As other Southern California counties moved into the Orange Tier, San Diego stayed put in the Red Tier. But vaccination trends could soon let San Diego join in on the easing restrictions.
California's color-coded system was replaced with a sweeping stay-at-home order at the end of 2020 amid surging COVID-19 cases -- and later extended when Southern California's ICU capacity sunk to 0%. It wasn't until Jan. 25 that Gov. Gavin Newsom lifted the stay-at-home orders and the tiered system returned, placing San Diego in the most-restrictive Purple Tier again.
San Diego slowly made progress, and, on March 16 the county was able to move into the Red Tier. That was because California reached a key vaccine milestone -- 2 million vaccine doses to people in vulnerable ZIP codes -- which changed the tiers' thresholds and allowed San Diego to qualify for the Red Tier for the first time in more than six months.
Now, as San Diego looks ahead to the Orange Tier and what it has to offer -- including increased capacities for certain indoor operations and the return of outdoor operations at bars that don't serve food -- Supervisor Nathan Fletcher outlined three key pathways the county can take.
Pathway 1: Lower Case Rate
The first pathway to the Orange Tier requires San Diego County's case rate to drop -- and stay low.
Case rate is a metric that highlights how many residents per 100,000 people test positive for COVID-19 on a 7-day average.
In order to reach the Orange Tier (at the state's current thresholds), San Diego's case rate must fall below 4.0 for two consecutive weeks. Throughout the month of March, the region's case rate fell from around 10.8 to 4.9.
"And although we are descending, it is probably less likely we would get under 4 in the immediate future," Fletcher said.
The state also considers two other metrics, testing positivity percentage and health equity testing positivity percentage, when assigning counties to tiers. Both have already qualified for less-restrictive tiers, making case rate the last benchmark San Diego County needs to reach for more reopenings.
These three metrics are published by the state every Tuesday, and all three must meet the requirements of a specific tier for two consecutive weeks before a county can make the move.
Pathway 2: More Vaccinations (Most Likely)
The second path focuses on moving up the goalposts with increased vaccinations.
California officials said they will update its reopening plan when certain vaccine benchmarks are hit among the state's ZIP codes hit hardest by the pandemic, which is considered the lowest quartile of the "Healthy Places Index."
This is what helped San Diego County get into the Red Tier. When 2 million vaccine doses were administered in these communities across California on March 12, the tier requirements shifted. For example, the threshold to be in the Red Tier changed from 4 -7 to 4-10, giving counties more room for cases while still reopening safely.
The next goal is 4 million vaccine doses. When that happens, the state will once again change the thresholds for each tier -- this time, shifting the Red Tier's case rate range from 4-10 to 6-10 and the Orange Tier's range from 1-3.9 to 2-5.9.
According to the county's data, San Diego's weekly case rate was reported to be 5.5 and 4.9 on March 23 and March 30, respectively. Both weeks were within the possible, new benchmark -- meaning if the vaccination goal is met, San Diego would retroactively and automatically qualify for the Orange Tier because it met the threshold for a least two weeks. (So long as its case rate continues to stay under 5.9.)
On April 2, California's COVID-19 website reported the state had administered about 3.7 million vaccine doses to the necessary regions -- 300,000 shy of the goal.
Pathway 3: Some Metrics in Yellow
The third and final path for tier advancement relies on the state's Health Equity Metric.
According to the state, counties with a declining case rate, or increases of no more than 5%, can advance one tier if its two other metrics, testing positivity percentage and health equity testing positivity percentage, both meet the criteria for two tiers ahead for two consecutive weeks. (And counties can only advance one tier at a time.)
This means that, for San Diego, the county could move into the Orange Tier if those two metrics qualify for the Yellow Tier, essentially overpowering a lackluster case rate.
San Diego County's latest overall testing positivity percentage was 2.4% and the health equity testing positivity percentage was at 3.4%, which do not meet the Yellow Tier requirements of less than 2% and less than or equal to 2.1%, respectively.
With all of that said, a county spokesperson has an important note to San Diegans: Just because the county becomes eligible to move into a less-restrictive tier doesn't immediately mean that move will take place.
"Eligible isn’t confirmation. But we are hopeful and very pleased with the direction things are moving," the spokesperson said.
For daily updates on COVID-19 in San Diego, click here.