California health officials are monitoring coronavirus spikes in these 9 counties

Alarmed by increasing cases of coronavirus, state health officials this week listed nine counties on a watch list. The list includes both large and small counties that appear to have trouble containing the virus, each for different reasons.

In each case, state officials say they are stepping in to help those counties with particular problems each is having dealing with virus outbreaks or hospitalizations. The list includes Sacramento County, where family gatherings are partly to blame for an increase in hospitalizations.

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.

Here is the state list of counties being monitored, as of Tuesday morning:

• Sacramento County has increased hospitalization, the state said, “due to increased informal and formal gatherings, transmission among large families, and workplace exposures in the food industry. Key action steps to address concerns include: 1) increase messaging on the importance of social distancing, not gathering, and personal protection measures; 2) increase access to community testing; 3) conduct workplace evaluation and testing; and 4) targeted outreach to ethnic communities and provision of language specific educational materials.”

• Fresno County is experiencing elevated disease transmission. One cause is skilled nursing facilities. Another is an outbreak at the Avenal state prison, which has staffers who live in Fresno. State officials say they will focus more prevention efforts at nursing facilities.

• Imperial County is experiencing elevated disease transmission. State officials say U.S. citizens crossing the Mexican border seeking healthcare are causing some transmission. The county has a shortage of hospitals. The state is transporting patients to hospitals in neighboring counties.

• Kings County is dealing with increasing hospitalizations, and limited hospital capacity. Causes include outbreaks at Avenal State prison, “resulting in secondary infection to staff working within the central and satellite kitchens.” There has been an outbreak at a local Adventist Health system facility and skilled nursing facility outbreaks.

• Los Angeles County “is experiencing the possibility of elevated disease transmission.” The county has a “high case rate that is highly related to high testing capacity and volume countywide, which also includes testing all residents and staff at over 235 skilled nursing facilities.” Key actions to monitor the situation include “monitoring positivity rate among those tested to ensure that there isn’t a significant increase that may signal more community transmission,” providing infection prevention expertise at nursing homes, and working on improving supply chains for personal protection equipment.

• San Bernardino County has more cases and increasing hospitalization. “Drivers of this include gatherings after May holidays, outbreaks at state prisons; county jails, and some skilled nursing facilities.”

• San Joaquin County is experiencing increasing hospitalization and limited hospital capacity. “Drivers of this include 1) community transmission due to gatherings; 2) workplace transmission followed by household transmission; 3) skilled nursing facility outbreaks; and 4) increase in widespread testing.“ The state plans “increased public messaging on the importance of personal protection measures and the risks involved with mass gatherings in multiple languages.”

• Santa Clara County is experiencing increasing hospitalization. Drivers of this may include: 1) increased testing of county residents and individuals in neighboring counties who seek hospital care in Santa Clara County, resulting in an increase of COVID+ patients admitted for observation and treatment; and 2)patient transfers from outside the county; and/or increased transmission among residents or individuals from neighboring counties who seek care in hospitals in Santa Clara County.”

• Tulare County is experiencing elevated disease transmission. “Drivers of this include outbreaks in skilled nursing facilities and work places and barriers to preventing transmission within households. Increased hospitalizations and ICU utilization have been related to multiple conditions other than COVID-19. “

This story was originally published June 9, 2020 at 11:53 AM.