California Department of Health (2023)

Plan for a safer economy

Updates from 06/15/2021:

  • IsCalifornia plans data chart(Excel) Updated to show county level status and level assignment date.

For more information, seethe project's home page.

Vaccine Equity Metric

The state has focused on saving lives and protecting its communities during the public health emergency. On August 30, 2020, California implemented the Blueprint for a Safer Economy to reduce COVID-19 in the state with criteria to relax and tighten activity restrictions. Each California county is assigned a tier based on test positivity and case rate adjusted for tier assignment. Additionally, on October 6, 2020, a health equity metric went into effect. To advance to the next less restrictive tier, each county must either meet an equity metric or demonstrate targeted investments to eliminate disparities in the extent of COVID transmission. -19, according to your height. The California Health Equity Metric is designed to help counties in their ongoing efforts to reduce COVID-19 cases in all communities and calls for increased efforts to prevent and contain the spread of COVID-19 among Californians who have been disproportionately affected by this pandemic.

The California pandemic has not affected all communities equally. Forty percent of COVID cases and deaths occur in our lowest immunization coverage quartile, which is combinedIndex of Healthy Places(HPI) in ZCTA with ZCTA scores derived from CDPH (CDZS). California believes that equitable vaccine delivery is a critical tool to safely and effectively increase economic activity. By proactively preventing transmission and protecting the most affected and vulnerable groups, we as a state have a better chance of surviving the pandemic.

Greater capacity to protect people in these disproportionately affected communities not only improves the health of those communities, but also has critical implications for the state as a whole, including:

  1. Reduced burden on the hospital system through fewer hospitalizations in populations that are generally at higher risk of chronic diseases and/or structural factors associated with cramped living conditions and exposures that are not easily avoidable.

  2. Reduced overall transmission of the virus through reduced transmission between close families or other community members in communities where we have historically seen the highest test positivity and case rates compared to communities where vaccines are quartile equal.

  3. Reduced likelihood of a threat from variants, as variants rely on high levels of community transmission to emerge, propagate, and dominate.

  4. Reduced risk of a vaccine outbreak (when a virus develops partial or complete resistance to the vaccine). Full and timely vaccination of individuals reduces the risk of high transmission rates associated with higher mutation levels and the potential for mutations that are wholly or partially resistant to a given vaccine.

For all of these reasons, California's approach to changing the plan for a safer economy builds not only on the general level of immunization in California, but with a special focus on immunization of people living in just neighborhood communities. of state vaccines as a key indicator of the state's ability to accelerate the protection and prevention of disease transmission to all communities in the state.

On March 4, 2021, the Blueprint for a Safer Economy was updated to reflect the full immunization effort in California aimed at achieving community immunity.

The changes to the plan include two main approaches: (1) changing the threshold for higher case rates per 100,000 population per day based on compliance with vaccination thresholds in Vaccine Equity Quartile communities and; (2) amend certain industry-specific guidelines and issue new industry guidance to incorporate last year's findings on the spread of the virus.

(Video) About the California Department of Public Health

Goal #1 of the nationwide Vaccine Equity Metric:

The Purple (Pervasive) level changes from more than 7 cases per 100,000 to more than 10 cases per 100,000; and the Red (major) level is expanded to 4-10 cases per 100,000 if:

  • 2 million doses were given to people living in the vaccine equity quartile. (measured nationwide).

The orange (medium) and yellow (minimal) areas remain unchanged.

Goal #2 of the nationwide vaccine equity metric:

The purple (general) tier threshold remains at greater than 10 cases per 100,000, the red (essential) tier fall rate range decreases to 6-10 cases per 100,000; and the Orange (Moderate) level case rate range changes to 2-5.9 cases per 100,000. The yellow tier (minimum) case rate range changes to less than 2 cases per 100,000 when:

  • 4 million doses were given to people living in the vaccine quartile (measured nationally).

Blueprint Tier Framework thresholds for meeting statewide vaccine equity metrics targets

California Department of Health (1)

On the day that a vaccine equity metric goal is met, the tier assignments will be revised to reflect the changes to the blueprint tier caps. Updated tier assignments will take effect two days after the tier assignments are announced.

Plan to reduce COVID-19 and adjust permitted industry activities to ensure the health and safety of Californians

This guide outlines a framework for safely moving forward as more businesses and activities open in the face of the pandemic. The structure of this guide is based on a better understanding of disease transmission vulnerabilities and risk factors and is guided by the following objectives:

  1. Phased progress based on risk levels with sufficient time between each phase in each community to fully assess the impact of changes.

