Coronavirus updates: 10 California counties cleared for more reopening as tiers are upgraded

Numerous California counties comprising several million residents were cleared this week to proceed further in the economic reopening process, but state and local health officials continue to urge people to follow mask and social distancing protocols to prevent another surge in coronavirus activity, and also to get their flu shots.

The state health department on Tuesday posted its weekly update of counties’ COVID-19 risk classifications. Ten counties with populations combining for more than 6.4 million improved to less restrictive tiers, and none of the state’s 58 counties were demoted to a more restrictive one.

Sacramento, Yolo, Butte, Contra Costa, Fresno, San Joaquin and Santa Barbara counties all moved from purple to red tier status. Amador, Calaveras and San Francisco counties moved from red to orange. None moved from orange to yellow.

CDPH bases its tier list assessments on two metrics for counties: rate of new lab-confirmed cases per 100,000 residents and percentage of diagnostic COVID-19 tests returning positive. Counties are then classified based on those figures into one of four tiers. From most to least restrictive, the tiers are: purple (“widespread”), red (“substantial”), orange (“moderate”) and yellow (“minimal”).

Improvement from purple to red represents the biggest leap. It allows for the return of indoor restaurant dining, along with the reopening of gyms, places of worship, movie theaters, shopping malls and a few other types of businesses and activities, all with restrictions that include hard capacity limits and mandatory face coverings.

Indoor restaurant dining had been disallowed by the state in Sacramento since July 1, in the wake of spiking COVID-19 activity. Now permitted with 25% indoor capacity, some local restaurants immediately jumped at the opportunity. Others said they simply can’t sustain enough profit to reopen at that level, and will wait until at least the orange tier, when they can fill 50% of their seats.

Schools in Sacramento and Yolo counties could also be allowed to reopen for on-campus learning as early as mid-October due to the improved classification. But with the logistical challenges that accompany such an undertaking, the speed at which campuses will actually reopen is unclear and will likely vary to at least some extent from district to district.

Over the course of the pandemic, more than 810,000 Californians have tested positive for COVID-19 and at least 15,792 have died, CDPH said Wednesday, reporting 152 new fatalities.

California numbers improving amid ‘concern’ about October surge

At the statewide level, both tier-list metrics have declined steadily and significantly since peaking in late July.

CDPH data as of Wednesday showed just 2.8% of tests returning positive in the preceding two weeks, after that number lingered near 7.5% for several weeks during summer. And statewide daily new infection totals have stayed below 5,000 for all of September — a stark contrast from the span of June 27 to Aug. 16, when more than 5,000 new cases were reported all but one day, and the day-over-day increase topped 11,000 seven times.

As September comes to a close, though, state leaders have recently expressed concern about those declines slowing down, if not reversing, over the course of October.

Health and Human Services Secretary Dr. Mark Ghaly said last week that health officials were starting to see the “concerning” impact of the Labor Day three-day weekend earlier this month. Ghaly, Gov. Gavin Newsom and numerous county health leaders have repeatedly pointed to holidays as critical moments in combating the pandemic. They’ve urged people not to gather with members outside their immediate households, saying there continue to be too many holiday get-togethers among large groups of friends and loved ones who are not observing mask and social distancing protocols.

Ghaly on Friday said he now anticipates a “concerning” uptick in COVID-19 infections that the state projects will drive hospitalizations to about double their current total: from just under 2,400 patients as of Tuesday’s update to over 4,800 by late October.

The reported total of hospitalized COVID-19 patients went from 2,317 on Monday to 2,392 on Tuesday, an increase of 3.2%. That’s the biggest one-day percentage increase since hospitalizations spiked 4% from July 12 to July 13. The figure stayed virtually the same Wednesday, increasing by one hospitalized patient to 2,393.

A one-day spike, by itself, is too small of a sample size to be definitive evidence that a longer-term trend will take shape. But given Ghaly’s recent comments on data projections, and the fact that Tuesday’s uptick snapped a nearly two-month stretch in which the hospitalization total declined almost every single day and increased by 1% or less on the handful of days it didn’t decline, it can be seen as an early warning sign.

“It really is about not letting our guard down as we did earlier in the summer,” Ghaly said in a Friday news conference.

In the earliest weeks of the pandemic, hospitalizations stabilized between about 3,000 and 3,500 from mid-April to mid-June. The total then surged over the course of July, peaking at 7,170 on July 21 before beginning a steady decline at the start of August.

California’s first reopening campaign, which lasted roughly from mid-May through mid-June, came to a screeching halt as those numbers soared. Reopening didn’t pick back up until more than a month and a half later, at the very end of August.

