COVID-19 (SARS-COV-2) UPDATES

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COVID-19 ( SARS-C ^O V-2) UPDATES

November 17, 2020

Karen Relucio, MD

Public Health Officer

Deputy Director of HHSA

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DOUBLING TIME

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CASE COUNT CURVE

0 500 1000 1500 2000 2500 3000

3/22/2020 4/22/2020 5/22/2020 6/22/2020 7/22/2020 8/22/2020 9/22/2020 10/22/2020

Num be r of cas es

Daily cases Cumulative Cases

0 5 10 15 20 25 30 35

3/21 - 3/27 3/28 - 4/03 4/04 - 4/10 4/11 - 4/17 4/18 - 4/24 4/25 - 5/01 5/02 - 5/08 5/09 - 5/15 5/16 - 5/22 5/23 - 5/29 5/30 - 6/05 6/06 - 6/12 6/13 - 6/19 6/20 - 6/26 6/27 - 7/03 7/04 - 7/10 7/11 - 7/17 7/18 - 7/24 7/25 - 7/31 8/01 - 8/07 8/08 - 8/14 8/15 - 8/21 8/22 - 8/28 8/29 - 9/04 9/05 - 9/11 9/12 - 9/18 9/19 - 9/25 9/26 - 10/02 10/03 - 10/09 10/10 - 10/16 10/17 - 10/23 10/24 - 10/30 10/31 - 11/06 11/07 - 11/13

Average Daily Cases by Operational Period

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11/7/2020, 9.7

2.0 4.0 6.0 8.0 10.0 12.0

Adjusted Case Rate (per 100,000) per day (7 day lag)

CASE RATES

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WEEKLY CASE RATE (PER 100,000) BY AREA

*Rates are estimates based on city address

5 0

100 200 300 400 500 600

6/6/2020 7/6/2020 8/6/2020 9/6/2020 10/6/2020 11/6/2020

Calistoga Area

Population: 5,285

0 100 200 300 400 500 600

6/6/2020 7/6/2020 8/6/2020 9/6/2020 10/6/2020 11/6/2020

Napa Area

Population: 79,516

1000 200300 400500 600

St. Helena Area

Population: 6,079

0 100 200 300 400500600

American Canyon Area

Population: 20,306

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11/7/2020, 4.5%

0.5%

1.0%

1.5%

2.0%

2.5%

3.0%

3.5%

4.0%

4.5%

5.0%

Test Positivity (7 day lag)

TEST POSITIVITY

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HOSPITALIZATION TRENDS

0 20 40 60 80 100 120 140 160

3/22/2020 4/22/2020 5/22/2020 6/22/2020 7/22/2020 8/22/2020 9/22/2020 10/22/2020

Num be r of cas es

New Hospital Admissions Cumulative Hospitalizations

0 2 4 6 8 10 12 14 16

3/21 - 3/27 3/28 - 4/03 4/04 - 4/10 4/11 - 4/17 4/18 - 4/24 4/25 - 5/01 5/02 - 5/08 5/09 - 5/15 5/16 - 5/22 5/23 - 5/29 5/30 - 6/05 6/06 - 6/12 6/13 - 6/19 6/20 - 6/26 6/27 - 7/03 7/04 - 7/10 7/11 - 7/17 7/18 - 7/24 7/25 - 7/31 8/01 - 8/07 8/08 - 8/14 8/15 - 8/21 8/22 - 8/28 8/29 - 9/04 9/05 - 9/11 9/12 - 9/18 9/19 - 9/25 9/26 - 10/02 10/03 - 10/09 10/10 - 10/16 10/17 - 10/23 10/24 - 10/30 10/31 - 11/06 11/07 - 11/13

New Hospitalizations by Operational Period

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ICU ADMISSION TRENDS

0 5 10 15 20 25 30 35 40 45 50

3/22/2020 4/22/2020 5/22/2020 6/22/2020 7/22/2020 8/22/2020 9/22/2020 10/22/2020

N um ber of cases

New ICU Admissions Cumulative ICU Admissions

0 1 2 3 4 5 6 7 8

3/21 - 3/27 3/28 - 4/03 4/04 - 4/10 4/11 - 4/17 4/18 - 4/24 4/25 - 5/01 5/02 - 5/08 5/09 - 5/15 5/16 - 5/22 5/23 - 5/29 5/30 - 6/05 6/06 - 6/12 6/13 - 6/19 6/20 - 6/26 6/27 - 7/03 7/04 - 7/10 7/11 - 7/17 7/18 - 7/24 7/25 - 7/31 8/01 - 8/07 8/08 - 8/14 8/15 - 8/21 8/22 - 8/28 8/29 - 9/04 9/05 - 9/11 9/12 - 9/18 9/19 - 9/25 9/26 - 10/02 10/03 - 10/09 10/10 - 10/16 10/17 - 10/23 10/24 - 10/30 10/31 - 11/06 11/07 - 11/13

