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The Marin County Department of Health and Human Services is conducting on-going surveillance of respiratory illness in Marin County to increase sensitivity in detecting potential COVID-19 activity. We will provide timely surveillance updates at marinhhs.org/coronavirus/data.
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There are two main indicators of potential COVID-19 virus transmission locally — the number of confirmed cases and the number of people experiencing severe respiratory illness. Tracking this will help our healthcare providers and partners know when COVID-19 activity may be increasing in Marin. Marin County Public Health receives regular updates on respiratory illness cases from all Marin County emergency departments (ED) and from Emergency Medical Services (EMS), our countywide 911 ambulance response system. We track these over time and evaluate these trends by age because older adults infected with COVID-19 experience more severe disease. Knowing there's always ups and downs in our usual activity, we're looking for significant changes.
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As of March 24th, 53 cases of Coronavirus Disease 2019 (COVID-19) have been identified. The level of respiratory illness activity in Marin County is somewhat elevated, but remains consistent with prior trends. For additional information on current activity and Marin County's response visit marinhhs.org/coronavirus. Respiratory illness and COVID-19 surveillance updates will be available at marinhhs.org/coronavirus/data.
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Confirmed COVID-19 Cases: As of March 24th, there have been 53 confirmed cases of COVID-19 and 0 reported deaths in Marin County. The average age of confirmed COVID-19 cases is 52 years (range: 0-98 years). Figure 1 presents positive COVID-19 tests by date of specimen collection.
Some of these cases are a result of community transmission, meaning that these cases are unrelated to travel and have no identifiable contact with a known case, indicating likely infection within our community.
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Figure 1. Positive COVID-19 Tests by Collection Date
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Decisions to test individuals for COVID-19 are made by medical providers based on assessment of symptoms and evaluation of other possible conditions (e.g., influenza). Many providers are now performing these assessments over the telephone. Providers who determine an individual should be tested are aware that they can refer patients to Marin County Public Health to obtain testing in our drive through testing site.
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Respiratory illness activity: Common symptoms of COVID-19 include fever, cough, and difficulty breathing. Respiratory illness activity will capture visits that may be due to COVID-19 and influenza-like illnesses. The majority of individuals with COVID-19 will experience mild to moderate symptoms. However, some individuals may experience more severe symptoms and require a higher level of medical care through EMS or the ED. Tracking the total number of visits and those due to respiratory illnesses provides a situational awareness of current resource needs in our community. Each daily count below reflects 3-day rolling averages. Figures 2-4 display information on current trends in EMS dispatches and ED visits due to respiratory illnesses total and by age.
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Utilization Trends: Over the past week, the number of ED and EMS visits and those due to respiratory illnesses have been somewhat lower than daily averages seen in January-March, 2019. Marin County Public Health will continue to monitor trends to identify any significant changes (Figures 2A-B).
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Figures 2A-B. Number of Total Visits and Visits due to Respiratory Illnesses
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THROUGH MARCH 23RD: Marin County Emergency Medical Services Dispatches (2A)
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THROUGH MARCH 21ST*: MarinHealth Medical Center and Novato Community Hospital Emergency Department Visits (2B)
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*Discharge data from MarinHealth and Novato Community Hospital show trends in ED visits due to respiratory illnesses and are updated as soon as data are available. Data from Kaiser San Rafael are not available at this time.
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Percentage of visits due to respiratory illnesses: Approximately 11% of Emergency Medical Services (EMS) dispatches and 6% of Emergency Department (ED) visits were due to respiratory illnesses (Figures 3A-B).
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Figures 3A-B. Proportion of Visits due to Respiratory Illnesses
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THROUGH MARCH 23RD: Marin County Emergency Medical Services Dispatches (3A)
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THROUGH MARCH 21ST*: MarinHealth Medical Center and Novato Community Hospital Emergency Department Visits (3B)
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*Discharge data from MarinHealth and Novato Community Hospital show trends in ED visits due to respiratory illnesses and are updated as soon as data are available. Data from Kaiser San Rafael are not available at this time.
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Age Distribution of Respiratory Illness Visits: The majority of respiratory illness-related EMS dispatches occur among those 65 years and older, while the majority of ED visits due to respiratory illnesses occur among those less than 65 years of age (Figures 4A-B).
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Figures 4A-B. Daily Age Distribution of Visits due to Respiratory Illness
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THROUGH MARCH 23RD: Marin County Emergency Medical Services Dispatches (4A)
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THROUGH MARCH 21ST*: MarinHealth Medical Center and Novato Community Hospital Emergency Department Visits (4B)
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*Discharge data from MarinHealth and Novato Community Hospital show trends in ED visits due to respiratory illnesses and are updated as soon as data are available. Data from Kaiser San Rafael are not available at this time.
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California
As of March 23rd at 2 p.m., there are 2,102 confirmed cases and 40 deaths in California. View full updates at the California Department of Public Health's COVID-19 website.
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United States
National COVID-19 activity is increasing, with 44,183 confirmed cases and 544 deaths across 54 states and territories (50 states, District of Columbia, Puerto Rico, Guam, and US Virgin Islands) as of March 24th at 4 p.m. View more detailed information at the Centers for Disease Control and Prevention's COVID-19 website.
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