Global COVID-19 death toll surpasses 1 million

The worldwide fatality toll from the respiratory disease COVID-19 surpassed 1 million earlier this week, according to data maintained by Johns Hopkins University.

As it has now for months, the United States continues to account for more than 20% of the global death toll: 206,000 of the more than 1,009,000 who’ve died as of Wednesday morning, according to Johns Hopkins.

Next in terms of death toll are Brazil at nearly 143,000, India at over 97,000 and Mexico at 77,000. After those nations are the United Kingdom at 42,000 dead, Italy at nearly 36,000 fatalities, Peru at over 32,000, and France and Spain each approaching 32,000.

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Get your flu shot, health officials plead

Top hospital leaders and public health officials are calling with continuing urgency for Californians to get their flu shots as seasonal influenza arrives.

“(I)f we add on the potential for more flu patients, we will again be stretching our inpatient hospital capacity to its limits, and we would like to do everything we can to keep us from getting there,” Carmela Coyle, chief executive of the California Hospital Association, said on a media call last Thursday.

This past weekend, Sacramento County public health officials hosted the first in a series of free flu shot clinics. The clinic ended early because doses ran out.

“The earlier people get vaccinated, the better. It takes two weeks for the protective properties of the vaccine to take effect,” county Public Health Officer Dr. Olivia Kasirye said in a recent news release from the county’s Public Health Department.

Newsom emphasized the urgent need to avoid the so-called “twindemic” — a spike in COVID-19 and a nasty flu season combining to overwhelm California’s hospital systems — by getting a flu shot.

Playgrounds can reopen, with new rules

Outdoor parks and playgrounds can open statewide under new guidance issued Monday by CDPH. Indoor playgrounds and recreational facilities must stay closed.

The new rules require that everyone 2 years of age and older wear a face covering, and that children remain under adult supervision to ensure mask use.

The guidance also requires that playgrounds post a maximum capacity limit, and that different households maintain a distance of six feet from each other. Eating and drinking is restricted, in order to ensure mask use, and visits should be limited to 30 minutes when others are present.

Latest Sacramento-area numbers: Over 500 dead across region

Sacramento, Yolo, Placer, El Dorado, Sutter and Yuba counties have combined for more than 500 COVID-19 deaths and over 30,000 infections since the pandemic began.

Last week, Sacramento County reported its 400th resident death from the virus.

Sacramento County health officials have now reported 22,654 all-time infections and 420 deaths, with 64 new cases added Wednesday.

More than 170 residents died of the virus in August, after nearly 90 died in July, according to the county health office. Another 77 fatalities have been reported for Sept. 1 through Sept. 26, the county says.

Sacramento County had 122 patients in hospital beds and 32 in intensive care units as of Wednesday, according to state data. The numbers are down from peaks of about 280 hospitalized and 90 in the ICU as of late July; the recent ICU total matches the county’s lowest since July 3.

Sacramento County is now in the red tier.

Yolo County health officials have reported a total of 55 COVID-19 deaths among 2,828 infections, reporting just four new cases Wednesday. There were four infected patients in Yolo County hospitals as of Wednesday, with three of them in intensive care, each up by one since Tuesday. The county has three ICU beds available.

Yolo has seen outbreaks at several long-term care facilities, which account for 151 of the total cases and 27 of its deaths. The county, like Sacramento County, is now in the red tier.

Placer County has reported a total of 3,596 cases and 45 deaths, reporting nine new cases and no new fatalities Tuesday morning. There are 19 people hospitalized specifically for COVID-19 in the county, and the ICU count is down to six 11, the county says. Both are the lowest tallies in months. The hospitalized total had plateaued at around 65 in early-to-mid August before declining sharply; the ICU total peaked at 16 on Aug. 25.

Placer County was promoted from the purple tier to the red tier earlier in September.

El Dorado County has reported a total of 1,150 COVID-19 cases and four deaths, adding seven new cases Wednesday. The county reported two of its four fatalities earlier in September. One patient remains hospitalized and in ICU treatment with the disease.

El Dorado County improved from the red tier to the orange tier last week.

Sutter County has reported a total of 1,726 COVID-19 cases and 11 deaths, last updated Wednesday afternoon. There were nine infected patients hospitalized in the county, including one in intensive care.

In neighboring Yuba County, a total of 1,177 people have been infected with COVID-19 and eight have died as of Wednesday. There are four infected people in Yuba County hospitals, none of them in intensive care, the county said.

Both Sutter and Yuba counties, which share a bi-county health office, remain coded purple.

The Bee’s Rosalio Ahumada, Cathie Anderson, Tony Bizjak, Sophia Bollag, Theresa Clift, Benjy Egel, Noel Harris, Sawsan Morrar and Andrew Sheeler contributed to this story. Listen to our daily briefing:

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