Update: COVID-19 County Data Monitoring

July 02, 2020 | by Admin

Update: COVID-19 County Data Monitoring

The California-Nevada Conference has been monitoring the COVID-19 data for the counties in our area. As of June 29, 2020, there has been a sharp increase of new confirmed cases in California for the last 2 weeks, and in Nevada for the last week. [1]
 
The California Department of Public Health maintains a County Monitoring List for counties that have sustained elevated disease transmission, increased hospitalizations and limited hospital capacity. As of June 29, there were 19 counties on the monitoring list (12 of those in the California-Nevada area), with seven of those counties in the list for more than 14 days. [2]
 
The state of Nevada has 96% of all COVID-19 confirmed cases in two counties, Clark and Washoe (the latter in the California-Nevada area), that have more than 540 cases per 100,000 population. As of June 29, due to the trends of infection rates, the governor extended the Phase 2 reopening plans until the end of July. [3]
 
The California-Nevada Conference staff compiled the information in the next pages from the CDPH website. It lists the CA counties located in the California-Nevada area that are included in the County Monitoring List, the drivers of their situation and the key action steps to be taken. While there isn’t a similar list for NV, at this moment Washoe County is the one that the conference is monitoring more closely.
 
This information is revised periodically as the list changes frequently according to the data collected and the actions of the counties. Currently, the list includes counties from Central Valley, El Camino Real, Great Northern and Los Rios districts.
 
This document is being shared as a guiding tool for pastors, local congregations, district superintendents and conference leadership in the decision-making process about reopening churches and offices across the conference.
 
California County Monitoring List
https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/CountyMonitoringDataStep2.aspx
California is monitoring COVID-19 closely in each local community and keeping the public informed. Counties (in the California-Nevada Conference area) currently being monitored at this step, the drivers of their situation, and key action steps identified are below:
Contra Costa County is experiencing an increase in hospitalizations.

  • County reports this is in parallel to a rise in community transmission as residents move away from shelter in place and resume more normal routines.
  • Key actions to address the increase include 1) working with communities and community-based organizations to share messaging about face coverings and other prevention techniques along with the importance of testing, 2) continue working with hospital and health systems to monitor and understand hospitalizations and prepare for the surge, 3) continue to provide infection prevention expertise to assist skilled nursing facilities and other congregate care facilities on infection control practices and proper use of PPE, and 4) educate the community about the importance of working with the Health Department on contact tracing to prevent spread to friends and loved ones. 
 
Fresno County is experiencing elevated disease transmission.
  • A driver of this are outbreaks in SNFs and the impact of the Avenal State Prison outbreak on staff who live in surrounding counties, such as Fresno.
  • Key actions to address concerns include 1) continuing to provide Infection Preventionists expertise to assist SNFs on infection control practices; 2) ensure baseline testing of SNF residents and health care workers; 3) ensure adequate and proper use of PPE; and, 4) coordination and communication between CDCR, CDPH, and the Local Health Department to mitigate outbreaks at state prisons with employees who return to live in Fresno County.
 
Glenn County is experiencing elevated disease transmission.
  • Drivers of this include an increase in outbreaks and clusters related to 1) household contacts, 2) social gatherings 3) businesses in the county 4) one church gathering and 5) one case that traveled to Mexico.
  • Actions to address these concerns include 1) Working with businesses on health check screenings and NPI enforcement and monitoring 2) Increasing case investigators and contact tracing 3) Increase testing and media campaigning for those that are symptomatic 4) Develop a process to handle incoming cases in a timely and efficient manner.
 
Kern County is experiencing elevated disease transmission and increasing hospitalization.
  • Drivers of this include 1) outbreaks at SNFs and state/federal prisons and 2) residents in surrounding counties being admitted to their county hospital.
  • Key action steps include: 1) communicate and coordinate with CDPH to provide Infection Preventionists expertise to assist SNFs and to ensure baseline testing at these facilities; 2) promote community testing sites; and, 3) targeted outreach and improve public messaging and education on the importance personal protection measures across various sectors.
 
Kings County is experiencing elevated disease transmission, increasing hospitalizations, and limited hospital capacity.
  • Drivers of this include county experiencing outbreaks at Avenal State prison within their jurisdiction, resulting in secondary infection to staff working within the central and satellite kitchens; outbreak at local Adventist Health (AH) admitting COVID positive patients from Tulare, Reedley, and SNF outbreaks.
  • Key actions to address concerns include 1) coordination and communication between local health department, CDPH, and California Department of Corrections and Rehabilitation (CDCR) to mitigate outbreak at Avenal State Prison; 2) order needed resources through the Standardized Emergency Management System such as oxygen concentrators, health care staff, testing kits, and PPEs; and, 3) continue to engage with SNFs on infection control measures.
 