ICU Admissions by Operational Period

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Male 56%

Female 44%

COVID-19 HOSPITALIZATION DEMOGRAPHICS

Unknown includes cases still under investigation. Total hospitalizations=135

9

Gender 36%

31%

27%

6%

0 65 and Older 50 - 64 30 - 49 18 - 29 Under 18

Age

Average=59 years

55%

24% 20%

0% 1%

10%

20%

30%

40%

50%

60%

Hispanic/Latinx Non-Hispanic White

Other Unknown

Race/Ethnicity

72%

21% 7%

0%

50%

100%

Yes No Unknown

Comorbidity

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COVID-19 HOSPITALIZATION DEMOGRAPHICS

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DEATHS

• Seventeen people have died of COVID-19 since March

• Average age at death was 77 years (range 43 – 97 years)

• Race/ethnicity

1 1 1 1

5

4

0

3 1 0

2 4 6

Mar Apr May Jun Jul Aug Sep Oct Nov

47%

35%

18%

0%

20%

40%

60%

Hispanic/Latinx non-Hispanic white Asian

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CASE TRENDS BY AGE GROUP

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TYPES OF EXPOSURE – NOVEMBER

1%

2%

6%

24%

28%

33%

Other Congregate Settings Travel Work Friends/Extended

Family

Unknown Community Household

13% Unable to Reach Common Gatherings;

• Small get-togethers

• Birthday parties

• Holiday parties

• Weddings, funerals and

other religious services

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OUTBREAKS AND COHORT CLOSURES

Congregate Facility Staff Residents Projected End Date

Skilled nursing facility 1 49 6 12/7

Skilled nursing facility 2 0 2 11/19

Skilled nursing facility 3 4 12 12/10

Memory care facility 1 2 12/8

Corrections 0 3 12/8

Farmworker 4 1

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HOSPITAL SHORT-TERM FORECAST

The ensemble forecast takes the median of all the forecasts available (e.g. COVID ActNow, John Hopkins, Stanford)

0 2 4 6 8 10

12 Hospitalization Forecast

Actual Hospitalizations Ensemble Model Acutal trendline

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MORTALITY SHORT-TERM FORECAST

0 5 10 15 20

25 Mortality Forecast

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HOSPITAL LONG-TERM FORECAST

COVID Act Now, current bed capacity = 208

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MORTALITY LONG-TERM FORECAST

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BLUEPRINT FOR A SAFER ECONOMY

Measures CDPH

Estimates for Napa

New Cases per 100,000 population per day

7 day average 22.1

Adjusted

New Cases per 100,000 population per day

7 day average

14.7 Testing positivity

7 day average 4.7%

Health equity testing

positivity 5.7%

• Napa County has been assigned to the purple tier

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TESTING AND CASE ADJUSTMENT

• Napa County is testing

between 1.5 to 1.75 times the state median (272.4), so case rate is multiplied by the case rate adjustment factor :

22.1 x 0.664 =14.7

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THE STATE HAS MOVED NAPA

COUNTY TWO TIERS

BACK

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EMERGENCY BRAKE PROVISION

• Counties will move back after 1 week, not just 2 weeks

• Because of significant increases, some counties will move multiple tiers

• Counties that move back must make industry changes urgently, instead of 3 days, with phased in enforcement

• State will assess tiers again mid-week

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IMPACTS TO SCHOOLS

• Schools who have not already reopened for in person learning may not be able to do so

• The move to purple does not lead to closure to schools that are already opened for in-person learning

• Awaiting updated guidance for youth sports, which designates allowable sports activities based on tier; delayed due to

emergency brake

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TRAVEL ADVISORY

• Discourage non-essential travel (travel for vacation/pleasure)

• Practice self-quarantine for 14 days upon return to California

• Stay local

https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Travel-

30

Advisory.aspx

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GATHERINGS GUIDANCE UPDATES

• Purple tier – no gathering indoors; outdoor gatherings only

• Gatherings should be two hours or less

• High risk individuals:

• Advised to avoid gatherings

• Wear N95 respirator or surgical mask instead of a cloth mask

• Remain at least 6 feet, or ideally even farther away, from others outside their household as much as

possible, especially when people are eating or

drinking without face coverings.

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MASKING MEASURES

• Face covering is required at all times when outside of the home, with some exceptions

• Individuals who have significant COVID-19 exposure outside of their home, such as in the workplace, should consider wearing a mask at home, especially if vulnerable individuals are part of their household.

• Wear mask when gathering with people you don’t live with – including friends and family who live elsewhere

https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/guidance-for-face-coverings.aspx

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COVID-19 (SARS-COV-2) UPDATES