County not in lockdown yet despite falling ICU capacity

Shelter-in-place order likely coming soon

W hile many surrounding counties went to stricter guidelines on Sunday and Monday, Solano County stayed with the status quo despite the county and its Bay Area region seeing a tumble in ICU capacity over the weekend.

That being said, a shelter-inplace order for the county could be right around the corner.

As COVID-19 case rates and hospitalizations continue to rise tremendously and threaten to overwhelm the hospitals and its workers, California health officials earlier last week announced a regional stay-at-home order that will be triggered if Intensive Care Unit (ICU) capacity drops below 15 percent in a given region.

The state is divided into five regions — Northern California, Bay Area, Greater Sacramento, San Joaquin Valley and Southern

California. Although Solano County is under the 15 percent capacity at 12.5, the county has not yet gone into a shelter in place order as it cited that its region — Bay Area — was still still above the 15 percent threshold at 25.7 percent as of Monday at 3 p.m.

“Solano County continues to follow the State’s current guidelines for addressing the recent surge in COVID-19 cases,” said Jayleen Richaards, public health administrator for Solano County Health and Social Services told the TimesHerald on Monday. “To add additional restrictions on top of what the State has already issued limits local businesses even further when they are not the cause of spread in Solano County. The primary contributor of spread in Solano County is personal behavior and people gathering with others outside of the household without following safety measures, like masking and physical distancing. We do not want to cause even more hardship to our local businesses.”

Solano County is currently in the purple tier of the COVID-19 levels. Solano is at 22.4 percent new COVID cases per day per 100,000 and is at 17.8 percent adjusted case rate for tier assignment. There is a 6.8 positivity rate (7- day average).

Despite the belief by some that only older people can get the coronavirus, 59 percent of the cases in Solano County have been with people aged between 18 and 49, according to Solano County public health records. Twenty percent of the cases in the county have come from people aged 50

to 64 years of age, while 11 percent of the cases are with people aged 65 years and older. The hospitalizations in the county are similar with 32 percent being between the age of 18- 49, 27 percent between the ages of 50 and 64, while 39 percent are 65 years of age or older.

Deaths in Solano County are a little different story. Only six percent of deaths have come from people aged 18- 49, while 74 percent of deaths have come from people aged 65 and older.

Yet despite these statistics, Solano County is one of 35 in the state that has not yet adhered to a shelter-in-place order. Twenty three counties have decided to go into lockdown, including nearby San Francisco, Alameda, Contra Costa, Marin, Santa Clara and the City of Berkeley. These counties closed despite the Bay Area region not being under the 15 percent ICU capacity threshold just yet.

While some counties like Solano are below the 15 percent capacity (12.5), some nearby counties are doing much better, like Napa County, which is currently at 47.8 capacity, Marin, which is at 45 percent, and Sonoma, which is at 21 percent capacity. San Francisco is at 23.6 capacity.

However, some stats may be a little flawed as many Napa residents go to Solano County for their hospitals stays. Other numbers between Napa and Solano aren’t too far apart as Napa is at 19.7 percent new COVID cases a day per 100,000, while it has a 9.9 percent adjusted case rate. However, Napa’s 3.5 percent positivity case rate is way below the 6.8 of Solano.

No matter what, hospital workers need all the help they can get.

“Like most health care providers in the state, Kaiser Permanente is seeing an

increase in the number of patients with COVID-19,” said Michael Vollmer, MD, Infectious Disease Specialist, Kaiser Permanente Vacaville in an email to the Times-Herald earlier this week. “While we wait for a vaccine, we encourage everyone to practice healthy habits to protect themselves, their families, and others. These include wearing a mask, maintaining physical distance, practicing healthy hand hygiene, avoiding crowded indoor spaces, and monitoring yourself for any COVID-19 symptoms.

“The increase in COVID-19 cases are creating an increased demand for testing and turnaround times for results may vary,” Vollmer continued. “It’s important to keep in mind that receiving a negative COVID-19 test in advance of a holiday gathering does not lower your risk of getting COVID-19 during the gathering. In fact, indoor gatherings have been one of the biggest driving factors of COVID-19 spikes in our region and nationwide. A negative test only confirms your negative status at the time of the test and doesn’t prevent you from getting and spreading the virus while interacting with others outside your household.”

Vollmer said that as cases have gone up, Kaiser has adapted.

“As the science regarding COVID-19 care has evolved, we have modified our practices to improve outcomes which can translate into reduced length of stay,” Vollmer said. “These interventions include using high flow oxygen, dexamethasone for patients requiring high levels of oxygen, remdesivir based on current national guidance, and proning techniques if a patient requires mechan

ical ventilation. We also have a COVID-19 monitoring program where patients receive follow up at home based on their risk level without necessarily requiring hospitalization.”

Although Solano County is not at the stay at home order level yet, that day is fast approaching.

“Currently the state projects that the Bay Area region would fall below 15 percent ICU capacity in mid- December or early next week,” Richards said. “Solano Public Health is urging residents to stay home and stop the surge, limit gatherings with people outside of the household, and wear a mask in public settings. Solano Public Health continue to monitor the situation closely with our local hospital partners and the state.”

Once the region does go under 15 percent, that area and its counties will have to go into a shelter in place order at 11:59 p.m. that day.

This means that private gatherings of any size are prohibited. Restaurants have to close to both indoor and outdoor dining. Takeout or delivery is still available. Bars and wineries, both indoor and outdoor will have to close. Restaurants will close to both indoor and outdoor dining. They can only do takeout or delivery. All retail stores can stay open, but must drop its capacity to just 20 percent. Hair salons, barbershops and gyms have to close.

Last mont h Va l lejo Mayor Bob Sampayan said he was worried about the economy if there was to be another shutdown.

“Look … I get it and I understand what people want,” Sampayan told the Times-Herald in November. “But we have to get rid of the virus soon. Yes we could have a vaccine, but we don’t know that for sure … I’m very worried about our economy and the small business person. They really have to struggle and they still have bills to pay, insurance to pay.”