New California Reopening Rules Require ‘Equity’ Measure

Speaker 1: 00:00 Every week, all eyes are on the triggers that determine whether we can reopen more businesses in schools, or if we must retreat again, in the face of COVID California added a new trigger to the list of conditions that must be met before we can advance from the second tier, the red tier to the orange tier that would allow more businesses to open. It's called the equity metric, and it goes into effect today. It's an effort to level the playing field of how covert affects different communities here to help explain what it is and how it could help is dr. Kimberly Brower, the vice chair for public health education at UC San Diego. She's an infectious disease epidemiologist who has researched how living in a marginalized community affects the transmission of infectious diseases. So dr. Brower, thank you for joining us. Speaker 2: 00:45 Thank you very much for inviting me. Speaker 1: 00:47 So now what is this new trigger that San Diego needs to meet in order to advance to the next tier for reopening? Speaker 2: 00:53 So this is a health equity index that's been added for all of California counties with over a hundred thousand people. And this is just one of a variety of indexes that counties need to meet in order to open further this health equity index won't trigger a backsliding in tears, but in order to move forward, the most disadvantaged neighborhoods in a County must not lag far behind all the other parts of the County. So in other words, the overall rate within the County must be somewhat similar throughout the County that you don't have a disparity going on. So Speaker 1: 01:37 How big is the disparity currently, you know, between the number of infections and deaths and disadvantaged communities in San Diego? How does it show up? Speaker 2: 01:46 Well, uh, unfortunately this virus has really been insidious in some of the most marginalized communities. So, so economically marginalized, as well as racial and ethnic groups that have traditionally not had the best access to healthcare. So in San Diego, um, 62% of our COVID-19 cases have been in the Hispanic or Latin X population. Also the, um, Pacific Islander population has been especially hard hit. So both of these groups have approximately four times the rate per hundred thousand cases as whites do in our County. African Americans have also been quite hard hit with twice the rate as whites. Speaker 1: 02:31 So what would the requirement be if they're like four times more likely to be infected now, where would it have to be in order to move up to the next tier? Speaker 2: 02:38 They're hoping in general to move to the next tier that you have no more than seven new cases per a hundred thousand countywide, and now they want to start making sure that that metric is being seen in a variety of neighborhoods, not just overall at the moment, they're still tweaking some of the regulations in regards to how they're actually going to determine this, but right now they've divided it based on a California healthy places index. They're going to look at the census tracks in San Diego with, um, the lowest income and, uh, housing and social and economic indicators and compare it to the rest of the County. So in other words, the low lowest core child to the rest of the County. So this is an incentive to be investing more resources in the more disadvantaged communities. What more do you think needs to be done here to, to level this playing field? Speaker 2: 03:35 You're right. This is a great incentive to get investment in these communities that have been hard hit by a variety of, um, disease conditions with lower access to healthcare in general, you know, right now about half of the COVID tests in the County, if you look at it by race, about half of them are being conducted amongst whites. And so this would be a way to try to level the playing field, to make sure that everyone is having access to a free and easily accessible testing, as well as linkage to care afterwards. So, um, it's a way to put the resources where it will have the greatest effect, right? Because whites currently make up less than half of the population. So correct about 45%, no, at least one San Diego County supervisor Jim Desmond of North County is very much opposed to this new trigger. Here's what he said on his YouTube channel yesterday. Speaker 3: 04:31 The very businesses that, uh, mr. Newsome has been, has closed and is kept closed. Alright. And at least on a limited basis, uh, the restaurants and hotels and the service type jobs are mostly those lower income type jobs. And he's kept those people out of work. Uh, so, you know, and unfortunately a lot of them live in, in, um, disadvantaged communities. And unfortunately, if they don't have a job, they can't get healthcare, they can't, then they don't get the possibly they get more of the virus. Speaker 2: 05:03 So supervisor Desmond is arguing that this extra trigger requirement could actually hurt the disadvantaged neighborhoods more. Um, what, what's your reaction to that? Well, I understand the concern. Everyone wants to open the economy as quickly and safely as possible. And what this new measurement says is yes, let's reopen our economy, but let's proceed safely. Let's ensure that these essential workers are protected. So although it may slow down slightly, our ability to completely open. Um, as I mentioned at the start, it's, um, not a way to go backwards. We're still going to remain at the same tier based on this index, but it will let us, um, combat COVID in a much smarter way so that if we pour our resources into the areas to hardest these workers who, you know, would love to start working a full time in all sorts of neighborhoods within the County, um, we'll have a much better chance to get to work and stay there rather than having to go through this cycle of opening and closing. Speaker 1: 06:14 That makes sense. But the, the North County that Desmond represents has a lower rate of infections and they of course are frustrated by the new restrictions on their businesses. So from their perspective, you know, they ask why should North County restaurants be restricted to just 50% occupancy because people in South County are getting sick. So how do you counter that argument? Speaker 2: 06:35 I would say infectious diseases, no, no borders. So within a small geographic area, you're going to have a lot of mixing of populations, people living in one community and working in another. And just because residences in one area have had at least in recent weeks, a lower infection rate, it doesn't mean that it can, um, quickly increase again. So this is a way to try to ensure that we're going to open safely and that we can open for a longer amount of time. If we make sure that we address basically all the, you know, if you think of the fire analogy, all the hot spots and really poor resources into those areas. And again, it's not closing anything that's currently opening. It's just taking a step back, looking at the general picture of COVID within our County and making sure that all areas are meeting certain thresholds just to prevent this exponential rise again, as people begin to mix, Speaker 1: 07:41 Right. And leveling that playing field. Dr. Brown, thanks so much for being with us. Thank you. We've been speaking with dr. Kimberly Brower, the vice chair for public health education at UCS D.