Sacramento coronavirus cases are spiking — and family home gatherings are a key cause
Sacramento County has seen a notable rise in confirmed COVID-19 cases and hospitalizations in the last two weeks, prompting state officials on Tuesday to say they will step in to work with Sacramento and several other counties in an effort to tamp down the resurgence.
Speaking to The Sacramento Bee on Tuesday, Sacramento County health officer Dr. Olivia Kasirye said her contact tracing team is noting increased cases after families have gathered in homes in violation of the state and county health orders, which still say people should not be gathering in groups inside homes.
Kasirye said it appears that the recent reopenings of restaurants, stores, barbers and hair salons may have convinced people that the virus risk has gone away.
Another round of reopenings is scheduled for Friday, this time including bars, movie theaters and camp grounds. The Sacramento Zoo is scheduled to open Monday.
“We have found as businesses begin to open up, for some people there was a sense that things are OK now, and they began having gatherings in the home and birthday parties,” Kasirye said. “That is most of the exposure. They are multi-generational. They have people with higher risk.
“You have people together for an extended period of time” not observing six-foot social distancing, and often not wearing face coverings,” she said.
The increase in Sacramento, officials said, is attributed to a small cluster of activities, including two large birthday parties held in private homes, one funeral and a church gathering. Church gatherings, with reduced attendance, are now allowed. But parties inside houses are not yet permitted under state and local stay-at-home orders.
Sacramento in particular “has experienced increasing hospitalization,” state health officials said in an updated statement on Tuesday listing Sacramento along with Los Angeles, Fresno, Imperial, Kings, San Joaquin, Santa Clara, San Bernardino and Tulare counties as focal points of concern.
“Drivers of this include an increase in informal and formal gatherings, transmission among large families, and workplace exposures in the food industry,” they wrote. “The state will work closely with local health departments to identify action steps and timelines for addressing issues that impact indicators of concern.”
Five of the nine counties listed above had at least a 10-percent increase in hospitalized COVID-19 cases during a recent three-day span compared with the previous three days, Tuesday to Thursday and Friday to Sunday. Sacramento County saw the most of any county by far, a 58 percent increase.
The state only counts this metric for counties with at least 20 hospitalized, to keep smaller sample sizes from skewing percentages. The next highest increase noted was Santa Clara County at a 31 percent increase.
The state said it will work with Sacramento health officials on increased “messaging on the importance of social distancing, not gathering, and personal protection measures” as well as community testing, workplace evaluations, and “targeted outreach to ethnic communities and provision of language specific educational materials.”
A Bee review of recent virus data from the the six-county region found notable upticks in recent weeks since Sacramento-area counties started reopening their economies:
- The highest one-week increase in newly reported cases since mid-April: 296 cases in the the week ending June 8, according to data from the California Department of Public Health.
The number of COVID-19 hospital patients with confirmed COVID-19 increased to 54 by Monday, more than double the number from a week ago, which was 25. The week prior to that, there were only 17 virus patients in local hospitals.
That new figure of 54 is considerably lower than the 123 peak registered two months ago, and is much lower per capita than the state as a whole, but bears watching because of the sudden rise.
The main increase in local hospitalizations has been in Sacramento County, which went from 8 hospitalized patients in late May to 37 on June 8.
Notably, perhaps the most important statistic – deaths – saw only a slight uptick: The three deaths in the last week is far below the one-week high of 21 deaths in mid-April.
The six-county area – Sacramento, Yolo, El Dorado, Placer, Sutter, Yuba – includes some of the earliest counties in the state to reopen stores, restaurants, malls and barbers, stoking some fears that the counties are moving too quickly and inviting a virus resurgence.
The upticks in cases were not unexpected, health officials tell The Bee. Those officials said they believed case numbers would go up this month in part because local counties are doing more testing in recent weeks.
Family gatherings causing coronavirus spike
But Sacramento County isn’t the only place where family gatherings is an emerging issue in containing the virus spread.
In Yolo County, the uptick in cases is more modest — “two to three cases a day versus one to two before,” said public health director Brian Vaughn.
But more than half of those new cases in the last couple weeks are from people infecting other family members in the same household, Vaughn said.
