BEA AHBECK/NEWS-SENTINEL Adventist Health Lodi Memorial RN Jill Borth holds a test swab during a free COVID-19 testing event at the First Baptist Church parking lot in Lodi Friday, Aug. 14, 2020. Adventist Health Lodi Memorial teamed up with El Concilio to provide free drive-thru COVID-19 testing in Lodi.

STOCKTON — San Joaquin County health officials were hoping to move into the state’s “orange” tier for COVID-19 transmission by Halloween, but a recent uptick in a recently-added metric may hinder that promotion.

Last month, the California Department of Health created a health equity metric that requires counties with more than 106,000 residents to bring COVID-19 infections down in the hardest-hit places where low-income residents and a handful of minority ethnic groups live.

In order for San Joaquin County to advance to the orange tier for moderate transmission, it must ensure that the testing positivity rate for residents in its hardest-hit census tracts — which includes east Lodi — is less than 5.2%. On Tuesday, Oct. 6, that rate was at 5.6%, but by Friday, Oct. 16, it had climbed to 7.4%.

Public Health Officer Dr. Maggie Park said it was discouraging to see the increase, but noted when the state originally created the metric nearly a month ago, the county was close to an 8% rating.

The health equity metric also mandates that testing must increase, and positive cases must decrease, for Blacks and African Americans, Hispanics and Latinos, and Hawaiians and Pacific Islanders.

Hispanics and Latinos make up 41.1% of the county’s population, and account for 30.7% of the COVID-19 cases reported and 42.5% of the deaths. However, 46.1% of the county’s cases are not identified by race, so the true percentage of infections by race or ethnic background is unknown.

Blacks and African Americans represent 6.6% of the population and make up 3.7% of cases and 9.7% of deaths.

“We’re still finding through contact tracing that people are contracting the virus at large gatherings,” Park said. “In addition, the second-most kind of contraction of the virus is from households. People are coming home and giving it to those they live with.”

Public Health Services is increasing its messaging campaign, Park said, and suggested the department could provide Spanish-speaking advocates to reassure Hispanic and Latino residents there are not penalties for being tested.

“There are legal ramifications and fears that are holding many in these census tracts back,” she said. “We have to be able to tell them they’re not going to lose their jobs if they get tested, or they will not be deported if they get tested. They will not lose any money if they are tested. There are so many reasons they don’t do it.”

The health equity metric is not the only goal the county must meet in order to advance to the orange tier.

The county’s overall test positivity rate is 4.1%, and is the only metric it has met for advancing. Its adjusted case rate must be less than 3.9% positive cases per day per 100,000 residents in order to advance as well. That rate is currently at 6.6%, up from 6.4% last week.

That increase is due to a change in the state’s median testing volume, Park said. Last week, the state set a median of 239 daily COVID-19 tests, an increase from the 216 tests it suggested when the colored tiers were created.

Last week, the county conducted 189 tests a day, she said, a decrease from the 196 daily tests it took the week prior, and was subsequently penalized.

Despite the discouraging increases, San Joaquin County is on par with statewide metrics of 6.8 cases per day per 100,000 residents and a 3.4% test positivity rate.

San Joaquin County is one of 26 counties in the state’s red tier, along with Sacramento, Stanislaus, Merced, Contra Costa and Fresno.

There 13 counties in the orange tier, including San Francisco, Alameda, Santa Clara, Amador and Calaveras. The eight counties in the yellow, or minimal transmission tier, include Humboldt, Trinity, Mariposa, Alpine, Sierra, Plumas, Modoc and Siskiyou.

The remaining 10 counties in the purple tier include Los Angeles, San Bernadino, Imperial, Monterey and Mendocino.

Total COVID-19 cases in the county since the pandemic began on Friday were at 21,187, an increase of just 41 since Thursday. There were only 695 active cases of the virus reported Friday, and 20,008 are believed to have recovered since the pandemic began. There have been a total of 484 deaths in the county.

Hospitalizations from COVID-19 continue to decline, as San Joaquin County Emergency Medical Services Agency reported there were only 33 patients in seven facilities being treated for the virus as of Friday. Only seven of those were in an intensive care unit, the agency said.

At Adventist Health Lodi Memorial, only three people were being treated for COVID-19 and two people were in an ICU. St. Joseph’s Medical Center in Stockton was treating 10 patients for the virus, the highest in the county. However, only one of those patients was in an ICU.

“We’ve seen a decline in cases, both in the ICU and on our med-search floors,” Lodi Memorial spokeswoman Lauren Nelson said. “We are still seeing COVID cases, and with the way the country is trending, we are expecting a second wave, unfortunately.”

Hospital officials are excited the county and state are opening up, Nelson said, but they are concerned people will think it is safe to stop wearing masks or maintaining social distancing. Because of that concern, the large white triage tent in the hospital parking lot will remain set up, she said.

San Joaquin County has remained in the red tier for more than two weeks, giving public schools the go-ahead to consider reopening campuses for in-person instruction.

The Lodi Unified School District is contemplating how to open safely, with its board favoring a staggered approach to having all students back on campus. That approach would see special day classes — such as special education, Independent School, the continuation high schools and Valley Robotics Academy — return to schools first.

A week later, elementary school students would return to campus, and middle school students would return the following week. Comprehensive high schools — Bear Creek, Lodi, McNair and Tokay — would return to campus in January.

This week, the Lodi Unified Board of Education decided not to set a reopening date until meeting with its labor unions. The board is scheduled to receive an opening update at its Oct. 20 meeting.

Other districts are taking the same approach to reopening. Stockton Unified School District said it will not reopen until holding discussion with its labor groups, while Lincoln Unified School District said it is currently working to refine its reopening plan.

Last month, Manteca Unified School District chose to implement on-campus and in-person support for small cohorts. The district plans to move to a hybrid model of having half of its students on campus and half on distance learning.

While more people throughout the county need to be tested, Park said, she fears more positive cases will be confirmed in the coming weeks due to holidays such as Halloween and Thanksgiving, as well as the recent onset of the flu season.

“I imagine there will still be gatherings for Halloween, but hopefully people will keep them small,” she said. “I know it’s hard. People are so angry, and the way (the pandemic) is affecting kids, it’s so disheartening. But people need to get tested. It’s the only way we can beat this and move to the next tier.”

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