  2. Aggressively reducing the transmission of cases to the lowest possible rate statewide so that the potential burden of COVID-19 does not challenge our healthcare system's ability to increase space, supplies and staff; and prevent the emergence and transmission of disease variants, including those that are vaccine-resistant.

layered structure

This structure defines the actions that each community must meet based on indicators that capture disease burden, testing and health equity. A county can be more restrictive than this structure. This chart also highlights signs of concern, including compromised health capacity that may lead to mitigation action. This framework replaces the previous metrics used to monitor county data. As the COVID-19 pandemic continues to evolve and new evidence and intelligence emerges, the California Department of Public Health (CDPH), in collaboration with other state officials, will continue to reevaluate metrics and thresholds.

The table below provides tiered framework metrics based on the risk of disease transmission in the community. Beginning March 13, 2021, the tier thresholds in the table below will be updated as the nationwide vaccine equity goals are met. The calculation of the metrics is described in Appendix 1. The description of the health equity metric can be found in theHealth equity metrics page.

California Department of Health (2)

Metrics with values ​​above or below the 0.05 thresholds are rounded up or down using standard rounding rules.

^ Excludes state and federal inmates, residents of ICE facilities, inmates of state hospitals, and US Marshal's inmates

* Treasury Department Population Denominator: State Population Projections -Total Population by Municipality – Table P-1

**Fall rate is determined using PCR-confirmed cases

***Counties are assigned a tier based on two metrics: test positivity and case rate. Large counties with populations greater than approximately 106,000 must also meet the health equity metric described inHealth equity metrics pagemove to a less restrictive level.

The case rate is adjusted based on the test volume per 100,000 population as described below. Due to data variability, this adjustment does not apply to small municipalities (defined as municipalities with fewer than 106,000 inhabitants).

(Video) California Department of Public Health

As counties focus on increasing testing in their health equity quartiles and supporting the opening of schools, they will likely see an increase in case numbers. We want to avoid discouraging increased testing while test positivity is low and there is sufficient capacity for contact tracing and isolation. Therefore, we are increasing the adjustment for higher volume testing.

  • For municipalities with a testing volume above the national median, the factor is less than 1 and decreases linearly from 1.0 to 0.5 as the testing volume increases from the national median to twice the national median. The factor remains at 0.5 when the testing volume is greater than 2 times the national median.

  • For counties with testing volume below the national median, the factor is greater than 1 and increases linearly from 1.0 to 1.4 as testing volume decreases from the national median to zero. However, this adjustment of the low test volume does not apply to counties with < 3.5% positive tests.

Adjustment factor for COVID-19 case rates in California

Test volume Cash rate adjustment factor*
0.25* Average condition1.3
0.50* state median1.2
0.75* Average condition1.1
state median1
1.25* state median0,875
1.5 * state median0,75
1.75* state median0,625
2.0*national average and above0,5

  • Counties with fewer than 106,000 residents are exempt from the case rate adjustment, and counties that test positive < 3.5% are exempt from the adjustment for testing rates below the state median.

Move through the levels

Structural Rules:

  1. The CDPH evaluates the indicators weekly on Mondays and publishes updated level assignments on Tuesdays.

  2. A county must stay at a tier for at least three weeks before it can move to a less restrictive tier.

  3. A county can only advance one tier at a time, even if metrics qualify for a higher tier.

  4. The health equity metric applies to jurisdictions with more than 106,000 residents. The metric rules for health equity are described in theHealth equity metrics page.

  5. Data from the city's local health authority (LHJ) is included in the overall metric, with the city's LHJs ranking pari passu with its neighboring county.

  6. A LHJ may continue to institute or maintain more restrictive public health measures if the local health officer determines that health conditions in that jurisdiction warrant such measures.

  7. Tier status takes effect on Wednesday after each weekly tier announcement on Tuesday.

  8. Once the statewide vaccine equity goals are met, the determination of the number of weeks a county has accumulated to transition to a more or less restrictive tier follows the framework established at the time of the tier assessment. For example, if a district had a case rate of 8 per 100,000 and <8% test positivity for 2 weeks prior to reaching the Goal 1 thresholds, the district is eligible to move to the red tier.

