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COVID-19 Status Update for 12/03/2020

Marin County COVID-19 Status Update for December 3 includes a new stay at home order that could affect the Bay Area if ICU rates continue to climb; new videos that outline social and behavioral health services available to Marin… Read More

Novel Coronavirus (COVID-19)

Surveillance Update

Marin County Public Health tracks demographic, geographic, and clinical information about confirmed COVID-19 cases to inform the COVID-19 response and understand factors associated with COVID-19 transmission and clinical outcomes in our community. We are consistently improving our data collection, analysis, and sharing procedures, so will continue to add to this report as data become available.

Last updated: 12/3/20 at 3:20pm.

COVID-19 testing and case data are reported as timely, accurately, and completely as we have available. Data are updated as we receive information that is more complete and will change over time as we learn more (see FAQs). Cases are lab-confirmed COVID-19 cases reported to Marin County Public Health by providers, commercial laboratories, and academic laboratories, including reporting results through the California Reportable Disease Information Exchange. A lab-confirmed case is defined as detection of SARS-CoV-2 RNA in a clinical specimen using a molecular amplification detection test. For more information about data sources and methods please reference the FAQs.

There are two main measures of potential COVID-19 activity locally— the number and characteristics of confirmed COVID-19 cases, and the general number of people experiencing severe respiratory illness. Seeing important increases helps our healthcare providers and partners know when COVID-19 activity may be increasing in Marin. Marin County Public Health receives regular updates on episodes of respiratory illness from all Marin County emergency departments (ED), and from Emergency Medical Services (EMS), our countywide 911 ambulance response system. We track these over time, and compare to prior years. Note there are always ups and downs in our usual activity, and we’re looking for significant changes. 

Information about confirmed COVID-19 cases is updated daily on weekdays by approximately 5pm Pacific Standard Time (PST). Information about respiratory illness activity is updated biweekly each Tuesday and Friday.

Summary Data

The following tables provide summary data regarding COVID-19 testing, cases, hospitalizations and deaths for Marin County residents living in the community (referred to as "community cases" or "community residents ").

 

Community Residents

This information shows how COVID-19 has impacted Marin County community residents since the first case. This data includes facility patients and staff who live in Marin County. This data does not include San Quentin inmates. The +50,514 increase in Total Tests on October 30, 2020 is due to Marin HHS transitioning from using HHS-calculated test volume to CDPH-calculated test volume. To see how the count of tests per day has changed over time, please view the chart below: "Daily COVID-19 Tests Conducted Among Marin County Residents".

Facility Staff and Residents

This table shows how COVID has impacted residents of long-term care facilities in Marin County. It is a subset of the above Community Residents table. Facilities include Residential Care Facilities (RCFs), Skilled Nursing Facilities (SNF), Independent Living (IL), and Other Group Living (OGL) facilities. Current positive staff and current positive patients include those who have tested positive for COVID-19 in the last 14 days.

 

 

Currently Hospitalized

This section shows a daily snapshot, referred to as a census, of COVID-19 cases hospitalized in Marin County hospitals (MarinHealth, Kaiser, and Novato Community Hospital). To see how these daily hospital counts have changed over time, reference the chart below, "Daily Census of COVID-19 Patients in Marin County Hospitals Over Time".

Daily Trends

Total Cases and Recovered by Date Reported among Marin County Community Residents

Tracking the cumulative number of COVID-19 cases, hospitalizations, deaths, and modeled estimate of individuals who have recovered helps us understand how this pandemic has impacted our community over time. The figure below displays the total number of cases and modeled estimate of individuals who have recovered among Marin County community residents (does not include data from San Quentin inmates) by date the information was reported to Marin County Public Health. The first case was reported on March 8, 2020. The charts below are live and interactive, hover over the chart with your cursor to see the total number reported each day and observe the daily increase over time. 

Total Hospitalizations and Deaths by Event Date among Marin County Community Residents

The figure below displays the total number of COVID-19 hospitalizations and deaths among Marin County community residents (does not include data from San Quentin inmates) by event date. For hospitalizations, event date is the "Hospital Admit Date" and for deaths, event date is the "Death Date". This chart was updated on October 19, 2020 to show hospitalizations and deaths by event date instead of report date to more accurately reflect the date of hospitalization and death. The +19 increase in Total Hospitalizations on October 19, 2020 is due to a quality improvement effort and does not reflect a jump in recent hospitalizations. To see how the count of hospitalizations have changed over time, please view the chart below: “Total Hospitalizations and Deaths by Event Date among Marin County Community Residents”.  

Cases Per Day by Test Date among Marin County Community Residents

This chart shows the daily number of newly reported cases (positive test results) among Marin County community residents (does not include San Quentin inmates) by test date. If an individual was tested on May 20 and Marin HHS received a positive result for that test on May 24, their positive result would be reflected in this chart and the positives and negatives test per day chart below on May 20.

