Sign Up for ReadySBC Alerts

If we can’t reach you, we can’t alert you.

STRONGER TOGETHER. SAFELY APART.

Santa Barbara County Reopening In Safe Environment - RISE Guide

A Local Supplement to the Governor’s Resilience Roadmap

Santa Barbara County is taking steps to reopening society and our economy within the framework of Governor Newsom’s Resilience Roadmap. To support implementation of the roadmap for phased reopening, a localized supplemental guide has been produced.

The Santa Barbara County RISE Guide, or Reopening In Safe Environment, was developed by medical experts and supported by feedback from all sectors of the community to create a science-based framework for residents, businesses and organizations by which to reopen in a phased manner, while prioritizing public health and protecting our most vulnerable populations.

The RISE Guide outlines the steps for reopening that can be safely taken in our community, balanced with the importance of resuming individual and economic activities as the COVID-19 epidemic evolves. The reopening approach is broken down into four phases, each with public health criteria for moving to and from phases:

  • Stage 1: Safety & Preparedness
  • Stage 2: Lower Risk Workplaces
  • Stage 3: Higher Risk Workplaces
  • Stage 4: End of Stay-at-Home Order

Implementation measures will be developed based on the RISE Guide by stakeholder groups representing public agencies, community groups and business sectors. These guidelines are intended to be instructive, not prescriptive, and no criteria by itself should be an automatic trigger for action. Rather, the set of factors described within may be utilized and interpreted based on patterns evident in the community.

It should be noted that any reopening may be associated with an unpredictable amount of risk. However, given existing scientific evidence and analysis of Santa Barbara County’s risk profile, these guidelines are proportionate but should be utilized in the context of the adaptive response in the event of worsening criteria. 

It is critical that all members of our community commit to implementing the phased preventative strategies outlined in this plan and be prepared to adapt to retightening of these preventative measures if necessary. A successful reopening will depend on everyone in our community doing their part.

 
The SPANISH language version of the RISE guide will be available the week of May 18th.
 

Dr. Ansorg (Public Health Officer), Chairman Hart, and members of the Board of Supervisors:

 

This guide, “Reopening in Safe Environment ” (RISE), offers a framework for how to safely reopen the economy and our communities.

 

At your direction, this framework was developed to provide a recommended path for the phased reopening of our county.  Midway through the development of this guide, the state released the Resilience Roadmap which set forth the stages and timing of reopening across all California counties.  As the guidance and direction from the State is rolling out over time, local decisions and latitude to reopen will remain dynamic, requiring ongoing evaluation. Thus, the RISE Guide serves as an important supplement to the state plan –unique route along the roadmap – with specifics on managing the virus and reopening society, here in Santa Barbara County.  In some cases, we offer an alternative perspective, or what many in the medical profession refer to as a “second opinion” on elements of State criteria that necessitate further consideration.

 

A LOCAL RESPONSE TO A GLOBAL CHALLENGE

While the pandemic is transpiring globally, it is borne and managed locally, by county governments, public health officials, hospitals, medical professionals and, of course, all individuals in our community. As a representative panel of medical and public health experts, we considered the capacity and resources necessary to effectively manage the spread of COVID-19 in Santa Barbara County as well as the risks surrounding likelihood of transmission through a phased reopening of the community.

 

The RISE Guide was developed with the acknowledgement that this virus will be with us moving forward and resuming our lives and livelihoods will require the coordination and partnership of public health, hospitals, business, and community through many stages.

 

That is why the development of this guide included the participation of over 350 individuals in a series of 27 roundtable meetings that included, including city leaders, local elected officials, chambers of commerce, industry sectors, faith-based communities, representatives of essential workers and organizations that regularly work with minority and underserved populations.

 

These stakeholders provided valuable insight on the practicalities of what reopening means across diverse communities and uncovered ideas for how to reopen safely across a broad range of community settings.

