Coronavirus watch list: 23 California counties where COVID-19 is getting worse

California is watching these 23 counties because of rising COVID-19 cases and hospitalizations.
SAN FRANCISCO -- UPDATE, July 6, 12 p.m.: Six counties were added to California's watch list -- including Madera County. Santa Clara County was dropped from the list on Monday, according to Gov. Newsom. See the full list below.

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As most of California has moved into Phase 3 of reopening, the state is once again seeing COVID-19 cases and hospitalizations rise dramatically.

The Department of Public Health has a watch list of counties that are being monitored for worsening coronavirus trends. In each case, the state is working with local health departments to identify the source of the problem and provide assistance as needed.

If a county is on the watch list for three days or longer, the state will order them to roll back reopening, Gov. Gavin Newsom said.

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The Department of Public Health has a watch list of counties that are being monitored for worsening coronavirus trends. In each case, the state is working with local health departments to identify the source of the problem and provide assistance as needed.

The following counties are currently on the state's list for "targeted engagement":

Colusa County: Increased transmission in Colusa County has been traced back to increased family and social gatherings, the state says. To combat the spread of the virus, the county must increase contact tracing and post daily on social media about the importance of face coverings and social distancing.

Contra Costa County: Contra Costa was added to the watch list, taken off for a few days, and now is back on. An increase in hospitalization is what's concerning here. The state advises Contra Costa holds off on reopening more businesses, such as indoor dining, gyms and movie theaters.

Fresno County: Fresno is in trouble for "elevated disease transmission," especially in skilled nursing facilities and Avenal State Prison. (While the prison is in Kings County, some of its employees live in Fresno and have brought the virus back into the community). Controlling outbreaks at those congregate facilities is key to getting Fresno off the list, DPH says.

Glenn County: Increased social gatherings, one church gathering and one traveler from Mexico are driving increased transmission in Glenn County. In response, the county needs to ramp up testing, contact tracing and the speeding up how they handle suspected cases.

Imperial County: DPH is attributing the problem in Imperial County to two factors: "U.S. citizens coming across the Mexican border seeking healthcare" and inadequate hospital staffing. The county is being asked to ramp up testing, contact tracing, transport patients to hospitals in other counties and create more alternative care sites.

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Kern County: Disease transmission and hospitalization are both on the rise in Kern County. The state says it's because of outbreaks at nursing homes and state prisons, as well as out-of-town patients coming to Kern County hospitals. The county is being asked to increase testing and public awareness of protective equipment to control the spread of the outbreaks from going any further.

Kings County: Not only is there elevated disease transmission and rising hospitalization in Kings County, but hospitals are also getting worryingly close to capacity. An outbreak at Avenal State Prison has spread the virus throughout the community, plus Kings County hospitals have admitted patients from other areas. Action items include getting the prison outbreak under control, as well as making sure hospitals are properly equipped to treat patients and protect staff.

Los Angeles County: One reason Los Angeles County has nearly half of the state's COVID-19 cases is because of its huge population and the fact that it's doing so much testing. Still, the county is being asked to keep a close eye on positivity rates as an indicator that community transmission is on the rise. They're also testing every resident and staff member at all 235 skilled nursing facilities in the county.

Madera County: There are two main concerns in Madera County: increased transmission and limited hospital capacity. Social gatherings, large household transmission and workplace transmission are likely to blame, officials say. In addition to public messaging on curbing COVID-19 spread, the county is also being told to prepare for increased hospital capacity by setting up alternative care sites and working with nearby counties to transfer patients.

Marin County: The spike in cases in Marin is largely due to a massive outbreak at San Quentin State Prison and elevated transmission among the county's Latinx community. The county needs to work with the corrections department to get the San Quentin outbreak under control and to make sure those in vulnerable communities have access to testing and care.

Merced County: Merced has seen outbreaks traced back to work settings and large household, particularly in the Latinx community, the county says. To mitigate the situation, the county will increase multilingual messaging on the importance of testing and face coverings. They're also going to work to make businesses safer so they don't have to shut down.

