The following indicators (“Indicators”) will be tracked by each of the Health Officers in the Bay Area to assess our collective progress in ensuring we have the strategies and infrastructure in place to contain and treat COVID-19. These Indicators are designed to provide measurable goals that will spur action on the part of the community at large, driving us to work together to create this infrastructure and to achieve our strategic goals. These Indicators are complementary to the high-level metrics that are being tracked by the California Department of Public Health and the Governor. The data below represent a baseline snapshot of Santa Clara County’s current progress toward these goals and updates to this data will be provided at regular intervals.
The Indicators are important measures of progress as we assess whether and to what extent we can move away from the existing shelter-in-place restrictions that have been required to slow the spread of the virus. However, other factors will also guide the Health Officers’ decision making, including the development of other methods to contain COVID-19, the impact of the staged reopening of various sectors, the level of compliance with social distancing orders and guidance, collective compliance with isolation and quarantine directives for persons who are infected or exposed, and other scientific developments during this rapidly evolving pandemic. Further, decisions to modify existing restrictions will be made based on the totality of the circumstances; substantial progress on several important Indicators and other factors may allow additional activities to resume even if certain goals within the Indicators have not yet been achieved.
These Indicators are based on our current understanding of the virus, our assessment of what goals are achievable in the coming weeks and months, and current tools to mitigate and contain the virus. We will be continuously assessing these Indicators as circumstances change; the science regarding COVID-19 (and its spread) continues to grow and evolve week by week.
Cases are persons who are contagious with COVID-19 whether or not they have symptoms. We currently lack the testing capacity necessary to know how many cases exist in our community, and to accurately track our progress in reducing both the total number of cases and by how much we are slowing the rate of transmission. We also need to greatly expand our capacity to isolate individuals who have COVID-19 as well as capacity to quarantine their contacts and ensure we break chains of transmission. With this infrastructure in place, we can contain COVID-19 without needing to keep very restrictive shelter-in-place measures in effect. We are asking for help from every sector in the community to quickly resource and stand up this infrastructure.
We plan to report publicly on our progress on these local Indicators, so that the community can also track our collective progress.
Indicator 1: The Total Number of Cases in the Community is Flat or Decreasing, and the Number of Hospitalized Patients with COVID-19 is Flat or Decreasing
- The number of new cases identified per day is flat or decreasing in the coming weeks and months.
- We know that as we increase testing, our numbers may temporarily go up. Increased testing will provide a more accurate picture of how many cases exist in our community. We will be closely monitoring and analyzing this information week by week.
- The number of hospitalized patients with COVID-19, across all hospitals, is flat or decreasing for 14 consecutive days.
Indicator 2: We Have Sufficient Hospital Capacity to Meet the Needs of our Residents
- For at least a week (7-day rolling average), no more than 50% of patients in staffable non-surge hospital beds are COVID-19 positive.
Indicator 3: Sufficient COVID-19 Viral Detection Tests Are Being Conducted Each Day
- At least 200 COVID-19 viral detection (PCR) tests are being conducted per 100,000 residents per day.
- This does not include antibody testing at this time, because the science regarding interpretation and validation of antibody testing is still in flux.
- We are focused on tests performed, rather than testing capacity, to ensure we are achieving the level of testing necessary.
- Our goal is to ensure everyone in the State’s priority groups in our County is being tested at appropriate intervals.
Indicator 4: We Have Sufficient Case Investigation, Contact Tracing, and Isolation/Quarantine Capacity
To break chains of transmission, we must rapidly develop the capacity necessary to identify and isolate persons with COVID-19 and those who have been exposed to COVID-19. In communities throughout the Bay Area and around the country, we must do this at an unprecedented scale and speed, many times beyond what public health departments across the country are resourced to do currently. This will require a massive and rapid infusion of resources, including disease investigators, information management tools, and the combination of housing, food, and income-replacement needed to allow infected and exposed community members to isolate themselves from others. This infrastructure must be designed to accomplish the following:
- We reach at least 90% of cases and identify their contacts;
- We ensure 90% of the cases that we reach can safely isolate;
- We reach at least 90% of all contacts identified; and
- We ensure at least 90% of identified contacts can safely quarantine.
Indicator 5: We Have At Least A 30-Day Supply of Personal Protective Equipment (PPE) Available for All Healthcare Providers
- All acute care hospitals, outpatient clinics, skilled nursing facilities, and medical first responders (Emergency Medical Services (EMS) and fire agencies) have a 30-day supply of PPE on hand. We will measure this as follows:
- Every acute care hospital in the County has certified in writing to the Health Officer that it has access to a 30-day supply of PPE and can independently procure adequate PPE to meet its needs going forward.
- No hospital, clinic, skilled nursing facility, other long-term care facility, or first responder agency is struggling to purchase PPE through standard channels, and none have needed to submit a request for assistance in obtaining PPE to the County Emergency Operations Center in the last 14 days.