 

A SANTA BARBARA COUNTY PLAYBOOK

The result of our work is comprised of three parts:

  • Core framework: An analysis of local medical and epidemiological factors and conditions to supplement the state Resilience Roadmap as well as criteria for moving between stages and key indicators for loosening and tightening restrictions. This will be a tool for decision making for public health for managing the disease.
  • Industry sector guidelines: An integration of state and county guidance and best practices aimed at standardizing industry practices in reopening with three goals: 1) safety and prevention of infection spread; 2) certainty and standardization for businesses and community; 3) and confidence for employees and customers to enter the workplace and civic life.  These guidelines are a snapshot in time, but they will continue to evolve with more guidance from the state, and best practices developed by our local stakeholders.
  • Readiness and containment plan: A full-spectrum plan for successfully combating Covid-19 that considers testing, tracing, treatment, healthcare capacity, PPE supplies, community engagement and unique local factors.

It is important to note this guide is a living document that will change to reflect additional input, changing conditions and new information. It is designed to evolve and adapt to meet the needs of public health as well as economic well-being.

 

RECOMMENDATIONS MOVING FORWARD 

We will be managing and treating COVID-19 in the weeks and months ahead, and it is imperative that the County of Santa Barbara continue to evaluate the State guidance with a critical eye and through the lens of the health and safety of all Santa Barbara County residents.

 

Portions of the current state criteria will unnecessarily hold the county at a standstill. Therefore, we recommend advocating for a change to these criteria to ensure the county, and its residents, are not adversely impacted.  The long-term health and safety of our residents requires us to safely and methodically reopen our communities while protecting vulnerable populations and ensuring the readiness of our healthcare system. This guide provides the guidance for the county to achieve these ends, while following the requirements in the State Resilience Roadmap.

 

Furthermore, in developing this guide, we have learned that it is not just about creating a plan. It’s about a community coming together to put ideas into practice and share the responsibility of safely and responsibly reopening. Through this process there has been a tremendous amount of goodwill built that needs to be nurtured.  Moving forward, it will be essential to communicate clearly and often to the community about the rationale for decisions, if public trust is to be maintained.

 

Thank you for the opportunity to participate. We stand ready to support the Public Health Officer and the Board of Supervisors in service to our community moving forward.

 

Sincerely,

 

Melissa Smith, M.D. (Chair)
Dr. J. Trees Ritter, D.O., FIDSA
Lynn Fitzgibbons, M.D.
Kevin Ferguson, M.D.

Paige Batson, M.A., R.N.

Santa Barbara County Public Health Officer

  • Van Do-Reynoso, Ph.D., Director of Public Health
  • Dr. Henning Ansorg

 Expert Panel

The following are medical and public health experts who authored the RISE Guide:

  • Dr. Melissa Smith (Chair)
  • Dr. J. Trees Ritter, DO, FIDSA
  • Dr. Lynn Fitzgibbons
  • Paige Batson, M.A., R.N.
  • Dr. Kevin Ferguson

Santa Barbara County Board of Supervisors

The following individuals steered the overall RISE Guide effort:

  • Gregg Hart, Chair, Second District
  • Peter Adam, Vice Chair, Fourth District
  • Das Williams, First District
  • Joan Hartmann, Third District
  • Steve Lavagnino, Fifth District

Project Team
The following individuals supported and integrated with the expert panel, engaged stakeholders, developed a communications plan and synthesized inputs into attached guidelines:

  • Mona Miyasato, CEO, County of Santa Barbara
  • Nancy Anderson, Assistant CEO, County of Santa Barbara
  • Terri Maus-Nisich, Assistant CEO, County of Santa Barbara
  • Melissa James, CEO, REACH
  • Andrew Hackleman, VP, REACH

The following stakeholder leaders from business, education, faith, and community sectors convened nearly 350 representatives from local communities, businesses, faith organizations, education institutions and more; generating insights, inputs and ideas critical to how businesses and society can safely operate in the phases of reopening:

Sector

Team Lead

Team Chair

City of Guadalupe

Todd Bodem

Mayor Ariston Julian

City of Santa Maria

Jason Stillwell

Mayor Alice Patino

City of Lompoc

Jim Throop

Mayor Jenelle Osborne

City of Buellton

Scott Wolfe

Mayor Holly Sierra

City of Solvang

Xenia Bradford

Mayor Ryan Toussaint

City of Goleta

Michelle Greene

Mayor Paula Perotte

City of Santa Barbara

Paul Casey

Mayor Murillo, Cathy

City of Carpinteria

Dave Durflinger

Mayor Wade Nomura

Isla Vista

Jonathan Abboud

Spencer Brandt

County Special Districts

Charlotte Holifield

 