To advance:

  1. A county must remain at its current level for at least three weeks.

  2. A county must meet the criteria to move down the tier in the past two consecutive weeks in order to advance to the next tier. which can be achieved by a combination of the following criteria:

    1. Meet adjusted case rate, test positivity, and health equity metrics at a less restrictive level. For small counties with fewer than 106,000 residents, the adjusted case rate and test positivity are used for the default assessment. If a small county does not meet the adjusted case rate to gain a week toward a less restrictive level (but meets test positivity criteria), the CDPH reviews the absolute number of new cases and whether the county's coverage of immunization delivery is within or equal 5% (absolute value) of the national average. For more information, seeSection Small circle structure.

    2. Meet the criteria to move to the next lowest restrictive level through accelerated health equity progression.

      (Video) California Department Of Public Health TV AD SPOT 0:30 'COVID Treatment Sing-Along'

to go back:

  1. If during the weekly review, a county's adjusted case rate and test positivity fall to a more restrictive level for two consecutive weekly periods, the state reviews the most recent 10-day data, including hospital data, and if the CDPH determines there are objective signs of stability. or improvement can remain in the community in the area. If the district's most recent 10-day data shows no objective signs of stability or improvement, the district should revert to the most hawkish level. For subsequent weekly reviews, the above rules apply.

  2. County and state health officials can always work together to determine specific statewide interventions or changes needed to address compromised hospital capacity and disease transmission factors, including shifting to more than one tier, as needed. Key considerations also include the rate of increase in new cases and/or test positivity, the most recent data as mentioned above, vaccination rates, public health capacity and other epidemiological factors.

  3. A small-county selection criterion is applied to counties with fewer than 106,000 residents to ensure that the transition to a more restrictive level is appropriate. For more information, seeSection Small circle structure.

  4. Districts have three days from Wednesday after Tuesday's tier allocations were announced to make changes or sector closures, unless extreme circumstances require immediate action.

small circle frame

Because the case rate metric in California is normalized per 100,000 residents, several counties with small populations have experienced large fluctuations in their daily case rate due to a small number of new cases being reported. For some counties, this presented the specter of having to return to more restrictive levels, despite the general stability of the disease and demonstrated ability to track, trace, investigate and support cases.

For example, if a small community is at the yellow level, a small number of cases, just 1 case per week for 2 consecutive weeks, can cause it to revert to a more restrictive level. While the overall proportion of cases may be the same as in a larger county, the absolute number of cases is also an important consideration when assessing a county's ability to control transmission through disease screening, traceability contacts, and supportive isolation.

It is not in the interest of the public health of communities to close or restrict entire commercial sectors based on such a small number of cases, and in some situations a small week-to-week variation in the case count can lead a county to go above and beyond the plane yellow. down to the purple level. Because the state wants to avoid rapid animal status changes based on small absolute changes in the number of cases, we created a Small County Case Scoring measure that can be applied to small counties. Beginning April 20, 2021, CDPH will also consider the absolute number of new cases and immunization coverage to determine whether a county may move to a less restrictive level if the default adjusted case rate rating prevents it from moving to a less restrictive level for a week buy or move. Small counties are those with fewer than 106,000 inhabitants.[1]

Case assessment measure for small circles

Small counties are subject to all existing Blueprint rules (thresholds for test positivity, minimum duration of 3 weeks at a tier before moving to a less restrictive tier, inability to skip a tier when moving from more restrictive tier designations to more restrictive ones). less restrictive, etc. .).

The small-county case triage measure provides protection for small counties from sudden tier changes due to a small increase in cases or the ability to move to a less restrictive tier.

For a small county that meets the test positivity criteria but does not meet the case rate criteria adjusted to a less restrictive level, the following new absolute case counts by county size and test positivity are used. If a county meets absolute caseload criteria and tests positive, CDPH also reviews county-level immunization coverage to determine if the county is vaccinating within 5% or equal (absolute value) of the average statewide immunization coverage to do so achieve work on last level.

Small population coverage is defined as the rate of vaccine administration in individuals who have received at least one dose, including one dose of Janssen vaccine.

California Department of Health (3)

[1] Twenty-two counties in California have populations of less than 100,000. Sutter, which has a population of 106,000, is also included because it shares a health authority with Yuba County. Counties below this size face similar challenges and opportunities in controlling transmission of COVID-19 and generally do not have large or densely populated cities. This distinction takes into account how quickly COVID-19 transmission can spread beyond households and the county's ability to quickly identify and contain outbreaks with contact tracing, isolation and quarantine capabilities in place.

risk criteria

Activities and sectors start in acertain level based on risk-based criteria(PDF) as described below. Lower risk activities or sectors are approved earlier and higher risk activities or sectors at later stages. Many activities or sectors can increase operational levels and capacity when a community reduces its transmission level.

