San Diego County remains in COVID-19 red tier

Rebecca Romero is assisted by Wendy Collins in taking the self administered COVID-19 test.
Rebecca Romero is assisted by Wendy Collins on Wednesday, Aug. 12, 2020 in San Diego, CA in taking the self administered COVID-19 test.
(Nelvin C. Cepeda / The San Diego Union-Tribune)

Out-of-bounds case rate reduced by local testing gains


Assured that the region’s current perch in the state’s reopening structure is secure for yet another week, county supervisors proceeded to reallocate millions in federal COVID-19 response funding Tuesday, Oct. 13.

Board members unanimously agreed, at the behest of Supervisor Jim Desmond, to shift $7 million of their total $388 million in CARES Act funding toward economic stimulus for businesses. They also agreed to make an additional $3 million available for local rental assistance and at least $2 million extra for local food banks.

A similar doling out of the goods, however, is not recommended for Halloween night.

Dr. Mark Ghaly, the state’s secretary of health and human services, shared public health guidelines that ask the public to forego trick-or-treating, parties and other activities that bring people together when coronavirus cases continue to pop up nationwide.

Overall, the health official recommended that the costumed masses keep their distance this year, participating in online revelry such as video costume contests and backyard candy hunts rather than collecting the loot door-to-door.

The physician, as indicated previously by Dr. Wilma Wooten, San Diego County’s public health officer, said the approach is a recommendation rather than a demand.

“We don’t want to turn, certainly, what is a celebration and a time of joy into something that is difficult or contentious,” Ghaly said.

Meanwhile, San Diego County continues to haunt the red tier in the state’s COVID-19 risk-ranking system.

For yet another week, the region skirted the scores that, if they continued for two consecutive weeks, would see San Diego County fall to the most-restrictive level, which is color-coded purple.

The system hinges on two main factors: the number of positive cases per 100,000 residents and the percentage of tests coming back positive as measured during a seven-day window that reaches back in time one week to account for processing delays.

By the state’s calculation, San Diego County saw its raw case rate per 100,000 hit 7.2 during the state’s Sept. 27 through Oct. 3 assessment window. That’s two-tenths of a case greater than last week’s score and slightly over the state’s limit of 7 for remaining in the red tier.

But San Diego County, as has been the case over the past two weeks, saw its raw rate reduced — this time to 6.8 — because it collectively performed 273 coronavirus tests per 100,000 residents, eclipsing the statewide median of 239.

For the second week in a row, the state gave each county a separate “health equity” score. This new number is a separate test positivity rate for the areas of each county scoring lowest in an index designed to highlight places with less access to resources necessary for healthy living.

This week, San Diego County areas with equity scores in the bottom 25 percent of a statewide index posted a collective positivity rate of 5.7 percent, nearly twice the 3 percent rate for the entire county. Last week’s rate was 6.2 percent, indicating progress toward a score of less than 5 percent that would allow the region to move to the orange tier, a less-restrictive level that would allow restaurants and other organizations to begin using 50 percent of their indoor spaces rather than the 25 percent allowed in the red tier.

On Thursday, Oct. 15, every county in the state is required to submit a detailed plan to the California Department of Public Health that details specifically how local public health departments plan to bring positivity rates in equity areas down.

Local health officials said little during a biweekly COVID-19 update to supervisors Tuesday, Oct. 13, about what steps will be taken besides adding testing locations in the most impacted areas.

They did, however, provide a long list of actions already taken, highlighting everything from prioritizing testing for at-risk groups to contracting for 1,000 hotel rooms to help residents isolate from family members. Rental assistance and educational and outreach efforts also made the list as did work with a handful of community organizations under contract to do contact tracing with specific demographic groups.

These groups represent the cutting edge of the county’s approach to reaching those who may not trust the government workers who quickly call each person in the region who tests positive, building lists of close contacts who are then called and counseled to quarantine if they have been exposed.

Thus far, county officials said, 3,812 close contacts identified by its own contact-tracing department have been handed off to these groups for further efforts after initial attempts to make contact did not get results.

South Bay Community Services, for example, has a contract to work with local Latino residents and employs a group of “promotoras” drawn from local communities to reach out, in person if necessary, to those who are not picking up when county tracers call.

Mauricio Torre, the organization’s vice president of program operations, recounted a recent experience with an San Diego State University student and part-time Uber driver who visited a party where testing confirmed a coronavirus infection.

The student, he said, did not pick up after many calls. Eventually, though, workers were able to get her on the line, he said, just as she was getting ready to “jump into her Uber car and drive people around.”

An offer of rent assistance and other help made available through county programs, Torre said, was enough to keep the student home. Having someone from one’s own community deliver the message, he said, is making a significant difference.

“That safe face, that caring voice, makes such a huge impact,” he said.

Tuesday’s county coronavirus report included 278 additional positive cases, six newly announced community outbreaks and 14 more COVID-related deaths. The deaths included eight women and six men who died between Oct. 3 and Oct. 11. All but one had an underlying medical condition.

— Paul Sisson is a reporter for The San Diego Union-Tribune