When the COVID-19 pandemic started and Californians were asked to stay at home, Gov. Gavin Newsom warned that lifting restrictions would be more like moving a dimmer than flipping a switch.
Five months later, county health departments are still navigating how to open business sectors without spurring outbreaks. New cases and deaths seem to be slowing down statewide after a surge in July.
On Friday, Newsom unveiled a new COVID-19 blueprint that sorts counties into tiers based on their positivity rates among people who have been tested, and number of cases in the population. Under the new system, counties can receive a purple (widespread), red (substantial), orange (moderate) or yellow (minimal) rating.
Currently 38 counties are in the purple tier, which means hair salons and stores can open indoors but restaurants, museums and other activities can only open outdoors. Only two counties are in the “minimal” category, where most businesses are allowed to open indoors with modifications.
California Department of Public Health
To move between categories, a county must meet the criteria for the less restrictive category for three weeks before being reclassified.
“Some counties undoubtedly will succeed in that endeavor, others may succeed for a while and then have additional problems,” said UC Berkeley epidemiologist Art Reingold.
He said whether a county is able to change its status depends on how many people wear masks while in public, and “the extent to which people who are young and healthy and may not see themselves as at much risk continue to act responsibly.”
El Dorado County announced this week that if they keep their new cases to less than four per day, they will be able to move from the red tier to the orange tier during the week of Sept. 21, which would mean being allowed to open many indoor businesses at partial capacity.
The county’s health officer, Dr. Nancy Williams, said even though cases there were declining last month, her agency didn’t have the option to green-light more business operations under the old system.
She said she was hesitant at first about lifting restrictions.
“I wasn’t ready to re-open restaurants yet,” she said about weighing the risk of transmission with the benefit of boosting the economy. In the red tier, restaurants welcome some customers inside.
“We’re always hearing about people’s hardships with their businesses not being open,” Williams said. “The economic benefits to being able to reopen some businesses, even a restaurant at 25% indoor capacity, helps them.”
Placer County health officials have announced that if their data holds steady, they expect to move from the purple tier to the red tier in one week.
Farrah McDaid Ting, a legislative representative for the California State Association of Counties, said she expects many counties to move to less restrictive tiers later this month. She says the current ratings are based on state data from the early part of August, and don’t account for the dip in cases that many counties began to see more recently.
She expects more updated data will be reflected in the Sept. 8th calculations.
“We’ll see a lot of counties have made improvements and will likely shift downward into the orange and maybe even yellow in some cases,” she said. “The map we see now is the starting point, and really the opening bell starts on Tuesday the 8th.”
Erin Mordecai, a Stanford University biologist who’s been modeling the potential spread of COVID-19, said as counties across the state gain the option to open indoor business, they have to be extremely careful.
“In short, we risk another surge in cases,” Mordecai wrote in an email. “We may have to make hard choices and tradeoffs in order to prioritize the activities that are most important to do in person.”
That may mean prohibiting some indoor activities, like at gyms, in order to limit new cases and prioritize reopening schools, she said.
Mordecai said it’s essential that indoor operations happen only in counties where case rates are low, and that there are modifications such as physical distancing, masks and regular cleaning.
Gov. Newsom did not include a green tier in the new blueprint, stating that going back to pre-pandemic conditions in the near future isn’t a reality.
Reingold, of UC Berkeley, said California is in it for the long haul.
“Until we have a safe and effective vaccine that’s broadly used, it’s likely that this virus will remain in circulation,” he said. “Going back to life as it was before’ with no restrictions and everybody able to interact in the ways they’d like is going to be fraught with the real risk of continuing outbreaks.”
County health departments acknowledge that opening more businesses inevitably means more new cases, McDaid Ting said. Still, she added, many counties are trying to inch closer to normalcy and will likely have more flexibility to do so under the new tiering system.
“Patience is wearing thin in some parts of the state,” she said. “The drumbeat to reopen more quickly is always there.”
Schools can reopen for in-person instruction once their county has been in the substantial tier for at least two weeks.