Cases of COVID-19 in Tulare County have spiked by more than 75% in the last two weeks, and officials fear the trend will continue into the winter months.
1,000-plus New Cases
The Tulare County Health and Human Services Agency (TCHHS) reported 482 new cases of COVID for the week ending November 9 and 625 for the week ending November 16. The county has also seen six additional COVID deaths, and an outbreak at three long-term care facilities.
“Overall, for the last two weeks our cases are up 75.1%. When we look at our seven-day lagged, our rate now is 15.2 per 100,000 (people tested),” said TCHHS director Timothy Lutz. “The only positive sight here, our seven-day lag positivity has still stayed below the 8%. It’s still very high at 7.2%, but at least we’re staying below that 8% threshold that we crossed a few weeks ago.”
Unfortunately, the recent “emergency brake” action by Gov. Gavin Newsom that placed 41 counties back in the purple tier also means the state will no longer use a seven-day moving average of a county’s positivity rate per 100,000 residents as a reopening metric, instead switching to a four-day moving average.
County Paying Employees to Get Tested
The county is also making a concerted effort to test more individuals, with the goal of lowering Tulare County’s positivity rate.
“Our testing volume has continued to show good progress,” Lutz said. “The seven-day lag was at 252 (tests) per 100,000 people; four-day was at 303 (tests) per 100,000, and that’s reflective of our increases in testing countywide.”
To help drive those testing numbers higher and loosen state restriction, the county has instituted the Employee COVID-19 Testing Incentive Program. If Tulare County’s approximately 5,000 employees complete four rounds of COVID-19 testing before December 28, they receive an additional paid day off in 2021. To encourage employee testing, the county is also allowing them to be tested while on the clock.
“For the COVID-19 Blueprint for Reopening Plan, if a county is able to test beyond state averages, the state can reduce reopening metrics,” said TCHHS spokesperson Carrie Monteiro. “Prior to this week, they were making adjudication of case rates. We did see a county on the margin, and they were able to avoid the jump because of increased testing.”
After the “emergency brake” action, those reductions are no longer being offered.
“The unfortunate thing is that it does mean once again the goalposts change, which is beyond frustrating given where we’ve been,” Lutz said.
Local Transmission Rate Climbing
While testing numbers are up, what they’re showing is an increased rate of transmission, with each COVID-positive individual infecting more than one other person on average, a number known as the “effective reproduction” rate or “R-effective.”
“Our R-effective has unfortunately gone above 1 again,” Lutz said. “We’re at 1.14, indicating spread is likely.”
Holiday gatherings, he said, have been drivers of disease spread, which is particularly concerning as we enter the winter holiday season.
“We are expecting that we’ll see this heightened transmission rate for a while, likely into January,” said Lutz. “The cool fall weather, more activities occurring indoors, are a driver, as are increases in gatherings that are happening from Halloween parties, and we would expect with Thanksgiving coming up, Christmas, New Year holidays, those gatherings to continue, which will continue to increase our case rates.”
During the last two weeks, hospitalizations for COVID-19 have risen by 38.5%. New infections in Tulare County, however, are happening at a slightly slower rate than the state average.
“(The local infection rate) is consistent with the state, where the state, over the last two weeks, saw an 89.7% increase in their cases, which they’re reporting is the fastest increase rate through the entire pandemic,” Lutz said.
Schools, Nursing Homes at Risk
The increase in infections in Tulare County is also cause for concern as students in many of the county’s schools prepare to return to in-person instruction. The county’s numbers have grown well above the limits for allowing educational waivers.
“Looking at the metrics, obviously, we’re very concerned,” Lutz said. “For the first time since mid-September, our seven-day lagged case rate moved above that 14-per-100,000, and that was really our trigger for granting the broader Pre-K-to-sixth-grade school waivers.”
The county has also seen another outbreak of infections at long-term skilled nursing facilities. Tulare Nursing and Rehabilitation, Sequoia Transitional Care and Redwood Springs have all had outbreaks among residents and staff. More than 50 people have tested positive at those locations. Lutz said health officials will monitor the situation closely to ensure contamination protocols are in place.
Those who work in the medical industry will be among the first to receive one of the new coronavirus vaccines, perhaps as early as December. The county, Lutz said, is already planning for vaccine distribution and storage.
No Enforcement of ‘Flagrant Violations’
Since the early days of the pandemic, many local officials have maintained an attitude that restrictions on businesses and gatherings were unnecessary. Local law enforcement agencies declared their intent not to enforce state health orders. During the Tulare County Board of Supervisors meeting on November 17, Supervisor Amy Shuklian (District 3) voiced her frustration at the lack of response by authorities.
“Obviously, this didn’t go away after the election like so many people said it would,” Shuklian said. “So, I’m just wondering when we’re going to stop turning a blind eye to the blatant disregard (for health orders), especially with large-group events and whatnot in the county.”
During the same meeting, supervisors Pete Vander Poel (D-2), Dennis Townsend (D-5) and Kyler Crocker (D-1) were called out for their lack of personal protective gear by Megan Casebeer-Soleno, Senior Deputy Public Defender, and recently elected member of the Visalia Unified School District Board of Trustees, who was in attendance as a labor representative.
“I’m shocked to see there are three supervisors not wearing masks here today,” Casebeer-Soleno said. “Be leaders. Protect our community. Grow up.”
Open Businesses, Gatherings Driving Spread
Businesses open in defiance of state orders combined with the lack of enforcement is among the major drivers of Tulare County’s continued high infection rates and the resulting state-level restrictions, according to Lutz. He also blamed large social gatherings.
“We are seeing a larger increase in noncompliance for businesses and particularly with events. We’re seeing multiple seasonable celebrations occurring,” he said. “Also seeing increases with weddings, birthdays at larger facilities, and, unfortunately, some facilities, they’re not really cooperating with public health and flagrantly violating the state guidelines.”
Ensuring compliance with state health orders has been handed off to local code enforcement officials, and both the Visalia Police Department and the Tulare County Sheriff’s Office have declared their intent not to enforce the rules.
Free Public Testing
Despite fighting an uphill battle, county health officials continue to reach out to the public for help in the form of voluntary testing. Widespread testing, TCHHS’s Monteiro said, helps identify the up to 40% of infected individuals who show no symptoms but still spread the virus.
“We want to catch those asymptomatic carriers and get them isolated,” she said. “Increased testing will give us a more accurate picture of how many individuals are actually infected in Tulare County.”
COVID-19 tests are available free of charge to anyone who wishes to be tested at three locations in Tulare County: the Tulare County Fairgrounds in Tulare, the Dinuba Memorial Building and the Porterville Veterans Memorial Building. The testing sites are open Wednesday through Sunday, 7am to 7pm.
Monteiro stressed the county does not, contrary to rumor, report multiple positive tests for the same infected individual.
“We do not report duplicate cases,” she said.
Widespread testing is intended to demonstrate the county is moving below the reopening metric of seven new cases per day per 100,000 residents.
“In order for Tulare County to move out of the purple tier, we’d have to have no more than 32 new cases per day,” Monteiro said. “We were very close to meeting that metric, but unfortunately, we are reporting a case rate today of 18 (new cases per day per 100,000 residents).
A full list of testing locations and times is available at the county’s COVID-19 monitoring website: covid19.tularecounty.ca.gov.