Merced is experiencing elevated disease transmission, increasing hospitalizations, and limited hospital capacity.  
  • Drivers of this include increased community transmission, increased exposures at workplaces (including several small outbreaks), and household clusters, particularly in the Latinx/Hispanic community. 
  • Action steps to address these concerns include: 1) increased marketing of community testing among priority populations; 2) increasing culturally responsive public messaging and education on the importance personal protection measures including face coverings; and, 3) educational outreach to businesses to convey importance of implementing safety measures in order to prevent future shutdown.
 
Sacramento County has experienced the possibility of increasing hospitalization.
  • Drivers of this include community transmission due to holiday gatherings amongst large families.
  • Key action steps to address concerns include (1) increase of public messaging on the importance of social distancing, not gathering, and mandate face covering, (2) more testing sites and education outreach in communities where positive cases are high, and (3) targeted educational outreach to ethnic communities.
 
San Joaquin County is experiencing increasing hospitalization and limited hospital capacity.
  • Drivers of this include 1) community transmission due to gatherings, 2) workplace transmission followed by household transmission; 3) SNF outbreaks; and, 4) increase in widespread testing.
  • Action steps to address concerns include: 1) increase public messaging on the importance of personal protection measures and the risks involved with mass gatherings in multiple languages; 2) continuing to provide Infection Preventionists expertise to assist SNFs on infection control practices, ensure baseline testing and proper use of PPE.
 
Santa Clara County is experiencing increasing hospitalization. 
  • Drivers of increased hospitalization may include 1) increased testing of county residents and individuals from neighboring counties who seek hospital care in Santa Clara County, resulting in an increase of COVID+ patients admitted for observation and treatment; 2) patient transfers from outside the county; 3) patient transfers from long term care facilities; and/or increased transmission among residents or individuals from neighboring counties who seek care in hospitals in Santa Clara County. Although the percentage change in hospitalizations shows an increase, the increase in the absolute number of patients hospitalized is low relative to the size of the population in Santa Clara County and is low relative to the number of hospital beds available in the County.
  • Key actions to address the increase include 1) coordination and communication between the local health department and hospitals in the county experiencing increases, to identify underlying causes, 2) data collection from hospitals that serve large proportions of out-of- jurisdiction patients to identify county of residence, 3) coordination and communication between the local health department and long term care facilities to support these facilities with caring for residents with confirmed COVID-19 when appropriate to avoid transfer to the hospital, and 4) increased public messaging, in multiple languages, on the importance of personal protection measures and the risks involved with mass gatherings.
 
Solano County is increasing hospitalization.
  • Drivers include a large outbreak among farm workers in the vineyards in Sonoma and Napa who are residing in Solano, as well as an ongoing surge in cases related to family gatherings and other social gatherings on the weekends.  The farm worker cases total many dozens over the past one to two weeks, and the close-contact cases appear to have begun with weekend activities in early May and are continuing to the present.  The large number of such cases overall is resulting in an increase in hospitalized cases.  These cases are not at present resulting in a strain on the hospitals or in ICU admissions, but the county is monitoring this closely.  County reports that hospitals in their jurisdiction have multiple levels of surge capacity for hospitalizations and for ICU admissions, if these become necessary.
  • Key action steps include: working with the neighboring counties and with the vineyard management companies to implement social distancing measures; 2) educating the workers themselves (using Spanish interpreters) on social distancing measures; 3) providing appropriate cautionary messages through social media and the press about the risks of gatherings, not social distancing and not using personal protection measures.
 
Stanislaus County is experiencing increasing hospitalization.
  • Drivers of this include an 1) increase in outbreaks and clusters related to family gatherings, businesses (in and out of county) and healthcare facilities; 2) the hospital being a regional hospital accepting patients that are residents outside the county; 3) decreased attention to personal protection measures such as face coverings and social distancing.
  • Action steps to address concerns include 1) prioritizing rapid contact tracing, isolation and quarantine by public health staff for new positive cases; 2) continual monitoring of tests being conducted in the county and relocating sites, when necessary, to more densely populated and higher incidence areas, 3) continually offering businesses resources and technical assistance to comply with local requirements; 4) closely monitoring healthcare facilities and continuing to provide Infection Preventionist expertise to assist SNFs with planning and response; 5) retaining trained employees from other county departments to continue to assist in contact tracing; 6) partnering with  community-based organizations serving minorities for outreach, education, and mobile testing; and 7) increased messaging including a public media campaign to promote face covering and social distancing.
 
Tulare County is experiencing elevated disease transmission.
  • Drivers of this include outbreaks in skilled nursing facilities and workplaces and barriers to preventing transmission within households.  Increased hospitalizations and ICU utilization have been related to multiple conditions other than COVID19. 
  • Key action areas to address concerns include 1) continue to engage with SNFs and businesses and with ongoing collaboration with Licensing and Certification and the HAI program; 2) continue to enhance contact tracing; and, 3) continue public messaging through multiple mediums about actions to prevent community transmission.
 
Last Updated: June 29, 2020
 


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