It no longer just matters how many people in California have COVID-19 but who has the disease caused by the novel coronavirus.
The state’s rollout of new health equity measures this week will require all California counties to develop a plan to bring down coronavirus infection in disadvantaged communities, where black and hispanic populations have been disproportionally hit the hardest by the pandemic.
Colusa County Public Health does not release specific COVID-19 information on ethnicity, but neighboring Glenn County reports that 71 percent of their COVID-19 cases are in the Latino community; 23 percent are caucasian, and six percent are “other.” Of those, 54 percent are female and 46 percent are male. Both Glenn and Colusa have a majority Latino population and a significantly large Latino workforce.
The new health equity measure is a move by the State that could slow the reopening of businesses in California, including gyms, bars, and restaurants, which have been especially hurt by the coronavirus shutdown, officials said.
Health and Human Services Director Elizabeth Kelly said Colusa County and counties with under 106,000 people will be held harmless for health equities, but that the county will still have to develop a plan to combat the spread of virus among the socio-economically disadvantaged.
Like the new colored tier that continues to keep Colusa County in the purple or “widespread” case count, measuring health equities in small counties is next to impossible.
“They can’t even measure the data because we are too small,” Kelly said.
The current tiered plan that took effect in August is a rigid four-step process based on the percentage of positive tests and per capita new cases, which would only allow Colusa County to reopen businesses or hold social gatherings if the county met state standards for both numbers for two consecutives weeks.
The new health equity measure now adds a requirement for counties to reduce the gap between the positivity rates in disadvantaged communities and the positivity rates in the county as a whole.
“Because of our county being so small, it’s not something we necessarily have to be concerned about as it is evaluated in the tier framework, but it does have to be part of our ongoing plan and response to COVID-19,” Kelly said.
Colusa County to date has had about 550 positive cases of COVID-19, with a total 2.5 percent positivity rate. The largest outbreak was in July, when 113 staff and patients of a nursing facility tested positive. All but six people recovered.
“The average since that day on a two-week interval is 44, which is .20 of 1 percent, which is one-fifth of one percent of our entire population testing positive at any given point,” said Supervisor Gary Evans, who insists the state has overstepped its authority by issuing onerous regulations that have crushed the economy.
Evans said that although Colusa County had Covid-related deaths of elderly patients receiving end-of-life or convalescent care, the total positivity and death rate from the disease is extremely low.
“Over the last 200 days since we have been playing this game, (Colusa County) averages less than 3 cases per day,” Evans said. “That being said, and this is Webster: Pandemic is an epidemic over a large region…and rapid spread of a disease so that many people have it at the same time. The definition of ‘many’ is consistent of some large definite number of persons, relatively numerous…a great many. I don’t see these definitions in any of these numbers, and by relationship, heart disease. The average fatalities in the state from heart disease is over 60,000 per year in California.”
Evans said COVID deaths in California is one quarter of heart disease deaths at six months, and one third of heart disease deaths nationwide.
“This is not an epidemic,” said Evans, referring to the COVID numbers.
That being said, County officials said the continued shutdown and directives on coronavirus are handed down from the national and state levels.
“It (coronavirus) is very contagious,” said Board of Supervisor Chair Denise Carter. “So without the precautions people are doing, it could be very significant.”
While local officials push back on the state’s metric, the county will still have to address coronavirus spread in low-income communities, although the state has not addressed the reason low-income communities are vulnerable: the financial need for people to work, extended or multiple families living together, and lack of access to health care.
Kelly said the state’s overall positivity rate is less than 3 percent, which sends a mixed message to residents in counties with low populations and where testing is not widespread. Because the measurements is skewed, last week’s three new positive cases was enough to put Colusa County back into the purple tier (widespread).
While Colusa County moved up to the red tier once since the new matrix was implemented, Kelly said the county must maintain a low positivity rate for three weeks, making it harder – if not impossible – for Colusa County to reopen.
“One of the biggest drivers in the community is that 90 percent of the population is considered essential workers,” Kelly said. “They leave their homes every day and go to work. They are not in other counties where they can work virtually or that sort of thing. Many go to work for two jobs.”
Kelly said because the state’s metric is not realistic or practical, it could keep Colusa County in the purple tier indefinitely.
Still, County officials encourage residents to take precautions to avoid contracting the virus, such as hand washing, maintaining distances, and wearing face coverings when in public. Officials also encouraged people to stay at home if they are sick. ♣