Criteria for determining low/medium/high risk sectors

  • Ability to accommodate the use of face coverings at all times (e.g. eating and drinking would require removing the face covering)

  • Capacity of physical distance between people from different families.

    (Video) California Department of Public Health

  • Possibility to limit the number of people per square meter

  • Ability to limit exposure time.

  • Ability to limit the extent of mixing of people from different families and communities

  • Ability to limit the number of physical visitors/customer interactions

  • Ability to optimize ventilation (e.g. indoor vs. outdoor, air exchange and filtration)

  • Ability to limit activities known to cause further spread (eg, singing, yelling, hissing; noisy environments prompt people to raise their voices)


Schools may reopen for face-to-face classes based on criteria consistent with theseK-12 school leadership. Schools in districts within the Purple Tier cannot reopen for face-to-face classes with the exceptions described inK-12 school leadership. Consult the guide andFrequently Asked Questions About K-12 Schoolsfor more information on the eligibility criteria for reopening schools in Blueprint.

As indicated noK-12 school leadershipSchools are not required to close if a district no longer meets the relevant criteria for school reopening (e.g. moving from the red tier to the purple tier or adjusting case rates in the district ≥ 25/100,000 population) but may require an increase in the Consider evidence-based testing supported by CDPHStructure.

decision-making process at district level

For more information see ourApplication for district level awardbook page.

APPENDIX 1: Calculation of the metrics

Metric Definition
Case rate (rate per 100,000 excluding arrest cases, 7-day average with 7-day span)

Calculated as the average (mean) daily number of COVID-19+ cases, this excludes: (a) individuals out of state or with an unknown residency and (b) individuals incarcerated in state or federal prisons, ICE facilities, US -Marshal incarcerated are only detention centers or Department of State Hospitals (identified as cases with a warrant center name or address associated with those locations) for 7 days (based on date of incident) divided by number of people who live in the county/region/state. This number is then multiplied by 100,000. There is a 7 day delay in this calculation due to reporting delays. For example, for data updated to 8/22/20, the fall rate has the date 8/15/20 and includes the average fall rate from 8/9/20 to 8/15/20.

Linearly adjusted case rate per 100,000 per day, excluding inmates (7-day average with 7-day lag)

Calculated as the case rate multiplied by a case rate adjustment factor based on the difference between the county's testing volume (testing volume, tests per 100,000 per day, described below) and the average testing volume. District tests calculated in all districts. Therefore, the average testing volume forms an anchor for this adjustment and is recalculated each week to reflect changes in testing trends. For districts with a test volume greater than the median, the adjustment factor is less than 1 and decreases linearly from 1.0 to 0.5 as the test volume increases from the anchor point to a doubling of that value. The adjustment factor remains at 0.5 when the county's testing volume is greater than twice the state median. For counties with testing volumes below the national median, the adjustment factor is greater than 1 and increases linearly from 1.0 to 1.4 as the county's testing volume relative to the national median decreases. The linear fit formula can be expressed mathematically as follows:

For counties with tests above the state median:

1-(((County Test Rate - State Median Test Rate)/State Median Test Rate) * 0,5)

For county tests below the state median:

1-(((County-Testrate - State-Median-Testrate)/State-Median-Testrate) * 0,4)

There are two conditions where this formula does not apply. The first are small counties, meaning those with a population of fewer than about 100,000, based on CA Department of Finance population projections (see reference * in Level Structure table). The small circle exception prevents potential false adjustments due to variability in testing influenced by secular events unrelated to the underlying risk of transmission. As a second condition for the adjustment exemption, counties with testing volume below the national median and test positivity <3.5% are not adjusted, based on the assumption that testing volume in those counties need not be as high as a low standard of evidence. Positivity Under both conditions, the adjusted case rate corresponds to the unadjusted rate.

