Curfew rules become clearer, COVID-19 cases still on the rise

New limited stay-at-home order from state public health department institutes a curfew for gatherings between 10 p.m. and 5 a.m. through Dec. 21; cases, hospitalizations are increasing throughout the county

CALIFORNIA – Curfew orders handed down by Gov. Gavin Newsom took effect last Saturday night at 10 p.m. only five days after plunging 41 of the state’s counties back into the “purple tier” last Monday. Newsom called it pulling the “emergency brake” on the state’s Blueprint for a Safer Economy, the third such schema since the governor issued his stay-at-home order in March. But since Tulare County never escaped the restriction of the widespread “purple tier” not much has changed, although some things have been thrown into ambiguity.

On Nov. 17, Gov. Newsom threw dozens of counties into the purple tier (widespread) in anticipation of surging COVID-19 cases over the coming weeks.Source: California Department of Public Health / Infographic by Robert Perry

On Thursday, Nov. 20 the California Department of Public Health (CDPH) issued a press release. In it, acting state public health officer, Erica Pan said the unprecedented rate of increase in COVID-19 cases all over California forced her department to take “immediate actions” to prevent the spread.

Pan stated that all gatherings with members of other households and all activities conducted outside of a person’s residence should, “cease between 10 p.m. and 5 a.m.” However, that excludes activities associated with the operations, maintenance, or usage of critical infrastructure required by law. Under the Blueprint for a Safer Economy, because Tulare County has only been in the purple tier, the only added restriction appears to be the curfew which is supposed to be lifted on Dec. 21. Restaurants though were left with some unclear news early on.

Secretary of California Health and Human Services, Dr. Mark Ghaly, said during his Friday press conference that the point of the 10 p.m. to 5 a.m. period is when the state believes people are gathering and “letting their guard down.” By limiting gatherings during that time he hopes to limit transmission of the virus.

“Masks come down and then maybe there are some activities that are increased that lead to an increased transmission,” Dr. Ghaly said. “We are fatigued…it’s all looking at the various tools based on the various lessons we’ve learned over time.”

While in the widespread tier no restaurants or bars could allow for indoor dining, and that hasn’t changed. As the state transitioned into it’s latest rendition of reopening, restaurants were allowed to provide outdoor dining. Cities all over the county made accommodations to restaurant owners by allowing them to block off sidewalks and parking stalls with firm barriers to provide seating. They are particularly prevalent in downtown Visalia.

But on Thursday Dr. Ghaly indicated that restaurants should go back to pickup and drive-thru orders during a press conference. The first questions he was asked was how this will affect businesses.

“This impact is that those nonessential business sectors…they are requested to stop all operations, not just indoor operations…those outdoor services should also stop,” Dr. Ghaly said regarding restaurants.

Restaurants are still considered an essential business under the state’s essential workforce guidelines. And while they were prohibited from indoor and outdoor dining through the first three months of the pandemic, the Blueprint for a Safer Economy allows them to host outdoor dining in the purple tier. The Tulare County Health and Human Services Agency added some clarity on Tuesday.

“Restaurants are allowed to continue outdoor seating operations. However, those seating operations are to close between the hours of 10 p.m. and 5 a.m.,” HHSA public information officer Carrie Monteiro said. “Restaurants are allowed to provide take out meal operations during the hours of the limited stay at home order in effect in widespread purple counties statewide.”

By the numbers

Tulare County’s seven-day average positivity rate per 100,000 people has held steady enough to qualify for moving into the “red tier” indicating substantial spread. The county’s health equity positivity metric has also been good enough to land them in the red tier. What had plagued them for weeks was the adjusted seven-day average of new cases per 100,000 people. As of Monday, Nov. 23 that metric stood at 17.6 new cases per 100,000 people and it would need to be less than seven to reach the red tier.

