Alameda County now finds itself on the state of California's "county monitoring list" due to a high rate of COVID-19 cases during the past two weeks, which is considered to be a sign of elevated disease transmission, county officials said Sunday.
The new designation comes with restrictions on business operations -- many of which were already prohibited locally because of Alameda County's slower reopening plan -- as well as targeted support from the state. But if the county stays on the watch list for three straight days, it would become subject to potential enforcement from state agencies.
"The magnitude of the (case rate) change is above what would be expected as a result of the County's substantial expansion of testing, and we have been placed on the State’s County Monitoring List," officials with the Alameda County Public Health Department said in a statement Sunday.
"Although Alameda County reopened more slowly, our epidemic is affected by accelerated reopening across the region and state, as our residents often live, work and recreate across county boundaries," they added. "While Alameda County has the highest number of cases among Bay Area counties, the County's case rate is 3rd highest in the Bay Area and less than half of California’s overall case rate at the time of writing."
News of the designation comes one day after ACPHD clarified that the state's latest COVID-19 guidance for restaurants effectively prohibits outdoor dining in the county -- although the three Tri-Valley cities didn't change plans for their jurisdictions over the weekend.
As of Saturday morning's data, Alameda County continues to lead all Bay Area counties with 7,725 confirmed cases of COVID-19. The county reports 148 deaths on record caused by the virus.
From the state's perspective, the county's case rate of 104 per 100,000 residents over the past 14 days is particularly alarming, resulting in the state placing Alameda County on the monitoring list Sunday. "Elevated disease transmission" is the only problem category for which the county didn't meet state criteria to avoid the watch list -- hospitalization rates and hospital capacity metrics were still below the state's minimum threshold as of Sunday.
"Factors driving increased case rates include increased interpersonal interactions without face coverings and physical distancing, and ongoing transmission among health care workers, within households, in frontline workplace settings, and in skilled nursing and other congregate living facilities," ACPHD said.
Placement on the monitoring list means a county must shut down many indoor activities for at least three weeks -- operations such as dine-in restaurants, wineries and tasting rooms, movie theaters, family entertainment centers, zoos and museums, and cardrooms. Those were all already closed under Alameda County's current shelter-in-place order.
All brewpubs, breweries, bars and pubs must stop all activities, indoor or outdoor, due to the county's new designation.
ACPHD officials said they are still moving forward with formally requesting a variance this week to allow outdoor dining and other activities to occur locally with the state's blessing
"Applying for a variance is a procedural action that would provide us with the flexibility to ensure that we can continue to allow the activities that the Health Officer determines are lower risk for our community," they said. "Approval of a variance is not an indication that we will pursue additional reopenings of other industries or sectors at this time."
As for potential enforcement, the county said the state this month launched a multi-agency strike team to make sure COVID-19 restrictions for counties on the monitoring list are being adhered to. The teams include the Department of Alcoholic Beverage Control (ABC), the Department of Public Health (CDPH), the Division of Occupational Safety and Health (CalOSHA) and other state agencies.
ACPHD officials also highlighted actions the county is taking to help reduce COVID-19 transmission rates.
Their list included pausing the reopening schedule, outreach and messaging about face coverings and physical distancing, continuing to ramp up testing, expanded case investigation and contact tracing, guidance and technical assistance for workplace safety, ongoing outbreak prevention and response efforts, and engaging the state and regional partners for assistance.
Of Alameda County's 7,725 coronavirus cases, communities with high positive counts include Oakland (3,001) and Hayward (1,191), with Fremont (409) and San Leandro (384) on the next tier.
The Tri-Valley cities have been on the lower end in comparison but their positive tallies have increased over recent weeks as well. Livermore now stands at 271 confirmed cases, Pleasanton with 148 and Dublin with 77.
It is unclear how many of the county's 148 deaths from COVID-19 have occurred in the Tri-Valley, but one confirmed death involved a resident of the Livermore Community Living Center, a residential facility for military veterans.