Carlsbad, CA–From the very beginning of COVID-19, public health officials agreed that decisions should be based on data. Exactly which data and how to calculate the data is still an evolving discussion.
Numbers are important. A tenth of one percentage point could mean the difference between a business surviving or closing its doors for good or whether or not kids can return to the classroom. This is why it’s so critical to understand the numbers and have agreed upon ways to analyze the vast amounts of data now available.
Today I am going to attempt to break down some of the confusion around the numbers.
New state metrics When the governor announced the new four tiered, color coded system for determining the risk of COVID-19 spread in a county, he touted the simplicity of the new approach. Instead of six state criteria, counties would only need to meet two, number of new cases per 100,000 in population and the percentage of positive tests.
County metrics Just like the state originally had six metrics, the county originally established 13 to guide its decision making (many of these overlapped with the state’s). Remember, counties can be more restrictive than the state, just not less. Even though the state is now looking mainly to just two metrics, the county is still monitoring its original 13.
Same metrics, different calculations Even when the state and county are measuring the same thing, such as the percentage of positive COVID-19 test results, they can differ on how that statistic is measured. For example, the county calculates a rolling 14-day average of testing positivity percentages. The state uses a different time period for calculating this positivity rate. Both are accurate, they just include different dates.
Case rate data The number of COVID-19 cases per 100,000 in population is one of the state’s two key metrics. When the state switched to this new four tier system, San Diego County qualified for tier three or the red tier because our case rate was 5.8 per 100,000, and the threshold was over seven.
However, because the state doesn’t want to punish counties that do more testing or give an advantage to those with less access to testing, it adjusts the case rate number for counties not testing at the same rate as the state. Based on that adjustment, San Diego County’s case numbers per 100,000 in population jump to 7.9, over the trigger.
For now, the state has agreed to use the county’s number because of discrepancies in testing data from state labs (backlogs and batching making it hard to calculate accurate daily numbers).
State and county health officials are working all this out, but for now, there is understandable confusion and frustration. I tend to give public servants the benefit of the doubt for just a little longer than many people would. Maybe it’s because I’ve had a peek behind the curtain of multijurisdictional coordination and decision making. It can get complex, let alone in the midst of a global pandemic.
Numbers creeping up Regardless of which statistic you use, San Diego’s numbers are starting to creep up. When the new tiered system was announced we were able to ease public health restrictions. This coincided with local colleges and universities – and some schools – reopening to in person classes. A total of 444 cases to date have been linked to San Diego State University alone.
Based on the state’s two key metrics, here’s what’s happened:
- Case rate per 100,000 increased from 5.8 to 6.9.
- Testing positivity rate increased from 3.4% to 4.2%.
Below are the state’s thresholds for the red tier.
Two weeks of consecutive results The case rate number is most concerning, but keep in mind, even if we exceed the state’s case rate threshold, we would need to do so for two weeks before our tier would be changed.
Our positivity rate, on the other hand, would actually qualify San Diego County to move to a lower tier because it’s already been below the trigger for tier 3 (orange) for two weeks. However, both metrics need to meet the criteria for two weeks straight before we could move to the less restrictive tier.
The reason tiers are important is because they affect what can open and under what circumstances. Here is a link to what’s allowed to open under which tiers.
Community outbreaks The county announced three new outbreaks yesterday, one in a restaurant/bar and two in business settings. In the past seven days, 22 community outbreaks were confirmed. The county’s trigger is no more than seven in seven days. A community setting outbreak is defined as three or more COVID-19 cases in people from different households traced back to a single setting.
Community outbreaks are one of the 13 triggers established by San Diego County to determine when it’s safe to ease health restrictions. And, it’s the one trigger that’s consistently missed the mark for weeks now. Last week the county’s public health officer acknowledged that due to a variety of factors, the threshold of no more than seven community outbreaks in seven days might be too low. At the time the 13 triggers were established, the county had not fully ramped up its case investigation and contract tracing capacities. As that happened, identifying community outbreaks became easier. The county had set the trigger based on data from the previous three months, before the increase in tracing.
Even though the state has shifted its focus to just two metrics (test positivity percentage and number of cases per 100,000 in population) the county’s 13 triggers are still being monitored, and the region’s largest school district adopted some of the 13 triggers for their own decision making, including the community outbreak number.
The county health officer said during a news briefing last week that she and her team are working with epidemiologists and other health experts to determine whether or not the community outbreak threshold should be adjusted and by how much.
To me, this again illustrates the challenges local and state governments are facing in trying to live up to the principle of data-driven decisions in a rapidly evolving situation.
Latest case numbers Since my update Tuesday, 12 more COVID-19 cases have been reported in Carlsbad for a total of 639. We estimate that 46 of those cases are active. Sadly, 12 more people have lost their lives countywide to COVID-19 for a total of 721. The 12 include six women and six men ranging in age from the mid-50s to late 80s. All had underlying medical conditions.
Countywide, we’ve seen 674 more cases since my Tuesday update for a new total of 41,324.
Here is a link to all the charts and graphs from yesterday’s news briefing.
Unmasking more mysteries around masks Best practices around masks have also evolved. I thought this recent article by the chief science officer for Consumer Reports had a good break down of the latest recommendations about fabric, styles, filters and more. The bottom line remains this: any face covering is better than no face covering, and staying 6 feet from people not in your own household is better still. But, the better your mask fits the more protection it provides, and some fabrics do a better job filtering than others.
Should you visit the dentist? Four out of five dentists may agree about the best brand of chewing gum, but apparently dentists don’t agree about all topics.
U.S. dentists have taken issue with the World Health Organization’s guidance to postpone dental visits due to the COVID-19 pandemic. An opinion article in today’s Union-Tribune mentions interim guidance put out last month by the WHO advising that routine, non-essential oral care be postponed. The American Dental Association strongly disagrees. The Centers for Disease Control and Prevention and the California Department of Public Health have said that routine dental care can resume. Here is a link to the CDC’s guidance for reducing risk of transmission during dental care. You can read the opinion article here.
Voting during a pandemic Due to the COVID-19 pandemic, every active registered voter in California will receive a ballot in the mail for the Nov. 3, 2020, Presidential General Election. In addition, polling places will be open for four days instead of one. There will be fewer polling locations than in prior elections, so your polling place has most likely changed.
For in person voting, here are your options:
- At the Registrar of Voters office beginning Oct. 5, Monday through Friday, from 8 a.m. to 5 p.m.
- At your assigned polling place or the Registrar’s office Saturday, Oct. 31, through Monday, Nov. 2, 8 a.m. to 5 p.m.
- All will again be open on Election Day, Nov. 3, when the voting hours change to 7 a.m. to 8 p.m.
For the mail in ballot, if you are an active registered voter, you can now sign up to track the status of your mail ballot – when the ballot is mailed to you, when the Registrar of Voters gets it back from you in the mail and when it is counted. Updates are available by text, email or a phone call.
The Registrar of Voters also recommends voters double check their registrations in the next couple of weeks to make sure your ballot is sent to the right address. You can do that here.
This weekend will be the six month mark since the start of our local COVID-19 emergency response. We are all feeling the effects. Families, business owners, seniors and others at high risk, teachers, first responders and most of all our health care workers. Please keep this in mind as you go about your new daily routines. Let’s continue to treat each other with kindness, have a little extra patience for one another and do everything we can to #Care4Carlsbad:
- Wear a mask when you leave home
- Keep 6 feet away from people not in your household
- Avoid crowds
- Wash your hands often
- Stay home if you have symptoms of COVID-19 so you don’t spread it to others
I’ll be back next Tuesday with more updates. Scott Chadwick, City Manager
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