Sonoma County leaders discuss response to next phase of COVID-19 pandemic

Sonoma County government’s elected leaders and health officials are giving greater focus this week to the shape of public life and health as the latest COVID-19 surge ebbs in the Bay Area.

On Tuesday, health officials told the Board of Supervisors the county continues to see a decline in new cases, dropping from a daily high of 249 per 100,000 residents amid the peak of infections linked to the omicron variant, to 102 new cases per 100,000 people.

COVID-related hospitalizations are still elevated but are starting to decline, Dr. Sundari Mase, the county’s health officer, told the board at its Tuesday meeting. The trend line in hospitalizations typically lags behind case rates by a week or more, Mase said.

The plunge in new infections has spurred county and state officials to drop health orders imposed last month to blunt the dramatic wave of omicron cases and aid short-staffed hospitals.

Sonoma County’s latest health order restricting large indoor and outdoor gatherings is due to expire at the end of Thursday, while the state’s universal indoor mask mandate is set to expire Feb. 15.

After that, state masking rules will revert to the state’s previous guidance issued Dec. 15, which requires face coverings for unvaccinated individuals in all indoor public settings. Pre-omicron statewide rules also require masking for all individuals regardless of vaccination status in higher risk settings like public transit and congregate living.

On Tuesday, the Board of Supervisors’ discussion turned to how health leaders differentiate between a pandemic, with volatile infection rates and hospitalizations that require an emergency stance, and an endemic phase, where illness is still present but at a more consistent, manageable level.

Rates of vaccination and immunity acquired from contracting the virus are among the many factors, Mase said.

“We’re still at a rate of 102 cases per day per 100,000, which is still quite high,” Mase said. “The question is when do we say that we’re in an endemic state.”

As for face masks, the county will be looking to see what the state does once its indoor masking order expires next week.

In January, Mase issued a health order banning indoor gatherings over 50 people, a move that sparked criticism from parents, school superintendents and business owners who said it was overly restrictive and appeared out of step with the rest of the region.

Sonoma County was the only county in the Bay Area to adopt such a health order.

“I am looking forward to the health order expiring,” said Supervisor David Rabitt.

He has been arguably the most critical of the five board members on the way the order was rolled out by health officials and how it constricted private and public life at a difficult time in the 2-year pandemic .

“Being out of sync with the Bay Area counties is challenging to say the least,” Rabbitt said.

What, if anything, Sonoma County does now with public health orders could be linked to a regional response coordinated with other county health officials, Mase said.

Mase said the next phase could rely on people to assess their individual risk and use precautions, such as face masks, accordingly. People who are at-risk for COVID, or who are caring for someone who is vulnerable, for example, will have to decide for themselves whether to wear masks, she said.

“We are really shifting towards more personal responsibility as we move into a different phase of this pandemic,” Mase said.

Rabbitt called for local hospital officials to address their struggles with staffing shortages and insufficient patient capacity.

During the omicron-fueled winter surge, hospital officials were vocal about the lack of psychiatric beds in the county, which they said prevented them from transferring mental health patients — as well as homeless and skilled nursing residents — after their hospital care was completed.

“It’s really the hospitals, the health care system,” Rabbitt said. “We need to have a plan that we don’t stop our economy because hospitals are not keeping up with what we need to do.”

Mase and Dr. Urmila Shende, the county’s COVID vaccine chief, also stressed the importance of vaccinations and boosters Tuesday, particularly in young children at this stage to help reduce transmission rates.

The vaccination rate for Sonoma County’s eligible population is 79%, ninth highest in California. But the rate among the county’s children age 5 to 11 is only 31%. For those in the 12-15 age group it is 66% and for those in the 16-24 age group it is 76%.

Vaccinations for children under 5 years old are on track to become available soon, possibly by the end of the month, Shende said. But, as with previous vaccine rollouts, the first few weeks of the next introduction could be bumpy.

“Unfortunately, it’s going to be somewhat limited by how much vaccine supply there is,” Shende said.

Board of Supervisors Chair James Gore called Tuesday’s update an “optimistic” snapshot of the late-stage pandemic.

But in a brief, closing comment he also asked Mase and her colleagues in the county’s public health division to work on a standard plan for communicating health orders with key partners.

That includes the county’s Economic Development Board, a hub and sounding board for business interests, including many who opposed or criticized the current ban on large gatherings, pointing to its impact on commerce.

“We’re moving into hopeful days, but we’ve got to be prepared for anything,” Gore said.

You can reach Staff Writer Emma Murphy at 707-521-5228 or emma.murphy@pressdemocrat.com. On Twitter @MurphReports.