Worse yet has been the new cases from one week to the next. The adjusted seven-day average of new cases grew by 7.6, while the seven-day average positive test rate grew by 1.9 over last week. There were also 209 new cases reported on Monday bringing the total number of cases to have occurred in the county to 19,882. Of those, 18,479 have recovered, and there have been 136 new recoveries reported over the weekend. Tulare County crossed the 300 mark in terms of deaths and reported 304 on Monday.

As of Nov. 17 deaths in skilled nursing facilities related to COVID-19 have reached 119. Nine of them have been between 41 and 64 years old, while 110 of them have been 65 years old or older. Otherwise there have been 181 deaths outside of skilled nursing facilities. Four of those were under the age of 41 years old, 54 were between 41 and 64 years old and 123 were 65 years or older. But those numbers may rise, specifically in skilled nursing facilities.

Tulare County HHSA director Tim Lutz reported to the board of supervisors last Tuesday, Nov. 17 that outbreaks have begun to materialize in three differing skilled nursing facilities. Lutz said that Tulare Nursing and Rehabilitation has had 22 residents and eight staff contract the virus. Sequoia Transitional Care has 10 residents and nine staff with the virus. And Redwood Springs has eight residents and nine staff with the coronavirus.

Lutz said in response to questions from board member Kuyler Crocker that staff has been the one to bring the virus in. He added that it is up to the facilities’ administration to clamp down on transmission, and enforcement of COVID-19 protocols comes entirely from the state. Hospitalizations are not looking great either.

According to Tulare County HHSA’s Monday report there were four more hospitalized COVID-19 patients as of Saturday, Nov. 21. That brings the total to 67 hospitalizations in the county. Fortunately, 40.2% of the ICU beds are still available. The state target is set at 20% or greater. As far as ventilator availability, HHSA’s Monday report showed the 56.6% of ventilators in the county are still unused.

Tulare County schools that have provided waivers are expected to continue unabated. Lutz said during his presentation that 87 school sites have been given the thumbs up. Twenty-eight other schools have submitted waivers that are currently under review. Dr. Ghaly said during his press conference last week that the state is confident in the COVID protocols in place in schools and doesn’t believe that limiting in-person school instruction is necessary. Unfortunately, it does mean that any hope of returning middle and high schoolers to class has vanished.

September and October were challenging months for students in seventh through twelfth grade. Tulare County’s Mental Health Branch saw 33 mental health hospitalizations for teens in September, and 28 in October. The hospitalizations were startlingly high for the board and Lutz, who said it was triple the average for September, and the trend continued into October. They seem to be coming back down to normal levels. Lutz said last Tuesday that as of Nov. 14 there have been eight youth hospitalizations.

Flouting the rules

In Tulare County it has not just been gatherings that have led to the spread of COVID-19. According to Lutz’s presentation from Nov. 17 it has also been noncompliant businesses who are holding large events. Specifically, he cited weddings and birthdays at larger facilities.

“Unfortunately, some facilities are really not cooperating with public health and flagrantly violating the state guidelines,” Lutz said. “Gyms and restaurants without ABC licenses continue to be problematic for us.”

Supervisor Amy Shuklian used her time for comments to lament the lack of adeherence to public health guidelines by bad actors in the community.

“I know this isn’t going away after the election like so many people said it would. So I’m just wondering when we are going to stop turning a blind eye to the blatant disregard, especially with large group events and what not in the county,” Shuklian stated.

What the new curfew means for the average person is not necessarily as complicated as what it means for businesses. Dr. Ghaly used a common line that had been stated by Gov. Newsom in March that residents can still go out “and walk their dog” after the curfew. And California Highway Patrol Commissioner Amanda Ray quelled any fears that people would be pulled over if they were out after 10 p.m.

“The mission of the CHP is unchanged. CHP officers will continue to patrol throughout California and use their sound professional judgment to conduct enforcement stops for violations of the law based upon probable cause,” Ray stated in a Thursday evening press release.

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