Sonoma County supervisors on Tuesday unanimously agreed to spend $4 million on a public health strategy intended to push back against the spread of coronavirus in disadvantaged communities.
Public health officials said they would most likely be back to request another $11.9 million to carry the program on from Jan. 1 2021 to June 2021 – and supervisors suggested they would support that request.
The strategy’s aim is twofold.
First, it is to reduce stark inequities in COVID-19 related health outcomes that have hit Latinos disproportionately hard. Latinos make up 26 percent of Sonoma County residents, but a few months ago were just under 80 percent of local COVID-19 cases. Though that number has since come down, it remains an alarming 54 percent of total cases.
“Long standing socioeconomic inequities do place our most vulnerable residents at risk,” said Sundari Mase, the county’s public health officer, citing the Latino, indigenous, low-income and essential worker communities as among those particularly impacted.
The parallel goal is for the county to win state approval to further open up its economy. To do that the county must comply with new state requirements that mandate reducing the spread of coronavirus in disadvantaged neighborhoods.
Sonoma County is the only one of the nine Bay Area counties still mired in the purple and most restrictive of four state-defined tiers – purple, red, orange and yellow – that govern what businesses and services can reopen and under what guidelines. That’s in large part because of the degree to which the county’s Latino community has been impacted by COVID-19.
“I’m in support of going forward because at the end of the day, we’ve got to get to red, and then we’ve got to get to orange and then we’ve got to get to yellow and we don’t want to slip back and we don’t want to stay where we are,” said Supervisor David Rabbitt. “I recognize that you all know that, and we feel the angst of the community that we’re still in this place.”
The new approach, dubbed the Enhanced COVID-19 Response Strategy, involves partnering with nonprofit organizations and focusing public health efforts on census tracts that have been identified as most impacted by COVID-19. Underpinning the strategy are expanded COVID-19 testing, financial incentives and support, and an intense outreach campaign focused on farmworkers, day laborers and domestic workers.
The county launched a new testing site Tuesday, part of a plan to ramp up the number of neighborhood-based tests from 200 to 800 a week by Nov. 1; to 1,000 a week in the second phase, between Nov. 2 and Nov. 15; and to 1,200 a week in the third phase, from Nov. 16 to Nov. 30.
Under the plan, $30 grocery gift cards will be offered as incentives to get people to take tests (with a once a month limit). The county’s Department of Health Services estimates, based on the experience of counties with similar programs, that testing demand will increase by 50 to 75 percent as a result.
For those who test positive, the plan also includes funding to help them stay home from work and remain safely quarantined; that compensation would top out at $1,216 for a two-week period of isolation and would be available to people without paid sick leave or worker compensation.
Together, said Mase, the incentives and income support, “will help people come for testing, increase our case finding, it’ll help low income individuals afford to isolate while they’re COVID positive, and it will help their family members afford to quarantine as they’re being monitored and tested.”
“I can’t say enough about how wonderful this strategy is,” said Supervisor Shirlee Zane. “We’re using the providers that are already out there; instead of just translating things, we’re going to people and going to where they live and where they work and where they shop, and that’s what we needed to do all along.”
The $4 million approved Monday comes from the federal Coronavirus Aid, Relief and Economic Security Act approved in March.
Zane said the funding public health officials say it will take to run the program through June is needed to stem continuing economic bleeding that is taking a toll on the county’s residents and business community.
“I don’t think that $15 million is too much at all to invest, because if we don’t invest that we’re going to lose a lot more,” she said.
The plan allocates funds to procure hotel rooms and other facilities to provide places for people – including those who are homeless – to quarantine if they test positive and their homes are too crowded to allow them to isolate effectively. County health services teams would support people quarantined under those circumstances with “wraparound” services such as laundry and delivery of medications and meals.
The strategy envisions public/private partnerships to reduce workplace transmission of coronavirus through “infection control practices” and employee education.
County staff also suggested that one tack would be to encourage businesses to support and expand communications, testing and incentive aspects of the plan through sponsorships and financial support.
Supervisor James Gore, referencing business people worn down and angry about the degree to which the county’s economy is still shut down, and possibly unsure how to contribute to changing that situation, said they had a key role to play moving forward.
“I know we have a lot of reticence from the business community to sometimes say, ‘How do I set up testing?’, or just reticence of the unknown and the fear of it,” said Gore. “So this is a call out to call our offices, to work with our health staff and others to make sure you’re a part of the solution.”
Other factors are holding Sonoma County back from advancing to the next, less restrictive tier of red. The county is behind in the number of new cases per 100,000 people per day; it is seeing 13 per day, while the state’s requirement to move to the next tier is seven per 100,000 per day.
But Sonoma County is meeting the state’s requirement for test positivity, or the percentage of tests that are positive. The county has a 5.1 percent positivity rate; the state requires an 8 percent rate or lower to advance. If the county can get its test positivity rate into the orange tier for two weeks, as well as the test positivity rate for its disadvantaged neighborhoods, then it can progress to red even if the numbers per 100,000 are too high.
As it stands the countywide test positivity rate is on the cusp of orange; and the positivity rate for the disadvantaged neighborhoods is in the red.
“We’re actually pretty close,” said Mase.