Nearly all of California has moved ahead to advanced Stage 2 coronavirus reopening plans – with much of the Bay Area a notable exception. How do the counties here compare on critical benchmarks to those areas reopening more quickly and allowing things like sit-down dining?
All California counties have been in Stage 2 for at least a few weeks, allowing lower-risk businesses to reopen. But progressing from “early Stage 2” to “advanced Stage 2” represents a big step, with dine-in restaurants, hair salons and schools allowed to reopen in the later phase. Just seven counties remain in early Stage 2 guidelines, and six are in the Bay Area: San Francisco, Alameda, Santa Clara, Contra Costa, San Mateo and Marin. (The seventh is Imperial in Southern California.)
To increase the pace for reopening, the state requires counties to submit attestation applications that share a laundry list of information, including clear protocols for safely reopening, new COVID-19 case and hospitalization rates, staffing levels for contact tracing, low positive test results, surge capacity at hospitals, and test sites within 30-minute driving time for 75% of residents.
We looked at some of the state’s criteria for moving further on reopening, comparing the data in Bay Area counties against that of some of the larger Southern California counties. Here’s what we found.
How the Bay Area compares on new coronavirus cases
In order for a county to have its application to advance approved, it must report fewer than 25 new coronavirus cases per 100,000 residents over 14 days, or fewer than 8% of new test results coming back positive over seven days.
As the chart at the top of this story shows, Los Angeles County, one of the last to be approved to move to advanced Stage 2, soars above the rest of the counties in terms of new cases, with 168 cases per 100,000 residents over the past 14 days. Los Angeles reported the highest single-day increase of cases on May 30 with more than 2,000 logged. Officials say the high number was partly due to a testing backlog. And Los Angeles has worked to increase testing capacity. In late April, Mayor Eric Garcetti announced that any county resident, regardless of symptoms, could receive a free coronavirus test. The county tested 10,000 in one day, three times the normal amount previously.
But Los Angeles, at more than six times the state standard, isn’t alone in not meeting the guideline on new cases. The chart above shows none of the larger Southern California counties is even close to meeting the state benchmark.
Among Bay Area counties, Santa Clara is the only one currently meeting the state guideline. Early in the pandemic, Santa Clara was the Bay Area’s coronavirus epicenter, with case spikes at the end of March and mid-April. But that has since changed, with daily case counts dropping significantly and remaining steady for the past month and a half. It’s given officials the confidence to advance further into Stage 2, allowing outdoor dining, shopping, child care and religious services to resume on Friday.
With many areas still not meeting the state’s benchmark for new case counts, these counties have justified advancing based on the alternative metric allowed by the state: percentage of positive test results over a seven-day span. All of the Southern California counties are under the state’s guideline of fewer than 8% of all tests performed coming back with positive results.
Orange County was barely below the state guideline according to numbers reported in its attestation application. The county continues to see spikes, most recently 213 new cases on Monday, one of the highest single-day totals during the pandemic. A number of these cases can be attributed to nursing homes and prisons. In early May, Orange County reopened its beaches.
San Bernardino also teeters on the line for both criteria. On May 23, with an average positive test rate of 7%, the county won approval to reopen restaurants and retail stores. Since then, daily case counts have remained high, and on May 28, there was a nearly 20% increase in ICU patients.
All Bay Area counties are well under the state guideline. Even Alameda County, which overtook Santa Clara in total cases after a recent spike, is reporting that about 5% of tests over the past seven days have been positive. That figure, while highest among the Bay Area counties, is better than most of the counties that are opening more quickly.
What about testing capacity?
The state’s required minimum testing volume to reopen faster is 1.5 tests per 1,000 residents. Though few counties ever actually test this many people, they must show the capacity to perform that number of tests in a given day — or justify on the application a reason if they can’t hit that baseline.
Alameda, where cases have recently been surging, is only halfway to reaching the state testing guideline. The county has doubled testing efforts over the past month, aimed particularly at low-income residents and communities of color where infection rates overall are higher. Two weeks ago, Santa Clara County began providing coronavirus testing to all county residents, regardless of symptoms, yet its daily average is just 53% of the state guideline.
But the guideline is based on capacity, not actual testing, and most Bay Area counties have surpassed the state guideline on certain dates, which would qualify them for approval. A recent report stated Santa Clara’s capacity for testing at more than 7,000 per day. San Francisco and Marin actually exceeded the state measure of tests per day over the past week.
It’s also important to note the Bay Area’s more strict checklist for a full reopening calls for two tests per 1,000 residents and none of the Bay Area counties has met that goal.
While Orange County made an effort in late April to ramp up testing, it has the lowest number for actual tests per day out of the larger Southern California counties. It averaged less than 31% of the state standard during the week it filed attestation papers. Los Angeles is the only one among these counties to actually perform the number of tests required to meet the benchmark at the time they filed their application.
How does the Bay Area compare on contact tracing?
The state guidelines for reopening faster require “at least 15 staff per 100,000 county population trained and available for contact tracing.” Most counties that have been approved did not have that level of staffing at the time of their application, but outlined a plan to hire and train adequate staff.
Only San Francisco and Los Angeles are actually meeting state goals for contact tracing. San Francisco has 276 tracers employed, which is more than twice the number required by the state. Los Angeles’ 1,759 contact tracers are 114% of the threshold.
Again, however, six counties in the Bay Area have set a stricter benchmark for contact tracing than the state, and none of the six counties have met that goal yet. For example, the state wants Santa Clara to have nearly 300 trained tracers but its stated goal is 1,000.
Gov. Gavin Newsom tapped UCSF and UCLA to build a contact-tracing army of up to 20,000 civil servants and volunteers via an online training academy. The goal is to conduct contract tracing for every single case in California, but all of the other counties are well behind the state guideline.
Todd Trumbull designed the graphics in this article.
Kellie Hwang and Mike Massa are San Francisco Chronicle staff writers. Email: firstname.lastname@example.org, email@example.com