Monterey County: Community and workplace transmission are both on the rise in Monterey County, according to the public health department. The county's action items include more testing, more contact tracing and expanding outreach to communities disproportionately affected by COVID-19.

Orange County: Hospitalizations are on the rise in Orange County because of increased gatherings, workplace transmission and congregate living facilities. The county will be "collaborating with cities and the business community to increase public messaging on the importance of social distancing, not gathering, and mandate face covering," as well as increasing testing.

Riverside County: The state has identified five factors contributing to a rise in cases in Riverside County: outbreaks at prisons and nursing homes; large public protests where people weren't wearing face coverings; patients coming from Imperial County for treatment; patients coming from Northern Baja California for treatment; and an increase in social gatherings. In addition to increasing testing, the county is being told to educate residents on the importance of wearing face coverings.

Sacramento County: "Community transmission due to holiday gatherings amongst large families" has landed Sacramento County on the state's watch list. The county is being asked to increase public messaging about social distancing and face coverings and increase testing in hot spot communities.

San Bernardino County: Increase transmissions here are largely attributable to large gatherings, workplaces, nursing homes, jails and prisons, and patients being transferred from Imperial County. The county needs to ramp up testing, contact tracing and "working with labs and employers to increase turn-around time from diagnosis to isolation." Residents also need to do a better job of wearing face coverings to mitigate spread.

San Diego County: "Widespread disease transmission" lands San Diego on the watch list. As a result, they have closed restaurants, bars and breweries; encouraged outdoor dining; and encourage young people to follow face covering and social distancing guidelines.

San Joaquin County: The problem in San Joaquin County is a rise in hospitalizations and increasingly limited hospital capacity. The suspected drivers of this are increased social gatherings combined with workplace transmissions, the state says. In response, the county is being told to "increase public messaging on the importance of personal protection measures and the risks involved with mass gatherings in multiple languages."

Santa Barbara County: Increased gatherings in the northern part of Santa Barbara County are being blamed for a rise in transmission. Curbing community transmission and increasing contact tracing should help, the state says.

Santa Clara County: A recent increase in hospitalization landed Santa Clara County on the watch list. "Although the percentage change in hospitalizations shows an increase, the increase in the absolute number of patients hospitalized is low relative to the size of the population in Santa Clara County and is low relative to the number of hospital beds available in the county," says DPH. The county is working with hospitals to identify if patients are local or coming from other jurisdictions, as well as increasing PSAs in multiple languages about the importance of face coverings and avoiding mass gatherings.

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Solano County: A large outbreak among farmers who work at Sonoma and Napa vineyards (but live in Solano County) is partially to blame for a rise in COVID-19 cases here. The county says those cases are in the "many dozens." Other cases can also be traced back to family and social gatherings on weekends. The county is being told to educate workers on social distancing using Spanish translators and work with businesses to ensure working conditions are safe.

Stanislaus County: Stanislaus County is experiencing an "increase in outbreaks and clusters related to family gatherings, businesses (in and out of county) and healthcare facilities." Health officials believe people may not be following face covering and social distancing guidelines. The county is also being asked to increase rapid contact tracing in order to isolate positive cases more quickly before they spread widely.

Tulare County: Tulare County is interesting because not only are they reporting more coronavirus transmission, but also "Increased hospitalizations and ICU utilization have been related to multiple conditions other than COVID-19." Preventing outbreaks at nursing homes and increasing public awareness are two action items for the county.

Ventura County: Increased cases in Ventura County have resulted in increased hospitalizations. Officials believe the increase comes from transmissions at large gatherings, in overcrowded housing, at essential workplaces and at nursing homes. They also believe they are detecting more cases since opening more drive-thru testing facilities. Action items for the county include: enhance contact tracing, make sure nursing facilities have protective equipment and continue messaging on social distancing and hygiene.

This story will be updated as counties are added and removed from the list. You can find more information from the California Department of Public Health.

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