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Is the case criteria for California’s new color-coded reopening plan too harsh?

By Eric Ting, SFGATE

Updated

  • FILE - In this June 6, 2020, file photo, California Gov. Gavin Newsom listens to a reporter's question during a news conference in Rancho Cordova, Calif. Photo: Rich Pedroncelli / Associated Press

    FILE – In this June 6, 2020, file photo, California Gov. Gavin Newsom listens to a reporter’s question during a news conference in Rancho Cordova, Calif.

    FILE – In this June 6, 2020, file photo, California Gov. Gavin Newsom listens to a reporter’s question during a news conference in Rancho Cordova, Calif.

    Photo: Rich Pedroncelli / Associated Press

Photo: Rich Pedroncelli / Associated Press

FILE – In this June 6, 2020, file photo, California Gov. Gavin Newsom listens to a reporter’s question during a news conference in Rancho Cordova, Calif.

FILE – In this June 6, 2020, file photo, California Gov. Gavin Newsom listens to a reporter’s question during a news conference in Rancho Cordova, Calif.

Photo: Rich Pedroncelli / Associated Press

Under the state’s new color-coded, four-tiered system of reopening, all nine Bay Area counties currently meet the test positivity requirement to move into the red tier, but seven are not meeting the case-per-capita criteria and are therefore stuck in the much more restrictive purple tier.

In order to move from purple to red, a county must report fewer than seven new daily cases per 100,000 residents and a test positivity of under 8%. Counties in the red tier — four to seven daily cases per 100K, test positivity between 5% and 8% — can reopen much more of their economies than counties in the purple tier, so long as county officials do not implement stricter regulations of their own. Specifically, red tier counties can reopen schools, indoor personal care services, indoor dining, gyms and movie theaters with modifications. Of these businesses and activities, purple tier counties can only open elementary schools if they go through a waiver process.

Counties move into less restrictive tiers by meeting the next tier’s requirements for 14 consecutive days, and analysis from SFGATE shows that of the purple tier Bay Area counties, Marin County is the only one consistently reporting a daily case total under its “magic number” that would be the equivalent of seven cases per 100,000 residents.

Since the beginning of the outbreak, many experts have questioned the usefulness of raw case counts as a metric for the spread of the virus, given the fact that case totals are a function of testing, and as testing increases, so will case totals.

“Case numbers alone are not indicative,” UCSF epidemiologist Dr. George Rutherford told SFGATE in May. “As testing increases, we’re going to catch more of the asymptomatic cases, which we know make up a significant number of infections. … the most sensitive indicator is percentage of tests positive, since as long as that number low, you know you’re testing enough to find asymptomatic cases.”

All nine Bay Area counties are well under the 8% test positivity threshold that would place them in the purple tier. In fact, San Francisco, San Mateo, Santa Clara, Marin, Solano and Napa counties have test positivity numbers between 2% and 5%, which would place them in the orange tier and allow them to increase capacity at indoor restaurants, movie theaters and gyms.

The purple tier replaces the state watch list, and county officials have previously publicly bemoaned the watch list’s criteria. Solano County’s health officer Dr. Bela Matyas has stated it may be impossible for his county to satisfy the case criteria, and San Mateo County’s Dr. Scott Morrow has called the watch list “some newly created bureaucratic box is just itching to be checked,” and something that brings “economic and societal damage without a concomitant reduction in spread.”

According to state officials, the case criteria for the new reopening plan is computed by using a seven-day average of daily new cases per 100,000 residents. Using a seven-day average could stop counties from being derailed by a single day of unusually high case totals, as counties must meet the next tier’s criteria for 14 consecutive days before moving forward.

The state seems to acknowledge that cases are a function of testing, as officials are using an “adjustment factor” for counties performing more tests than the state average.

“Case rates include an adjustment factor for counties that are testing above the state average,” state officials wrote on a page explaining the new system. “The incidence is adjusted downwards in a graduated fashion, with a maximum adjustment at twice the State average testing rate.”

The specific numbers behind the adjustments were not made available.

On the interactive page for the new reopening plan, San Francisco County — a red tier county — is listed as having a case-per-100K number of 9.2, which would seemingly land it in the purple tier. However, the county is testing a large numbers of individuals and has a 3.4% positivity rate, so the state’s adjustment factor has likely moved the county from the purple tier to red tier.

It is unclear how many other Bay Area counties would get a large boost from the state’s testing adjustment factor, but without it, most populous counties ramping up testing would likely never get out of the purple tier.

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Eric Ting is an SFGATE reporter. Email: eric.ting@sfgate.com | Twitter:@_ericting

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