Percent Positive

The chart below shows the state's calculation of percent positive for Marin County residents. It is calculated using a 7-day lag (on August 17 the most recent calculated date will be August 10), with a 7-day window (sum of all positive tests in prior 7 days divided by the sum of all tests in the prior 7 days).   To see the total estimated number of tests performed in Marin County everyday, regardless of Marin County residency status, please see the "Daily COVID-19 Tests Conducted" chart below. 

 

 

 

Daily COVID-19 Tests Conducted Among Marin County Residents

As of October 30, 2020 this tests per day chart uses data from CDPH to display testing volume among Marin county residents. This is the same data used to calculate the county-level testing rate for the State Blueprint Metrics. Testing volume for the last two weeks is provisional and subject to change due to the lag in testing reporting.

Daily Census of COVID-19 Patients in Marin County Hospitals Over Time

This information helps us understand how COVID-19 is impacting our community as the most severe cases will become hospitalized and may require life-saving care in an Intensive Care Unit (ICU). It also helps inform us about the use of available hospital resources to inform emergency planning for incoming COVID-19 cases. The figure below shows a daily census of total patients, and count of patients in the ICU, hospitalized with COVID-19 in Marin County.

Case Characteristics: Geography & Demographics

Total Community Cases by Geographic Location

Mapping cases by geographic regions helps us view where COVID-19 cases have been diagnosed in our community. The map below shows the cumulative and 30-day number of confirmed COVID-19 cases and cumulative and 30-day rates of COVID-19 cases per 100,000 residents by city and community in Marin County since March 2020. Note that the number of confirmed cases in a given community are reflective of testing. This map is interactive, click on each jurisdiction to view the name of the community/city, the total population for that area, the cumulative and 30-day number of COVID-19 cases, and the cumulative and 30-day COVID-19 case rate per 100,000 residents. Because the total population in one jurisdiction can be vastly different from another, the case rate per 100,000 residents helps us better understand the concentration of cases among the total population for that jurisdiction. This map is based on the residence provided by COVID-19 cases during the investigation process (also referred to as contact tracing). Communities with less than 10 cases do not have their case counts shared to ensure that individuals are not identifiable to the public. All data are subject to change as we may learn new information during a case investigation. If the map fails to load click here.

Marin County Public Health has routine quality improvement procedures in place to provide the most accurate and timely data as possible. Mapping procedures were updated in November 2020 to further improve our ability to report COVID-19 case counts by geographic location, including updating our methodology to account for corrections to case addresses throughout a case investigation. All cases reported for San Quentin only include those reported among community residents.

Geographic data are unavailable for approximately 5% of cases as a result of reporting delays or challenges.

 

Cases, Hospitalizations, and Deaths by Age, Gender and Race/Ethnicity among Marin County Community Residents

Comparing demographic information for confirmed COVID-19 cases to the demographics in our community's population helps inform us about which groups may be more impacted by COVID-19. The figures below display the number of laboratory confirmed COVID-19 cases, hospitalizations, and deaths among Marin County community residents (does not include San Quentin inmates) by age group and by gender compared to the Marin County population as a whole. Missing demographic data arises from individuals not filling out demographic questions during the testing registration process. The donut chart below these figures presents the same information by race/ethnicity. To date, the majority of confirmed cases have occurred among individuals less than 49 years of age, while the majority of hospitalizations and deaths have occurred among individuals greater than 50 years old. The majority of confirmed cases, hospitalizations, and deaths have occurred among those who are male and of White, non-Hispanic; Hispanic; or Asian, non-Hispanic race/ethnicity.

 

 

Other Measures of COVID-19 Impacts

In addition to measuring documented cases of COVID-19, we also look at data tracking deaths from any cause (all-cause deaths) and severe respiratory illness to see early signs of how COVID-19 may be affecting Marin County.

 

Weekly Count of All-Cause Deaths in Marin County: Comparing 2018-2019 to 2020

Looking at trends in all-cause deaths may help us to identify if we are seeing fewer or greater number of deaths than usual in Marin County. Seeing a sustained spike in the number of deaths occurring in a given week in 2020 compared to 2018-19 may demonstrate COVID-19's impact on Marin County. The line chart below shows the two-week rolling average of all-cause deaths among Marin County community residents by week in 2020 as compared to 2018 and 2019 combined. The date on the horizontal axis represents the last day in the two-week rolling average. For example, the two-week rolling average of 36 for the week ending on April 25 (representing the week of April 17-25), means that there were 76 deaths recorded in the two week period prior to April 26 (April 11-25). Note this chart only includes deaths among Marin County community residents and does not include deaths among individuals incarcerated at San Quentin prison. Between January 1, 2018 to June 30, 2020 the two-week rolling average of deaths among people incarcerated in San Quentin was between 0-1. To view updated data on COVID-19 deaths among San Quentin COVID-19 cases, visit the California Department of Correction's website.

