In-Depth: Why is San Diego County lagging behind LA in reopenings?

LA hits yellow tier; SD remains in orange
COVID-19 tests
Posted at 4:25 PM, May 04, 2021
and last updated 2021-05-04 21:24:48-04

SAN DIEGO (KGTV) -- State health officials announced Tuesday that Los Angeles and San Francisco counties can enter the least restrictive yellow tier, but San Diego County’s COVID-19 metrics will keep it in the orange until at least mid-May or later.

Starting Thursday, Los Angeles County gyms, movie theaters, amusement parks and museums will be allowed to boost capacity. Some of those businesses will be allowed to serve twice as many customers as their San Diego counterparts.

Even LA’s sports teams will have a competitive advantage. Dodger Stadium will be allowed to host up to 37,520 fans per game, or 67 percent of its capacity. Petco Park will stay capped at 14,006 fans, which is 33 percent capacity.

IN-DEPTH: How safe are crowds in San Diego after California reopens?

“We don’t know exactly all the reasons why there are fluctuations or variations” between the counties' COVID metrics, San Diego County Supervisor Nathan Fletcher said last week.

The news represents remarkable progress for LA County, which for a time was the hardest-hit area in the U.S. earlier this year. At one point in mid-January, LA County recorded twice as many cases and deaths as any place in the country.

The relatively faster reopening pace may also be puzzling for San Diegans who have rolled up their sleeves at a higher rate: 35.4 percent of San Diegans are fully vaccinated compared to 31.9 percent of Los Angeles residents.

But in the three metrics that matter for reopenings, LA is doing significantly better. San Diego’s case rate and test positivity rates are not only higher than LA’s but slightly above the statewide averages. San Diego's test positivity rate in underserved areas, known as the health equity metric, is more than three times higher than LA’s.

Across all three categories, the state's numbers show San Diego remains firmly in the orange tier.

Yellow Tier Threshold Los Angeles County San Diego County
Cases per 100k residentsLess than 2.0 1.65.0
Test positivity rateLess than 2.0%0.7%2.2%
Health equity positivity rateLess than 2.2%0.8%2.7%

“We see this all the time in medicine; people don't tend to take a threat very seriously unless it really hits close to home,” said Dr. Christian Ramers of Family Health Centers of San Diego.

Dr. Ramers theorizes that public perception and behavioral changes are contributing to LA’s lower case rate.

“I think Los Angeles through the winter surge was hit incredibly hard, and more people proportionally had a friend or relative or knew somebody who was in the hospital or a died of COVID,” he said.

His other theory has to do with the way the state does the math. The California Department of Public Health built a points system to encourage counties to do more COVID-19 tests. LA is averaging about 60,000 people tested per day, about 70 percent more tests than San Diego when adjusted for population.

“We don't get extra credit for having high testing numbers that places like San Francisco and Los Angeles really do,” Dr. Ramers said.

In a best-case scenario, the soonest San Diego County could advance to the yellow tier would be on or after May 19, but the county would have to slash its case rate by more than half. San Diego County’s own calculations, which differ from the numbers released by the state, show its test positivity rate reached 1.9 percent and now meets the yellow tier threshold.

As a state, California had the lowest per capita case rate in the country over the last week. The Golden State has also fully vaccinated the most people, more than 12.6 million.

If current trends continue, Governor Gavin Newsom has said the state is on track to retire the tier system and reopen the economy on June 15.

But other states are now moving faster. New York, New Jersey, and Connecticut plan to lift most business restrictions and capacity limits on May 19.

Politics aside, Dr. Ramers points out those states are beating California in at least one metric.

“The vaccination rates completely changed this whole calculation,” he said. “Vaccination has such an incredibly profound effect on protecting the population.”

When adjusted for population, the three east coast states have administered more doses per person than California.

Connecticut, New Jersey, and New York all rank among the top 10 states for doses administered per 100,000 residents. California ranks 18th, with 79,424 doses per 100,000.