Rural California counties tighten mask rules as COVID patients flood hospitals
Rural parts of Northern California are watching a hospital crisis play out in front of them — and all around them.
Several sparsely populated counties north of Sacramento and the Bay Area are in the midst of their worst COVID-19 surges of the entire 18-month pandemic, with new cases, hospitalizations and deaths accumulating at their fastest rates yet in some areas.
And with infections still spiking and more counties’ hospitals hitting capacity, rural Californians are increasingly finding themselves without alternative options for emergency care.
Seven California counties set their all-time records for COVID-19 hospitalizations in the first half of August: Del Norte, Humboldt, Tuolumne, Nevada, Mendocino, Lake and Amador. Three more — Placer, Shasta and Plumas — have joined that group in the past two weeks.
Ten coronavirus patients died in one week at Sutter Coast Hospital in Crescent City, the only general acute care hospital in Del Norte County, state Sen. Mike McGuire said during a virtual town hall meeting Thursday evening.
Four of those patients died in the 24 hours leading up to that meeting, McGuire said.
“There are more that we believe have died outside of the hospital in the community.”
Del Norte had only recorded 10 virus fatalities in the previous 17 months of the pandemic, from March 2020 through early this month, according to the local health office website.
Sutter Coast has just 49 licensed beds, and 20 or more were occupied by patients with confirmed COVID-19 for the week of Aug. 20 through last Thursday, according to California Department of Public Health data.
Eight were critically ill and in the intensive care unit, which has nine beds, early last week. The hospital has been modifying other parts of the hospital to accommodate additional ICU patients, Sutter Coast CEO Mitch Hanna said in Thursday’s Zoom meeting.
Hanna said the hospital is also being impacted by staff members testing positive for COVID-19. The state has sent doctors, nurses and other resources to assist.
If Sutter Coast is at capacity, where else are Del Norte residents to go?
To the east, there’s wilderness. To the north, there’s southern Oregon, which is facing its own record-shattering surge of COVID-19 hospitalizations. To the south, it’s a nearly three-hour drive along Highway 101 to get to northern Humboldt County — which, like Oregon, is amid its steepest hospitalization surge yet, with only a handful of ICU beds available in recent days.
To the west, there’s the Pacific Ocean.
It’s a similar situation in many parts of Northern California, coastal or not. Siskiyou County, also along the Oregon border but inland, as of Friday reported having 13 virus patients, two shy of its all-time high. A day earlier, Siskiyou hit a record-high five patients in intensive care with just two ICU beds available.
Go north from Siskiyou along Interstate 5 and end up in Jackson County, Oregon, which is entrenched in a hospital crisis deep enough that it made national headlines this week. Head south and arrive in Shasta County, which in recent days has shattered its records for hospitalizations and ICU patients with COVID-19.
Sutter Coast now has two tents outside: one for patient triage and another to handle a potential overflow of patients, Hanna said.
“I want to be blunt: We believe the worst of this public health crisis is still to come over the next two to four weeks,” McGuire said Thursday. “That’s when we could potentially expect a peak in cases.”
Stricter COVID rules return to some counties
In the Sierra Nevada foothills, Nevada County tightened its local COVID-19 health orders twice in two weeks.
County health officer Dr. Scott Kellermann first ordered masks mandatory in shared indoor settings, joining the likes of Sacramento, Los Angeles, the Bay Area and others combining for more than half of California’s population. Nevada County’s indoor mask order took effect Aug. 20.
Kellermann then went a step further last week: In one of the tightest local orders issued anywhere in California since the state dropped most restrictions June 15, Nevada County now also requires masks in crowded outdoor settings; prohibits events with more than 2,500 people in attendance, both indoor and outdoor; and requires any event with between 500 and 2,500 guests to develop a plan to verify vaccination status or proof of a negative COVID-19 test before entry.
CDPH has ordered a similar requirement at the state level for proof of vaccination or testing, but with the minimum size at 1,000 attendees and for indoor events only. That goes into effect Sept. 20.
The strict local rules come as Nevada County faces its worst surge, driven by the delta variant. The county has reported just over 7,000 confirmed COVID-19 cases for the entire pandemic, more than 2,000 of which have come since July 1, according to the county’s online data tracker.
Nevada County had just a single resident death from the virus between late January and early August. At least 10 have died in the past three weeks, county health officials report.
“The hospitals in Nevada County are impacted, and all hospitals in the region are reaching their inpatient limit,” the county wrote in a news release Wednesday announcing the amended health order, which took effect last Friday. “There is very limited capacity for transferring patients within the region.”
Del Norte County health officer Dr. Aaron Stutz on Thursday ordered a universal mask mandate for indoor public settings and crowded outdoor events.
Stutz in a separate letter to the community also “strongly recommended” that bars and restaurants cut capacity to 50% of normal; that venues consider canceling large events; and that employers able to switch to remote work do so.
“Hospitalizations and deaths associated with COVID-19 in Del Norte County have risen to a record high, resulting in an extreme impact on our rural healthcare infrastructure and requiring resource requests from the state,” Stutz wrote in the latter document.
Rural Plumas and Trinity counties also last week ordered mandatory masking in indoor public settings regardless of vaccination status. Close to two dozen counties now have mask orders in place, including Mendocino and Humboldt, which returned to mandates earlier this month.
Oregon issued a new statewide mask mandate, covering indoor and outdoor public spaces, which took effect last Friday.
For Nevada County, the new, tight restrictions came shortly after the end of the county fair, which proceeded as planned in mid-August but with the health office and other county officials asking the immunocompromised and those ages 65 or older to consider not attending. It remains too early to know the potential impact of the fair on infections.
‘Totally avoidable’: More calls for vaccination
Del Norte County has one of California’s worst vaccination rates, with only 43% of eligible residents ages 12 and older fully immunized, according to the county website. Statewide, over 66% of eligible Californians are fully vaccinated, according to the CDPH.
Stutz said about 96% of hospital admissions at Sutter Coast have been unvaccinated.
McGuire, whose district covers counties along the Northern California coast, called the current surge in Del Norte “totally avoidable.”
“It’s a surge mostly among the unvaccinated,” McGuire said Thursday. “The best way out of this pandemic right now is by getting the shot.”
Marin County, at the southern end of McGuire’s constituency, has the highest vaccination rate in all of California, with 75% of all residents fully immunized and 81% with at least one dose.
It also as of Monday had one of the state’s lowest test positivity rates at 3%, and no hospital crisis to speak of, state data show. Just 3% of its hospital beds were occupied by COVID-19 patients, according to CDPH figures updated Monday.
Stutz, who is also an emergency physician, posted a video to Facebook last week, pleading with the community to get vaccinated. He stood outside Sutter Coast in medical scrubs, standing next to a tent in the parking lot he said was ready to handle overflow patients.
This story was originally published August 30, 2021 at 1:27 PM.
