available.

Yolo County has reported a total of 11,029 cases and 138 deaths, last adding 64 new cases on Sunday. The county reported seven new fatalities Wednesday but none since then.

State data showed Yolo with 29 virus patients Monday, down from a record-tying 33 on Sunday. The ICU patient total spiked from 11 on Saturday to a record-high 18 in Sunday’s update, according to CDPH, dipping down to 17 by Monday. One ICU bed was available, up from zero on Sunday.

El Dorado County has reported 8,002 positive test results and 59 deaths. The county reported 53 new cases and six deaths Friday.

Deaths are surging among El Dorado residents. Friday’s six new deaths were preceded by four reported Thursday and five on Wednesday.

That’s more than 25% of the county’s death toll for the nearly 11-month health crisis confirmed in just three days. Following just four deaths from March through mid-November, at least 55 El Dorado residents died of COVID-19 between Nov. 25 and Jan. 13, county officials say.

State health officials reported 23 virus patients in El Dorado hospitals as of Monday, up from 20 on Sunday, which had been the lowest total in nearly two months. The ICU total was at nine, up from seven on Sunday, with available ICU beds dropping from three to two.

In Sutter County, at least 7,927 people have contracted the virus and 83 have died, last updated Friday. Sutter on Friday added 72 new cases and one death, following 24 cases and three deaths Thursday.

Sutter County on Friday reported 29 residents hospitalized with COVID-19 including six in intensive care, each down by one compared to Thursday.

Neighboring Yuba County has reported 5,049 infections and 29 dead. The county added 36 cases and no deaths Friday following 18 cases and two fatalities added Thursday.

Yuba said Friday it had 23 residents hospitalized with the virus with four in the ICU.

Not all patients are hospitalized in-county, but the only hospital serving the Yuba-Sutter bicounty region — Adventist-Rideout in Marysville — had 53 hospitalized virus patients as of Monday, up 11 since Friday. However, the ICU total held steady at 12. The hospital had three available ICU beds in Sunday and Monday updates, up from two Thursday through Saturday.

The Sacramento Bee’s Adam Ashton, Vincent Moleski and Jeong Park; and The Fresno Bee’s Victor Patton contributed to this story.