 

Respiratory Illness Activity

Common symptoms of COVID-19 include fever, cough, and difficulty breathing. Respiratory illness activity will capture visits that may be due to COVID-19 and influenza-like illnesses. The majority of individuals with COVID-19 will experience mild to moderate symptoms. However, some individuals may experience more severe symptoms and require a higher level of medical care through EMS or the ED. Tracking the total number of visits and those due to respiratory illnesses provides a situational awareness of current resource needs in our community. Each daily count below reflects 3-day rolling averages.Figures 1-3 display information on current trends in EMS calls and ED visits due to respiratory illnesses total and by age.

Utilization Trends:Over the past week, the number of ED and EMS visits and those due to respiratory illnesses have been lower or just above daily averages seen in January-April, 2019. Marin County Public Health will continue to monitor trends to identify any significant changes (Figures 1A-B).

Figures 1A-B:Number of Total Visits and Visits due to Respiratory Illnesses

 

Total Marin County Emergency Medical Services Calls (1A)

 

The stacked bar chart below shows the total number of EMS calls and those due to respiratory illnesses based on 3-day rolling averages. Over the past month, EMS respiratory-related calls have been at or slightly above August to October 2019 averages.

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Total Kaiser San Rafael, MarinHealth Medical Center and Novato Community Hospital Emergency Department Visits* (1B)

The stacked bar chart below shows the total number of Kaiser San Rafael, MarinHealth and Novato Community Hospital ED visits and those due to respiratory illnesses based on 3-day rolling averages. Total ED visits have been at or above August to November 2019 averages in recent weeks.    

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*Discharge data from Kaiser San Rafael, MarinHealth and Novato Community Hospital show trends in ED visits due to respiratory illnesses and are updated as soon as data are available.

 

Percentage of visits due to respiratory illnesses: The percentage of Emergency Medical Services (EMS) calls and Emergency Department (ED) visits due to respiratory illnesses is presented below in Figures 2A-B.

Figures 2A-B: Daily Proportion of Visits due to Respiratory Illnesses

Percentage of Marin County Emergency Medical Services Calls (2A)

The line chart below shows that the percentage of EMS calls due to respiratory illnesses has a similar pattern as observed during this time in 2018 and 2019, with a slight increase observed in September.

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Percentage of Kaiser San Rafael, MarinHealth Medical Center and Novato Community Hospital Emergency Department Visits* (2B)

The line chart below shows that the percentage of Kaiser San Rafael, MarinHealth, and Novato Community Hospital ED visits due to respiratory illnesses is increasing compared to trends observed during this time in 2018 (dotted blue line) and 2019 (dashed grey line). The percentage of ED visits due to respiratory-related illnesses is slightly above levels seen during this time in 2018 and 2019.   

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*Discharge data from Kaiser San Rafael, MarinHealth and Novato Community Hospital show trends in ED visits due to respiratory illnesses and are updated as soon as data are available.

 

 

Age Distribution of Respiratory Illness Visits: The majority of respiratory illness-related EMS calls occur among those 65 years and older, while the majority of ED visits due to respiratory illnesses occur among those less than 65 years of age (Figures 3A-B).

Figures 3A-B: Total Visits Daily due to Respiratory Illnesses by Age

Total Marin County Emergency Medical Services Calls by Age (3A)

The stacked bar chart below shows the total number of EMS calls due to respiratory illnesses by age categories 0-18 years (gold), 19-64 years (brown), and 65 or more years (purple). The majority of EMS calls due to respiratory illnesses occur among those 65 years or older. The total number of respiratory illness EMS calls based on 3-day rolling averages remain at or below August to October 2019 averages over the past month.

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Total Kaiser San Rafael, MarinHealth Medical Center and Novato Community Hospital Emergency Department Visits by Age* (3B)

The stacked bar chart below shows the total number of Kaiser San Rafael, MarinHealth, and Novato Community Hospital ED visits due to respiratory illnesses by age categories 0-18 years (gold), 19-64 years (brown), and 65 or more years (purple). The majority of ED visits due to respiratory illnesses occur among those less than 65 years of age. Respiratory illness ED visits based on 3-day rolling averages have recently increased and are above the average for the same time period in 2020.  

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*Discharge data from Kaiser San Rafael, MarinHealth and Novato Community Hospital show trends in ED visits due to respiratory illnesses and are updated as soon as data are available.

 

National and Statewide COVID-19 Activity

Visit the California Department of Public Health's COVID-19 website for updates on activity statewide and the Centers for Disease Control and Prevention's website for information on nationwide activity.

 

Definitions and Terminology

+Respiratory illnesses are identified using free-text chief complaint and structure primary impression fields in routinely collected Emergency Medical Services and Emergency Department data. Visits that mention at least one of the following (including common misspellings) were classified as those due to respiratory illnesses for the purposes of routine surveillance: influenza-like illness, influenza, fever, shortness of breath (only if with fever or cough in ED), difficulty breathing, respiratory distress, pneumonia, cough (only if with fever or shortness of breath in ED), sore throat, wheezing, bronchitis.