General Business

Glenn Morris

Kristen Miller

Education

Kirsten Zimmer Deshler

 

Faith-Based

Tim Mossholder

Father Jon Hedges

Lodging

Kathy Janega-Dykes

Andrew Firestone

Agribusiness

Claire Wineman

Andy Rice

Building & Development

Laurie Tamura

Derek Hansen

Beverage Industry

Alison Laslett

 

Restaurants

Tom Patton

Sherry Villanueva

Technology

Larry Doris

Sachi Thompson

Manufacturing

Primit Parikh

 

Transportation/Energy

Marjie Kirn

Eric & Samantha Onnen

Events/Venues

Rich Block

Mark Booher

Hispanic Business

Luis Villegas

Esmerelda Mendoza

Nonprofits

Kathy Simas

Michael Baker

Thought Leaders

Brian Goebel (Individual)

Dr. Peter Rupert (Individual)

The following organizations hosted discussions and provided input a feedback:

  • Tri Counties Labor Council
  • Central Coast Labor Council
  • Solvang Chamber of Commerce
  • Buellton Chamber of Commerce
  • Santa Maria Valley Chamber of Commerce
  • Just Communities
  • Pan Asian Network
  • Santa Maria – Lompoc NAACP
  • Lideres Campesinas
  • Santa Barbara/Goleta Chamber of Commerce
  • Lompoc Chamber of Commerce
  • EconAlliance
  • Central Coast Alliance for Sustainable Community (CAUSE)
  • Mixteco Community Organizing Project (MICOP)
Santa Barbara County RISE GUIDE Overview and Purpose

Describes the conditions under which the County may begin to reopen institutions and businesses safely while prioritizing public health

Provides guidelines to limit the spread of COVID-19 and establishes tools and approaches to minimize future outbreaks once restrictions are loosened or lifted

Offers measurable decision points to identify how phased transitions can occur and which public health criteria might inform decisions to loosen or tighten restrictions in Santa Barbara County based on State guidance

In the absence of a COVID-19 vaccine or specific therapeutics to combat infected individuals, preventive strategies, such as the restrictions being implemented worldwide, are the most effective path to contain and mitigate the infection.

The Santa Barbara County RISE Guide draws on four main sources for its framework:

EntityDocument/sRelease Date (2020)

U.S. Federal Government

Guidelines: Opening Up America AgainApril 16

State of California

Six Critical Indicators & Update on the Pandemic Roadmap & Resilience RoadmapApril 14 & 28; May 8
Resolve to Save Lives (RSL), an Initiative of Vital StrategiesWhen and How to Reopen After COVID-19April 1
San Luis Obispo CountySLO County START GuideMay 1

The RISE Guide is supplemented by two accompanying documents:
1. State and Local Guidance for Industry Sectors for organizations and businesses can be found on Page 42 of the RISE Guide

2. Santa Barbara County Readiness and Containment Plan can be found on Page 65 of the RISE Guide.

It is challenging to predict when COVID-19 may reoccur in Santa Barbara County after the first epidemic wave. However, it is recommended that the County tighten restrictions or recommend preventive measures at the individual and institutional levels if infection rates or risk substantially increase. Data from other counties can also be used to assess risk and inform strategy.

 

Additional unique factors warrant concern for Santa Barbara County as the epidemic evolves:

  1. The popularity of Santa Barbara County as a tourist destination. It is likely that tourism will increase, albeit not likely to previous years’ levels, as people tire of stay-at-home orders and the weather warms. It is also possible that visitors may perceive Santa Barbara County to be a low-risk travel destination (i.e. due to low population density and low infection rate), potentially making it a more attractive destination than the more urban regions of Northern or Southern California.
  2. The influx of a significant number of college students spending time outside of the area and potentially returning with COVID-19 with or without symptoms. With combined student populations of over 51,300, higher education institutions in Santa Barbara County could significantly increase risk for the county population for three reasons: a) The sheer number of students coming into the city and county, b) The range of locations that students would be coming from include a number of state and national infection hot spots, and c) Likelihood of congregation in restaurants, bars, gyms, beaches, and on campus.
  3. A lack of immunity among a majority of residents given a relatively low prevalence of COVID-19 during the first wave as compared to other areas of California. Although SARS-CoV-2 antibody (or immunity) tests have become widely available, they do not yet have the accuracy to reliably assist in identifying individuals who have been infected, recovered and potentially have at least short-term immunity. The performance characteristics of these tests and the durability of any conferred immunity has yet to be determined.
  4. The dynamic movement of the farmworker labor force. Farmworkers in Santa Barbara County are a population that requires careful consideration and attention to ensure their health and safety, as conditions in agricultural work are unique, as are the specific concerns and needs of this essential workforce.
  5. An ever-increasing population of residents struggling with insecure housing. This includes homeless individuals and families, as well as many county residents who are under-housed, with multiple individuals and families living in a single household.  These conditions can increase both incidence and prevalence of COVID 19 and should be given special consideration.
  6. Lompoc penitentiary is a large congregate living environment. Although the county does not have jurisdiction or administrative authority over the operations at the facility, disease spread at the penitentiary impacts the larger county population, because employees live and interact in the local community, which can increase risk of community spread. Both for humanitarian reasons, and because the penitentiary COVID-19 case count is included in the county total, Santa Barbara County government officials should continue to work with advocates for incarcerated populations, as well as with federal authorities, to ameliorate conditions that are leading to disproportionate cases in the prison population.

An influx of visitors and students, increased public congregation, and lack of immunity could significantly increase risk for COVID-19 in the county. As such, a second epidemic wave of the COVID-19 outbreak could be larger, infecting more people than the first.

The Roadmap Stages for Santa Barbara County are contained in the governor’s Resilience Roadmap:

 

Stage 1: Safety and Preparedness

Stage 2: Lower Risk Workplaces

Stage 3: Higher Risk Workplaces

Stage 4: End of Stay-at-Home Order

 

Loosening of restrictions will be phased in gradually based on local data. Subsequently, data will be continually monitored for signs of a substantial spike in new infections or a new epidemic curve, in which case restrictions may be reinstated.

 

Using Data to Inform Strategy

Patient outcomes (i.e. new infections, admissions, deaths) and system capacity (i.e. facilities, personnel, ability to trace contacts) will be drivers of county guidelines to loosen or tighten restrictions. To protect public health, it is critical that loosening of preventive measures be retightened when local or regional data suggest worsening of key parameters.

 

Ensuring Health Care System Capacity:

  • Adequate health care staffing, testing, ventilators and PPE, along with surge capacity

Protecting Vulnerable Populations:

  • Adequate PPE and staffing to manage effective care and positive cases in institutional settings
  • Adequate COVID-19 testing for residents and workers in institutional settings

Ensuring Public Health Capacity to Test, Trace and Isolate:

  • Adequate capacity to test those in priority groups and those in congregate living and healthcare facilities
  • Capacity to trace and isolate individuals with positive COVID-19 tests and to quarantine close contacts
  • Collect data electronically from providers and labs, including race/ethnicity data

Developing Protocols to Keep Workers and Residents Safe:

  • Protocols in place to ensure safe reopening of businesses and institutions, including attention to physical distancing and infection control measures
  1. Ability to test, contact trace, isolate, and support the exposed
  2. Ability to protect those at high risk for COVID-19
  3. Surge capacity for hospital and health systems
  4. Therapeutic development to meet the demand
  5. Ability of businesses, school and childcare facilities to support physical distancing
  6. Determination of when to reinstitute measures like Stay-At-Home

Preventive Strategies

It should be noted that some preventive actions should continue indefinitely. For example:

  • Personal hygiene (washing hands frequently, covering coughs, staying at home when ill, using face masks in public when ill)
  • Vulnerable individuals such as the elderly and those with pre-existing conditions should stay at home, self-isolate, or be cared for whenever possible. For infected patients who cannot be safely cared for at home (or if unhoused), designated facilities should be provided.
  • Isolation of cases and quarantine of case contacts
  • Quarantine of travelers from high-infection areas

Adapted guidelines for loosening restrictions, by category, with State Readiness Requirements for Variance.