In particular, a majority of recent cases are stemming from gatherings between family members who live in different households for holidays or celebrations like Memorial Day.
“I do think the longer it goes, the more you have the idea that you can get complacent,” Vaughn said.
“It seems clear to me now that from the research, the biggest risk are when you’re in an enclosed space with a lot of people,” he said, “and when you are there for a long period of time.”
In Placer County, there have been “many cases with histories of social gatherings, such as Mother’s Day gatherings or a funeral,” county public health officer Dr. Aimee Sisson said in a statement.
There have been several clusters of cases in Placer County recently, including several tied to one family related to international travel. But there have been other clusters among fast food workers and in the Auburn jail.
“In an environment of community transmission, it is difficult to pinpoint where and how someone became infected with a virus that has an incubation period of up to weeks and that can be transmitted by people without symptoms,” Sisson said in a statement. “For most cases, a precise infection source cannot be determined.”
Coronavirus spike after protests?
Recent streets protests have prompted some coronavirus concerns. Last week, thousands of people from around Northern California gathered in downtown Sacramento, and to a lesser extent in Placer and El Dorado counties to rally for police reform in the wake of a widely condemned Minneapolis police killing.
Sacramento County health officers Kasirye suggests people who participated in those events get tested for coronavirus. She said the fact that the gatherings were outdoors reduces the chances of spread. But the gatherings, which Kasirye considered important free speech, involved chanting and shouting, and are at least somewhat worrisome epidemiologically.
“It’s a little too early to tell what the impact has been. We’re watching the numbers. There is a certain level of nervousness.”
The more focused concern, though, at the moment, are the increased hospitalizations in Sacramento County. Kasirye said many of those patients are people who had underlying health conditions.
That reinforces the message, she said, that people who are older or have health issues should consider themselves at higher risk and take more precautions.
The increase in cases in the Sacramento region mirrors some upticks around the state. Notably, though, the Bee review found that the Sacramento region still is faring better in the fight against the virus than the state as a whole:
In the two weeks ending June 8, there were about 19 new cases per 100,000 residents in the Sacramento region, well below the statewide rate of 92 new cases per 100,000 residents.
In those same two weeks, there were just 0.23 new deaths per 100,000 residents in the Sacramento region, well below the statewide rate of 2.2 new deaths per 100,000 residents.
The region had about 2.1 patients hospitalized with confirmed COVID-19 per 100,000 residents as of Monday, well below the statewide rate of 8.2 confirmed patients per 100,000 residents.
The increases, however, bring up the question: Under what conditions would state or county health officials decide that the coronavirus is making enough of resurgence to warrant shutting down some businesses or activities.
It’s a cost-benefit analysis, in a sense. Residents and leaders have made it clear in recent weeks they want to reopen the economy, get people back to work, and to allow more social activity. That is being done, however, knowing it means more COVID-19 spread.
“We’re in the land of trade-offs,” said Andrew Noymer, an epidemiologist from UC Irvine, who has been observing the virus response in California. “There is no reopening without increase in cases. There is no increase in cases without some mortality. Now, that’s just the way it is.”
The entire process of closing the economy in March and reopening it in May and June has been fluid, with ever-changing rules as Gov. Gavin Newsom and health officials react to data from counties, hospitals and coroners, but also to political pressure from constituents, many of whom have lost jobs and livelihood in the shutdown.
The governor’s health officials announced last week they will allow a new set of reopenings as of this Friday, including bars, gyms and fitness centers. Sacramento County officials on Tuesday confirmed they will allow those openings locally as well.
The county also announced it will hire 24 “navigators” next week who will be assigned to visit small- and medium-size businesses and help them implement coronavirus safety measures as they reopen.
Health officials say they will be focused not so much now on the number of cases or even on the number of hospitalizations. Instead, it is the percentage of positive test results that will determine whether the virus is resurging. If the the percentage of positive tests remains low, the economic reopening can continue, officials say.
Secondarily, if hospitals start struggling to deal with the number of patients, that likely would be another trigger point for reinstating elements of the state’s now three-month-old stay-at-home order.
This story was originally published June 9, 2020 at 11:10 AM.