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State Issues Regional Stay at Home Order, Triggered by Bay Area Hospitals Dipping Below 15% ICU Capacity

12/3/2020

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UPDATE 12.4.20: Bay Area health officers collectively elected to proactively enter into the state’s most restrictive shutdown since March over the next few days, with Marin going into lockdown at 12pm on Tuesday, Dec. 8. The Bay Area has not yet dipped below 15% ICU capacity, which was the trigger established statewide by Gov. Newsom.
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UPDATE 12.4.20: In making the announcement with his public health officer counterparts, Marin Public Health Officer Dr. Matt Willis acknowledged the devastating impact this pre-emptive move will have on local businesses. 

“This is a hard way to close what’s been a really hard year,” he said. 
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“This decision is enormously difficult and painful to make,” added Santa Clara County Health Officer Dr. Sara Cody. “It is helpful for us as counties to make them together and act quickly to save lives but we also understand that we are asking our businesses to do something that is rather heroic.”


12.3.20: California Governor Gavin Newsom announced a series of regional COVID-19 Stay at Home orders Thursday, saying that "lives will be lost unless we do more than we’ve ever done, unless we do everything in our power to make the tough decisions and get through the next weeks and months. We must do everything in our power to diminish the acute surge we are currently experiencing."

"This is the final surge," Newsom said in a press conference Thursday afternoon. "We have a light at the end of the tunnel with vaccines, but we need to take this seriously – this is the moment." Newsom noted that 327,000 vaccines are expected to be made available to California initially via Pfizer, with other providers on the way. Marin will receive 2,000 vaccines in the initial phase, according to Marin County Public Health Officer Dr. Matt Willis. 

The Regional Stay Home Order is divided among five regions, with Marin included in the Bay Area region with Alameda, Contra Costa, Monterey, Napa, San Francisco, San Mateo, Santa Clara, Santa Cruz, Solano and Sonoma counties. The order will go into effect within 48 hours within a region that dips below 15% ICU availability.

The Bay Area's current ICU capacity is currently around 20 percent but is "closing quick," according to Willis. The state projects that the Bay Area is the only region that won't dip below 15% ICU capacity within the next week. The Bay Area is projected to reach 15% capacity by mid- to late-December. 

The order prohibits private gatherings of any size and closes some critically important local sectors, particularly outdoor dining and all personal care services, and reduces retail to 20% density, down from 50%. All sectors require 100% masking and physical distancing. Travel is prohibited “except as necessary for permitted activities,” but state officials encouraged residents to continue participating in safer outdoor activities and state parks and beaches will remain open. Gyms and fitness centers can open at 10% density inside and can continue operating outside.

“Today’s message is not about how we mix safely, it’s how we reduce our mixing altogether,” said Dr. Mark Ghaly, the director of Health and Human Services.

“The bottom line is we want to mitigate mixing,” Newsom added. “Period. Full stop. We need to create less opportunities for the kind of contact and extended time of contact that occurs in many of these establishments ... I'm not naive about what is being asked of you, and about the pressure and stress that you are under particularly our small business owners and workers."

Once the order goes into effect within a given region, it will remain in effect for at least three weeks and, after that period, will be lifted when a region’s projected ICU capacity meets or exceeds 15%. Once that happens, each individual county will then be placed within the colored tier that reflects its metrics within the statewide Blueprint for a Safer Economy framework. (Marin is currently in the red tier). If a region's ICU capacity dips below 15% again, the order would go back into effect for that particular region for at least three weeks.
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"We are using a regional approach in part because that is how hospitals and healthcare delivery systems work," Ghaly said. "When capacity can’t be met within a specific county, we lean on nearby hospital and systems."

Willis acknowledged the impact of Marin being grouped regionally with a number of Bay Area counties that are experiencing a surge in COVID-19 hospitalization. "We’re not feeling the same pain as is being experienced to the south of us, especially in Santa Clara, San Francisco and Contra Costa counties," Willis said. "Health officers there are really concerned. We have never seen what we’re seeing now in terms of actual surges into hospitals and that’s why such aggressive action is being looked at."

Ghaly cited the recent positive outcomes of lockdowns in Europe, where the United Kingdom and Germany, for instance, have seen 30-35% reduction in coronavirus transmission. "They’ve always been a couple of weeks, if not months, ahead of the experiences in the U.S., particularly in the most heavily impacted areas," he said. "The timing here is about doing this now." 

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