OC Officials Concerned State Metrics Will Keep County Mired in Red Tier

October 7, 2020 Updated: October 7, 2020

Orange County officials are worried that case rate numbers and the state’s new health equity metric won’t allow the county to move to the next, less restrictive tier in California’s color-coded COVID-19 monitoring system anytime soon, making it difficult for many local businesses to survive.

The state started to publish health equity data for each county on Oct. 6. The equity figure measures the test positivity rates in the county’s most disadvantaged neighborhoods, which are determined by being in the lowest quartile in the census tracts used by the state’s Healthy Places Index.

With a measurement of 6.6 percent, Orange County—which is currently in the red tier—doesn’t qualify for the next tier, orange, which requires less than or equal to 5.2 percent.

The county also continues to report increasing COVID-19 case rates. This week, Orange County’s case rate rose to 5.2 per 100,000 people, up from 4.4 last week and 3.6 the week before. The orange tier requires 3.9 or fewer per 100,000.

The county’s testing positivity rate is 3.2 percent, which is within the orange tier requirement of between 2 percent and 4 percent.

“It’s very tough to move on to the next tier. That’s going to really hurt businesses,” said Board of Supervisors Chairwoman Michelle Steel at a meeting on Oct. 6.

“How are we going to jump out of that red tier?”

When Orange County moves up to the orange tier, retail stores, shopping malls, museums, movie theaters, places of worship, gyms, and restaurants will have fewer restrictions on indoor capacity.

Bars and breweries would be able to reopen outside, while wineries and family entertainment centers could reopen inside, with modifications.

Dr. Clayton Chau, director of the Orange County Health Care Agency and the county health officer, said the increase in case rates is due to the leftover effects of Labor Day weekend, as well as the effects of businesses that were able to reopen after the county moved up to the red tier on Sept. 8.

But Chau noted that certain county indicators point in a positive direction.

“We are suggesting that the state should also reconsider using the hospital measure as one of the metrics as well, which it was a couple months ago, because our hospitalization rate has been low, and our ventilator percent availability is really good,” he said.

Supervisor Lisa Bartlett agreed. She said that dense, urban counties across California have experienced a recent uptick in case rates, but hospital capacities and overall health care systems have not been overwhelmed.

“There’s plenty of hospital beds, ICU beds; we’ve got plenty of PPE [Personal Protective Equipment],” Bartlett said. “We’ve got a handle on the skilled nursing facilities, we’re not having outbreaks anymore to a great extent, the jail population is not an issue.”

The supervisor said she was pushing the state to offer a credit to counties for having these advantages in place.

To be considered at the next tier assignment on Oct. 13, California’s health equity guidelines require counties to submit a plan by then that defines each group that is disproportionately impacted by COVID-19, states the percent of cases in those groups, and shows that the county will invest funding toward reducing disease transmission in those groups.

Types of investment could include disease investigation, changes in testing strategy, contact tracing, isolation support, or education and outreach efforts.

This plan, plus the health equity data, will only be used to determine the tier progression of counties with a population greater than 106,000 people.

According to state guidelines, if Orange County is not able to meet the case rate threshold for the orange tier, the county would still be able to transition to the next tier by reducing its equity measurement to the least-restrictive yellow tier’s requirement of less than or equal to 2.1 percent.

The equity metric will not be used as a factor in determining if a county needs to move back to a more restrictive tier.

New guidelines for reopening theme parks, sporting events, and concerts were expected to be issued by California state officials last week, but were delayed. According to expectations, those events might not be allowed until a county transitions to the yellow tier.

At the meeting, Steel claimed Gov. Gavin Newsom was using a “one-size-fits-all” approach for all of California’s counties, and said Orange County needed more local control.

“We really have to save small businesses, we really have to move on,” she said.

Supervisor Bartlett added that Orange County is a “job center” for many families in surrounding counties. She said if one county can open up further, it would benefit people in multiple counties.

“Orange County employs a lot of individuals who live in our surrounding counties,” Bartlett said.

“We also have people from Orange County who go to other counties, so depending on what each county might be willing to do or not do, that impacts their surrounding counties.”

Follow Sarah on Twitter: @dadasarahle