EpidemiologyHealthcarePublic Health
State Indicators Required to Accelerate Through Stage 2
  • 1 case per 10,000 in last 14 days (45)
  • No COVID-19 death in last 14 days

(Note:  These State indicators were appealed by the Santa Barbara County Board of Supervisors on May 13, 2020)

  • County or regional capacity to accommodate surge of 35% due to COVID cases an in addition to providing care for non COVID
  • Plan to protect workforce
  • At least 15 staff per 100,000 county population trained for contact tracing.
  • Availability of temporary housing to shelter (for COVID-19 isolation) 15% of county residents experiencing homelessness
  • Skilled nursing facilities have 14 day supply of PPE for staff, with established process for ongoing procurement from non-state supply chains.

Santa Barbara County Indicators Recommended for all Stages (in addition to State indicators above)

 

  • Less than 10% positivity of tests in last 14 days
  • Less than 2% fatality rate in last 14 days
  • Over the past 14 days, number of patients hospitalized with COVID-19 illness is stable
  • Ability – including staffing – to increase up to 30% number of patients treated in intensive care units from current census
  • Ability – including staffing – to screen large numbers of symptomatic patients safely (e.g., outdoor tents, drive through)
  • Hospital facilities have a robust plan to protect the hospital workforce, both clinical and nonclinical with PPE.
  • Sufficient face masks such that patients seeking care have appropriate face covering even if cases increase by 30%
  • Ensure at least baseline capacity in general health services, including through expansion of telemedicine for COVID-19 and usual care
  • Contacts elicited for at least 90% of cases
  • 100% of symptomatic contacts and others with symptoms undergo testing within 24 hours of identification of symptoms, unless definable as “probable case” per CDC
  • Designated facilities for non-hospitalized COVID-19-infected people who can’t be safely cared for at home (e.g., because of space constraints, homelessness, medically vulnerable household members, or otherwise)
  • Demonstrated ability to convey physical distancing recommendations

Adapted mitigation measures needed when one or more criteria in at least 2 of 3 columns are met.

EpidemiologyHealthcarePublic Health
  • Increasing new case counts of at least 10% for 5 consecutive days above a stable baseline in the context of no substantial increase in testing
  • Doubling time of cases less than 5 days (from a stable baseline)
  • High likelihood of exposure at mass gathering or congregation of people or delayed detection of a case (>5 days from a mass gathering or long-term care facility)
  • Increasing number of new health care worker infections averaged over a 7-day period
  • Inability to scale up to 35% the number of ICU patients from current census (including staffing)
  • Can no longer screen large numbers of symptomatic patients safely, including staffing (e.g., outdoor tents, drive through)
  • Less than 4 weeks supply of PPE for 35% increase in current case load
  • Insufficient PPE for all health care workers
  • Insufficient face masks such that all patients seeking care have appropriate face coverings.
  • Do not have baseline capacity in general health services, including through expansion of telemedicine for COVID-19 and usual care
  • Health care facilities can no longer be structured to reduce possibility of exposure at triage and all other locations
  • Cannot elicit contacts for 20% or more of cases
  • 10% or more of non-household symptomatic contacts fail to get tested or get tested in more than 24 hours of symptom onset
  • No designated facilities for non-hospitalized COVID-19 infected people who can’t be safely cared for at home (e.g., because of space constraints, medically vulnerable household members, or otherwise)
  • No longer have the ability to convey physical distancing recommendations.
  • Inability to test 2 per 1,000 residents, per day
  • Greater than 7% test positivity over 7 days, average
  • Increasing test positivity over prior 7 days

Template signage, provided in English and Spanish, is available to download on the County’s Public Health COVID-19 website at: https://publichealthsbc.org/business-resources  

  • Provide signage at each entrance of the facility to inform employees and customers of common COVID-19 symptoms and that they must not enter the facility if they are sick with or suspect they may be experiencing COVID-19 symptoms.
  • Provide signage regarding the social/physical distancing protocol at the facility; persons to maintain a minimum six-foot distance from non-household members as much as practicable and not engage in any unnecessary physical contact.
  • Provide signage regarding proper hand washing technique should be posted at all handwash sinks and stations.
  • Provide signage encouraging regular hand washing in breakrooms and other locations where employee information is provided.