How does SLO County measure up to state coronavirus standards?
Coronavirus cases in San Luis Obispo County have continued to climb in recent weeks, reaching 1,644 cases Monday. So what would it take for some county business sectors to reopen?
A modified state order, according to the county public health department.
Some local business sectors, including gyms, hair salons and tattoo parlors, had to close their doors once again July 16 because Aan Luis Obispo County was in violation of the state’s reopening criteria for three consecutive days.
Weeks later, the county continues to add cases at a rate that exceed the state criteria. However, even if San Luis Obispo County’s case rate once again meets the state’s criteria, it will take a modified state order to allow the closed business sectors to reopen.
Once a county is on the state’s coronavirus watchlist for three consecutive days, certain business sectors must close and remain closed even if the county is removed from the watchlist, county health department spokesperson Michelle Shoresman wrote in an email.
“If our data improves, it is possible that we could come off the monitoring list. However, that alone does not change our re-opening status,” Shoresman wrote. “The state health officer must modify their orders allowing re-opening. We have not been told that there will be a new attestation process, at this time.”
San Luis Obispo County was placed on the state’s watchlist for failing to meet the case rate requirement — one of six criteria it must meet to remain open.
“Unfortunately, we’re still trending up,” county public health officer Dr. Penny Borenstein said at a July 22 news briefing. “We’re a population of roughly 280,000, so 280 cases in a two-week period is what puts us on the list.”
How SLO County stacks up to state COVID-19 criteria
The California Public Health Department developed four metrics to determine whether a county can safely reopen — testing capability, elevated disease transmission, increasing hospitalization and limited hospital capacity.
Testing capability is measured by the average number of tests the county performs over a seven-day period.
Elevated disease transmission is measured either by case rate over a 14-day period or testing positivity in a seven-day period.
Increasing hospitalization is measured by the increase in hospitalized patients within a three-day window. Intensive care unit beds and ventilator capacity is based on a point-in-time statistic provided by hospitals on a daily basis.
Here is a look at how San Luis Obispo County is holding up to state criteria.
Testing capability: Met.
To meet the state’s testing criteria, counties must be able to conduct an average over a seven day period of 150 tests per day per 100,000 people. In San Luis Obispo County that would equate an average of around 420 tests per day in a seven-day window.
According to state data, San Luis Obispo County conducted an average over the past seven days of 199.4 tests per day. Testing volume data has a seven day lag to account for delayed reports,according to the state website.
Although the county’s average number of tests conducted per day falls short of the criteria, San Luis Obispo County’s capacity to test far exceeds 420 tests.
The county has the capability to test more than 300 people per day through the county public health lab, which is reserved for high-risk situations and congregate care facilities. State-sponsored test sites test an additional 260 people per day, and private labs may test more people.
The county has recently requested that only people who have COVID-19 symptoms or have been exposed to coronavirus get tested through the state-sponsored testing facilities
Earlier in July, the county requested that only people who have COVID-19 symptoms or have been exposed to coronavirus get tested through state-sponsored testing facilities due to high-demand and testing result delays.
Low case rate: Not met.
The county must have fewer than 100 new cases of coronavirus per 100,000 people in the past two weeks in order to meet case rate criteria. In San Luis Obispo County, that would mean no more than 280 cases since July 13, or an average of 20 cases per day.
San Luis Obispo County has had 643 new cases from Monday, June 13 to Monday June 27, an average of 45.9 new cases per day. The current case rate is at about 227 cases per 100,000 people.
Less than 8% testing positivity: Met.
In order to remain within the state’s criteria, the case rate must remain below 8% on average over a seven-day window.
The current positivity rate as of July 28 is 6.1%, according to Shoresman, which is about 4% higher than it was a month ago.
Shoresman said the county’s positivity rate was 6.3% the week of July 13. On June 25, the county was at a 2.7% positivity rate.
The California Department of Public Health does not provide the positivity rate for counties that are meeting state criteria.
The health department website said the state calculates the rate with a seven-day reporting lag in mind. That means that a case positivity rate for July 28 would correspond to data from July 14 to July 21.
Less than 20 hospitalized patients or low hospitalization increase: Met
The hospitalization threshold calls for less than a 10% increase in an average number of COVID-19 patients in a three-day period, or fewer than 20 hospitalized patients.
In San Luis Obispo County, the number of hospitalized patients has not exceeded 16 since the virus reached San Luis Obispo in mid-March. Saturday and Sunday saw the highest number of COVID-19 hospitalized patients.
Over the last few weeks, local hospitalizations have been tending upward but have remained relatively low and stable as the overall case count continues to increase, Borenstein said at the July 22 news briefing.
“Hospitalizations, which as I’ve said on many occasions, is probably our most important metric,” Borenstein said. “It is an indication of not just the disease, but the severity of disease, which is of course what we all worry about.”
Borenstein said there is no “good answer” as to why hospitalizations have remained stable while cases rise. She said the county may see a surge in hospitalized patients in a week or so given the nature of COVID-19.
“We may be in a period where we haven’t yet seen our hospital rates go up but that may still happen,” she said.
ICU bed availability: Met
San Luis Obispo County has about 20 intensive care unit beds available as of June 27, according to data acquired by the California Department of Public Health.
The 20 beds meet state criteria for having more than 20% of the county’s intensive care unit beds available in case of a surge for coronavirus patients.
The exact number of intensive care unit beds in the county was not immediately available Tuesday afternoon.
Ventilator availability: Met
In order to meet the state’s criteria, more than 25% of a county’s ventilators must be available and ready for use.
While the California Department of Public does not list the exact number of ventilators available, San Luis Obispo County is meeting the required metric.
On June 30, Shoresman wrote to The Tribune that the county had 17 reserve ventilators and 20 on order, in addition to ventilators currently at local hospitals.
Update: An earlier version of this story used a June 25 positivity rate. The number has been updated to reflect the current positivity rate is 6.1%.
This story was originally published July 28, 2020 at 2:24 PM.
