County braces for new state mandate that would pause indoor activities

Bartender MIriam Niemela works the register at the Carriage House bar in Kearny Mesa.
Bartender MIriam Niemela works the register at the Carriage House bar in Kearny Mesa, which like all other bars in the county will have to shut down to prevent the spread of COVID-19.
(John Gastaldo/John Gastaldo)

Restrictions would affect other types of businesses from wineries to zoos


Just as the public got comfortable sliding into restaurant booths again, it looks like indoor dining, and a host of other recently-returned indoor activities, may soon land back on the COVID-19 casualty list.

County health officials warned Wednesday that increasing case totals are likely to put the region on the governor’s COVID-19 watchlist by the weekend, a designation that would mean immediate adherence to significantly-more-restrictive operating requirements as soon as Monday.

Earlier in the day, Gov. Gavin Newsom ordered 19 counties on his watch list due to sustained and elevated levels of coronavirus activity to immediately cease all indoor activities at a wide range of locations including restaurants, movie theaters, zoos, museums, card rooms, wineries and tasting rooms. Tribal gaming centers have not yet been affected, due to their sovereign status, but the governor said his administration is in extensive conversations with locations that have reopened.

In order to end up on the governor’s list, a county must cross one or more of six different state early warning thresholds designed to flag places where the novel coronavirus virus appears to be moving from person to person at an increasing rate. The six red flags measure the average number of tests performed, the number of cases per capita, the percentage of tests coming pack positive, increases in COVID hospitalization, intensive care unit bed occupancy and mechanical ventilator availability.

San Diego, officials said during a news conference Wednesday afternoon, set the state’s per-capita warning bell ringing Tuesday when the region had more than 100 confirmed COVID cases per 100,000 residents as measured over a rolling 14-day period. The number remained at 105 in Wednesday’s daily report, and Dr. Wilma Wooten, the county’s public health officer, said she does not expect the figure to drop below 100 soon enough to avoid making the governor’s restrictions list.

“We anticipate by the weekend that we will be on that list as well,” Wooten said.

But landing on the list is not enough to trigger the governor’s restrictions and force restaurants to serve diners outside only.

Once on the list, the average must remain elevated for an additional three consecutive days before a county is forced to comply. County Supervisor Nathan Fletcher said compliance would likely be required, if the numbers do not change, just as the July Fourth weekend ends.

“On July 6, we would be forced to take the enforcement action which means three weeks pause on indoor activities for the entities mentioned in the governor’s orders,” Fletcher said.

It was the third straight day of difficult news for the hospitality industry. On Monday, officials said that, starting Wednesday, all local bars would have to close unless they started operating like restaurants, selling food with every drink order. A second provision followed Tuesday with all restaurants learning they will have to begin closing every night at 10 p.m., a move that effectively evaporated the city’s night life just weeks after it restarted.

There was no progress to be had in Wednesday’s daily COVID statistics report.

The county announced a total of 474 new cases Wednesday, once again verging toward the 500 mark just one day after posting a lower total of 317. The local 14-day rolling average of positive COVID tests sits at 4.5 percent, still significantly lower than the 6 percent statewide positive rate that the governor announced during his midday news conference Wednesday. Seven additional COVID-related deaths were announced, bring the local total to 372.

The number of COVID cases being treated in local hospital beds showed a bit of positivity Wednesday, falling from 493 to 453. However, the number was still nearly 100 hospitalizations higher than it was just one week earlier.

Though the county has said that restaurants and bars, along with gatherings in private homes, are the most likely locations to cause COVID outbreaks in the community, there is anecdotal evidence that these establishments have been, by and large, running tight ships.

The San Diego Union-Tribune undertook an unscientific, but extensive survey of operations inside coastal San Diego County bars and restaurants Tuesday evening, visiting establishments in Carlsbad, Encinitas, Cardiff, Pacific Beach, Mission Beach and the Gaslamp Quarter from 8 p.m. to 11 p.m.

Without fail, every single restaurant that a reporter visited was following safety protocols to the letter. Waiting lines were properly marked to control overcrowding; face masks were mandated until patrons were seated at their tables; patrons were kept seated while consuming alcohol; tables were spread at least six feet apart.

People walk in Pacific Beach without masks Tuesday at 9 p.m.
(Pam Kragen)

The same could not be said, however, for the public. Many dozens of people in their 20s could be seen walking in packs without face coverings even with the weekend still on the horizon.

And it is pretty clear that younger people are paying an increasingly-high price.

Chris Van Gorder, chief executive of Scripps Health, the local medical system that has recently had the highest collective number of hospitalized COVID patients, said in an email Tuesday that infections among younger people have recently caused emergency department traffic to surge and intensive care beds at some facilities that serve communities where infection rates are highest have reached significantly higher occupancy rates.

“I’m sorry for the impact on the businesses, but I applaud the action of the county,” Van Gorder said in an email sent Tuesday. “I hope this first step serves as a warning to other businesses and the community that, if they do not strictly enforce physical distancing, wearing masks and proper cleaning and hygiene steps, all the work and sacrifice of the last four months will be lost as we end up with the COVID surge we worked so hard to avoid.”

When the COVID-19 pandemic first surfaced in March, Dr. Wilma Wooten’s first public health order required local hospitals to cut back on elective surgeries where possible but, asked whether a similar mandate might be in the offing given the recent increases in hospitalizations, officials said a blanket order is unlikely at this time.

The county prefers, said Dr. Eric McDonald, the county’s epidemiology director, to take a more tailored approach this time around. Each individual hospital, he said, has the ability to tailor their approach in real time, rescheduling cases deemed less urgent if the number of COVID-related admissions surges.

“The hospitals are doing a great job of actually managing this themselves,” McDonald said Tuesday.

So far, local bed capacity has held up pretty well. Even with recent increases in hospitalization, medical centers have collectively continued to have thousands of hospital beds available. But that’s not necessarily a universal truth.

Patricia Maysent, chief executive of UC San Diego Health, said Tuesday that her hospitals have begun to see higher rates of employees calling in sick after becoming infected in the community. This trend, she added, is particularly worrisome because hospital beds are useless without bedside workers.

“I am highly concerned about the growth that we’re seeing in the numbers,” Maysent said. “In some sense, staffing, rather than beds, becomes the rate-limiting factor.”

So far, though, hospitals have not started cancelling non-emergency surgeries and procedures. Diane Hansen, chief executive at Palomar Health, said many learned the lesson of canceling too quickly back in March only to find themselves with empty beds as a blanket stay-at-home order kept coronavirus transmission rates low.

“I think, if we’ve learned anything from the first go-around, it’s really, let’s wait a little longer before we shut everything down because, when we need to, we can do it in a heartbeat,” Hansen said. “It’s that spinning back up on the other side that takes so much longer.”