This week, California Health and Human Services (HHS) Secretary
Dr. Mark Ghaly announced improvements in COVID-19
transmission in nine counties today, allowing Alameda,
Riverside, San Luis Obispo, San Mateo, and Solano to move from
the highest purple tier to the red tier. El Dorado, Lassen, and
Nevada move to the orange tier, and Mariposa moves to the yellow
– or lowest – tier. He also indicated that the state would
release new guidance soon allowing nail salons to operate
indoors within counties in the purple tier.
The counties that moved to less restrictive tiers this week all
worked hard to implement local efforts to reduce transmission,
worked with communities on mask compliance, and implemented
important testing, tracing, and tracking efforts. The state as a
whole now boasts a 3 percent testing positivity rate
https://update.covid19.ca.gov/, and only about half of the
counties are still in the purple tier
https://covid19.ca.gov/safer-economy/.
CSAC has engaged daily with HHS Secretary Dr. Ghaly on these
issues to ensure more counties can safely progress through the
tiers while protecting vulnerable groups and local economies.
Specific CSAC requests include:
The original two metrics (test positivity rate and case rate)
should remain the sole metrics tied to county progression through
the tiers. Additional adjustments or new metrics would “move the
goalposts” as counties are already stretched thin trying to
comply with the existing requirements for reopening.
However, the case rate metric (average of 7 cases per
100,000) penalizes small counties; counties seek a mutual
solution with the state to correct this imbalance. The CSAC Rural
Caucus Working Group is actively engaging the state on this
issue.
Counties support the state’s commitment to a data
adjudication process and request that it be both timely and
adequately resourced by the state.
Health inequity work and outreach to vulnerable populations
is critical, but should not be used to determine county tiering,
but rather to measure progress toward reducing health
disparities.
Recent experience has led CSAC to seek additional time, from
two weeks to four weeks, from the state before a county has to
“move backwards” from a lower tier to a higher, more restrictive
tier. Two consecutive weeks of increasing cases or positivity
rates is a reasonable time period to identify a trend, but
counties request an additional two weeks of “probation” during
which local health measures can be deployed before adjudicating
the data for continuing community spread and, if necessary,
reinstituting closure orders.
CSAC will continue to provide updates and opportunities to engage
with the state on these critical issues.
