A woman is vaccinated at the Sharp Super Station in Chula Vista. Courtesy of the County News Center
By Ana B. Ibarra and Rachel Becker | CalMatters
California hit a benchmark on Friday with 2 million doses of COVID-19 vaccine being delivered to underserved communities, sparking a big change that will turn the state reopening map from purple to mostly red.
Reaching the milestone puts less stringent statewide standards in place when counties can allow indoor activities such as dining out and exercising in the gym. In some countries this means that these activities are allowed with restrictions for the first time since August.
Last week, state officials announced they would ease the COVID-19 case rate required to allow counties to move from the most restrictive purple to the red tier. Instead of 7 cases per 100,000 inhabitants, the red level allows 10 cases per 100,000 inhabitants. This paves the way for counties to allow restaurants, gyms, museums, cinemas, and other businesses to reopen in indoor spaces with limited capacity.
The change reclassified San Diego County from the purple to the red tier for the March 8th weekly rating. If the next assessment next Tuesday also shows fewer than 10 cases per 100,000 population, San Diego will officially be in the new tier.
The easing of standards depended on the first delivery of 2 million vaccinations in zip codes that are considered disadvantaged based on a set of metrics called the Healthy Places Index, which include income, housing, health care and air pollution.
California hit the 2 million goal on Friday afternoon, hitting 2,016,539 at 12:30 p.m.
What does it all mean? What can be reopened and when?
Where did those 2 million cans go?
Some of the neighborhoods eligible for increased vaccine supplies were also sources of infection such as National City, parts of Chula Vista, east Los Angeles, South Gate, and North Highlands in Sacramento.
Most of the prioritized zip codes are in Los Angeles County, the Inland Empire, and the Central Valley. Fewer in Northern California made the list because their positions in the Healthy Places Index were above the national average.
For example, the Fruitvale neighborhood in Oakland and the Tenderloin district in San Francisco have been included, but others that are also sources of infection, such as East San Jose, are missing.
Overall, of the 11 million vaccinations given in the state, 18.2% were listed in zip codes in the lowest, least healthy quarter of the Healthy Place Index. Meanwhile, 31.2% of government doses were given in the top and healthiest quarter.
What’s happening now?
It is of course complicated! Perhaps a dozen counties will place fewer restrictions on businesses. However, the timing varies. Some counties could move on Monday.
As of Thursday, 34 counties, where 80% of the population lived, were in the purple category. Another 20, accounting for about 20% of the population, were red. Three were orange and one, Alpine, was yellow.
An analysis by the Los Angeles Times estimated that the new thresholds could make it easier for 12 counties – 45% of the state’s population – to get out of the purple plains as early as this weekend. These include the counties of Los Angeles, Orange, and San Bernardino.
Los Angeles County’s health officials said Thursday that they are expected to be moved to the less restrictive red tier sometime between Monday and Wednesday.
The counties must meet the state’s new drop load targets for two weeks. But since some counties, like Los Angeles, have hit them for a while, they can move to the red row earlier.
In addition, counties must adhere to a certain threshold for the percentage of positive tests and a “health equity metric” that includes evidence that positive tests are not significantly higher in underserved neighborhoods than in the rest of the county.
What can be reopened in the red step?
Moving to the red level means the return of restaurants, museums and cinemas with a capacity of 25%. Gyms (including fitness centers in hotels) can be reopened with a capacity of 10%.
Places where indoor activities were already possible, such as shopping malls, can increase capacity from 25% to 50%. You can find the full list here.
This is big news for businesses in counties, particularly in Southern California, that have never left the Purple Plains since the state released its draft for a safer economy in late August.
The state also announced Thursday that breweries and distilleries will be able to open outdoors from Saturday with certain restrictions if their county is purple or red. Bars, on the other hand, remain closed on the red tier but can operate outdoors once their county falls into the orange tier.
Moving to the red tier is also a step towards reopening schools. While elementary schools in the purple tier could technically reopen, the red tier allows school districts to bring back middle and high school students, although this also depends on local negotiations between teacher unions and school districts.
However, the decisions are left to the districts. Counties are allowed to take stricter measures for companies, but not loose rules.
What does this mean for COVID-19 tests?
As the counties continue to test, they are likely to find more people infected with the virus. Since their ability to reopen depends on bringing the number of infections below a certain threshold, state officials are concerned that it could lead counties to test less.
Testing in California has been down since mid-January, reflecting a nationwide slump. John Swartzberg, an infectious disease specialist and clinical professor emeritus at the University of California’s Berkeley School of Public Health, said it was important to continue testing.
“It is clear that we are not testing enough,” said Swartzberg. “It will give us a closer look at where we are.”
Because of this, the state is shaving some infection cases off the total for counties with high testing rates, making it easier for them to fall below key reopening thresholds.
Will the state reopen too early?
The feelings are mixed. Experts welcome the focus on speeding up vaccinations in hard-hit communities, but disagree on the effects of easing restrictions.
UC Berkeley’s Swartzberg warned against moving too fast before more vaccines are in your arms.
“We made the same mistake over and over again during this pandemic,” he said. “We’re opening too early.”
However, George Rutherford, an epidemiologist at the University of California at San Francisco, said California was in a better position to prevent a surge now with better surveillance and immunity.
“We have a lot more pillows than we did in September and October when we tried to reopen after the summer flood,” he said. “I think the pace is fine.”
Can counties move backwards as infections rise?
Yes. Dr. Mark Ghaly, the state’s health minister, said these adjustments mark the state’s entry into a new normal, but warned that the state “will continue to be held.” [its] Put your foot on the brakes, not the gas. ”
Despite the easing of standards, he said the state still had some of the strongest public health protections in the country. “Counties, as fall rates rise, may go back to the purple level with additional constraints,” he said.
The reporting, translation, and dissemination of CalMatter’s COVID-19 is supported by generous grants from the Blue Shield of California Foundation, the California Wellness Foundation, and the California Health Care Foundation. CalMatters is a public interest journalism company dedicated to explaining how the California State Capitol works and why it matters.