Statewide: Taking it slow, use color codes for risk levels
SACRAMENTO — California overhauled its rules for when businesses can operate during the coronavirus pandemic, imposing a statewide system that will allow for partial openings in areas where the disease is under better control.
Under the plan, unveiled Friday by Gov. Gavin Newsom, counties will be placed into four colorcoded tiers — purple, red, orange and yellow, in descending order of severity — based on the prevalence of the coronavirus in their communities and gradually move through those levels. Restrictions on business and public life will be eased as transmission drops.
Newsom said the approach is simpler, more stringent and, most important, slower than the first time the state reopened this spring. As the governor began to ease a statewide stayathome order in May, many counties moved swiftly to bring back businesses and revive their ailing economies, leading to a summer surge of new coronavirus cases.
“We don’t believe that there’s a green light that says, ‘Go back to the way things were or back to a prepandemic mindset,’ ” Newsom said at the news conference.
Much of the state may not immediately see any changes to public life under the new system, which takes effect Monday. Thirtyeight counties, encompassing 87% of the population, fall into the most restrictive tier, purple, where indoor operations for nonessential businesses largely must be closed. All Bay Area counties, except San Francisco and
Napa, are now in this tier.
Counties will have to improve in two key areas to progress from one tier to another: daily case rate and test positivity rate. They will also have to show progress in addressing health equity, which has been a major issue during the pandemic, with Black and Latino residents getting COVID19 at much higher rates than the rest of the population. More details on the equity benchmark will be announced Tuesday.
Previously, counties had to meet benchmarks for personal protective equipment, contact tracing, testing and hospitalizations in order to proceed with reopenings. While the state will continue monitoring those areas, counties will not need to meet specific goals in those categories to advance to the next tier.
Case rates are measured by daily confirmed cases per 100,000 people, to account for population. California, for instance, has a case rate of 10.9 cases per 100,000 people. San Francisco has a case rate of 9.8 cases per 100,000 people, according to the state.
The test positivity rate is the percentage of total tests that come back positive. The World Health Organization has recommended that countries keep the rate below 5% for at least two weeks before considering reopening. California’s test positivity rate is 6%. San Francisco’s test positivity rate is 3.4%. For context, states that have successfully tamped down the virus, like New York, have test positivity rates of 1% or lower. States that are struggling, like Florida and Texas, have test positivity rates between 10% and 20%.
Purple counties have more than seven new daily coronavirus cases per 100,000 residents and more than 8% of tests coming back positive. Indoor dining, gyms, nail salons and other personal care services, movie theaters, museums and houses of worship cannot yet open. Hair salons and barbershops will be allowed to reopen indoors and retail stores can operate with 25% capacity.
San Francisco and Napa County are in the nextlowest tier, red, where many of those nonessential businesses will be able to reopen with limited capacity. Bars, card rooms and office buildings must remain closed. The red tier metrics require a daily newcase rate between 4 and 7 per 100,000 people and a positive test rate of 5% to 8%.
In the orange tier, businesses can be open with some modifications and limits on capacity. The required metrics are between 1 and 3.9 daily cases per 100,000 people, and a positive test rate of 2% to 4.9%.
Businesses can be nearly fully reopened when their counties are in the yellow tier, which requires them to have fewer than one new daily case per 100,000 residents and fewer than 2% of tests return positive.
Hospitalization and ICU rates will not be formally considered part of the new framework because case rates and test positivity rates are earlier indicators of transmission, said Health and Human Services Secretary Dr. Mark Ghaly. Hospitalizations tend to trail new cases by several weeks. However, officials will continue monitoring hospital and ICU capacity and will work with counties to pause or backtrack if hospitals or ICUs become overwhelmed with COVID19 patients, Ghaly said.
Statewide, the number of people hospitalized and in ICUs for COVID19 have been trending down for the past several weeks. As of Friday, hospitalizations were down 40% compared with the peak on July 21, dropping from about 7,200 people to 4,200, Ghaly said. And the number of COVID19 patients in ICUs has declined about 35% from the peak on July 21, dropping from 2,058 to 1,329 as of Thursday, according to state data.
The state will update counties’ status weekly. Counties must spend at least three weeks in each tier before they can advance to the next one — a much slower pace intended to give public health officials time to monitor the effects of the changes on transmission of the coronavirus.
If counties hit the case rate and testing targets for the next level for at least two weeks, they will be allowed to ease restrictions further. If they miss the criteria for their current tier for at least two weeks, they will drop back a level and must adopt more restrictions again.
“Having four tiers rather than a binary system makes a lot of sense to me,” said Dr. George Rutherford, head of the division of infectious disease at UCSF. “Once you’re in a tier, you can’t change tiers for three weeks at least. Slowing things down will be very helpful . ... Slow and steady wins the race. This is a way to kind of keep everything clear and in front of us and not move too quickly. We know what happens if we move too quickly.”
Schools can reopen for inperson instruction in counties that have been in the red tier for two weeks. But counties in the purple tier can reopen elementary schools if they receive a waiver from the local health department.
But some local officials and businesses worry the new strategy may move too slowly.
“I do have concerns about how ‘slow’ the approach should be, considering the high numbers of businesses on the brink of closure and those who have already lost their jobs,” said San Mateo County Supervisor David Canepa.
California Business Roundtable said it is “gravely concerned that California will see a wave of permanent job loss.”
As coronavirus cases surged in California in June, Newsom began shutting down much of the economy again to slow transmission. By the middle of July, the governor had ordered bars, indoor dining, movie theaters and card rooms closed statewide. In counties on a state monitoring list for heightened spread of the virus, gyms, houses of worship, hair and nail salons, offices and shopping malls were told they could only operate outdoors.
The state’s new system eliminates the watch list in favor of the colored tiers.
At one point, the state was monitoring more than 40 counties, encompassing nearly the entire population of California. But as some — including Napa, Santa Cruz and the state’s secondlargest county, San Diego — fell off the list in recent weeks, pressure grew on the Newsom administration to provide guidance on how they could begin to reopen businesses.
A dropping caseload has given Newsom confidence to attempt a second reopening, which he promised would be more cautious and deliberate than the first. The sevenday average for new coronavirus cases has dipped to less than 6,000, well below a peak of more than 10,000 in late July, though still about three times higher than when the state first began rolling back lockdown measures in May.
Newsom also announced a deal this week to more than double California’s test processing capacity over the next six months, which he said could help the state return more quickly to public life.