Overall test positivity, excluding inmates longer than 7 days (PCR only, 7-day delay)

Calculated as the total number of positive polymerase chain reaction (PCR) tests for COVID-19 during a 7-day period (based on the date of sample collection) divided by the total number of PCR tests performed; this excludes testing for: (a) individuals out of state or with an unknown residency, and (b) individuals detained in state or federal prisons, ICE facilities, US Marshal's exclusive detention centers and US Department of State hospitals ( identified such as cases with a name or warrant facility associated with state prisons/hospitals). This number is then multiplied by 100 to get a percentage. Due to the notification delay (which can differ between positive and negative tests) there is a 7 day delay.

Example:For cumulative laboratory data received on 06/30/20, the reported test positivity is dated 06/23/20 and is based on testing with specimen collection data from 06/17/20. until 23.06. calculated

Tests per 100,000 per day excluding prisoners (7-day average with 7-day lag)

Calculated as the number of polymerase chain reaction (PCR) tests performed per day during a 7-day period (based on the date of sample collection), excluding tests for individuals incarcerated in state or federal prisons, ICE facilities, and detention areas used only in the US occur, incarcerated are Marshal and Department of State Hospitals (identified as cases with the name or address of an inquiry center associated with state hospitals/prisons) divided by the number of people residing in the county/region/state. This number is then multiplied by 100,000. Due to the notification delay, a delay of 7 days is included in the calculation.

Example: For cumulative laboratory data received by 08/22/20, the average number of tests reported in 7 days is dated 08/15/20 and includes PCR tests with sample collection dates from 08/09/20 to 08/15/20.

Data source: CalREDIE

(Video) California Department of Public Health


What is considered a close contact for CDPH? ›

In indoor spaces 400,000 or fewer cubic feet per floor (such as home, clinic waiting room, airplane etc.), a close contact is defined as sharing the same indoor airspace for a cumulative total of 15 minutes or more over a 24-hour period (for example, three individual 5-minute exposures for a total of 15 minutes) during ...

Is the booster mandatory in California? ›

Boosters have been available in California since September 2021. Accordingly, making boosters mandatory are necessary.

Are California healthcare workers required to be vaccinated? ›

COVID-19 Vaccination

All persons who work in healthcare facilities must complete a primary COVID-19 vaccine series and receive a single booster dose as required by the California and the LA County Public Health Officers.

What does fully vaccinated mean CDPH? ›

"Fully Vaccinated" means individuals who are considered fully vaccinated for COVID-19: two weeks or more after they have received the second dose in a 2-dose series (Pfizer-BioNTech or Moderna or vaccine authorized by the World Health Organization), or two weeks or more after they have received a single-dose vaccine ( ...

How many days before symptoms is someone considered a close contact? ›

Close contacts are people you have been around (less than 6 feet away for a combined total of 15 minutes or more over a 24-hour period) during the two-day period before you first had symptoms OR if you do not have symptoms, two days before you were tested for COVID-19, through to the time you started isolation.

What is the difference between exposed and close contact? ›

What is exposure? You are exposed if you've had close contact with someone who's confirmed positive for the virus by a testing lab. Close contact means within 6 feet for more than 15 cumulative minutes within a 24-hour period of someone positive for COVID-19.

What qualifies as fully vaccinated in California? ›

People are considered fully vaccinated for COVID-19: two weeks or more after they have received the second dose in a 2-dose series (Pfizer-BioNTech or Moderna or other vaccine authorized by the World Health Organization), or two weeks or more after they have received a single-dose vaccine (Johnson and Johnson [J&J]/ ...

Do nurses in California have to be vaccinated? ›

Thus CDPH is updating its order requiring health care workers to be fully vaccinated and boosted by March 1, 2022 to allow delay of the March 1, 2022 deadline for receiving a booster for covered workers with proof of a recent infection for up to 90 days from date of infection.

Does everyone need a booster for Covid? ›

Updated Boosters Are Recommended

For everyone aged 5 years and older if it has been at least 2 months since your last dose. For children aged 6 months–4 years who completed the Moderna primary series and if it has been at least 2 months since their last dose.

What is close contact COVID California? ›

The California Department of Public Health (CDPH) defines a “close contact” as someone who shared the same indoor airspace as a person who has COVID-19 (e.g., in a home, airplane, or clinic waiting room) for a cumulative total of 15 minutes or more within a 24-hour period while the case was considered contagious (see ...

What does the CDC consider close contact? ›

Close Contact through proximity and duration of exposure: Someone who was less than 6 feet away from an infected person (laboratory-confirmed or a clinical diagnosis) for a total of 15 minutes or more over a 24-hour period (for example, three separate 5-minute exposures for a total of 15 minutes).

Who do you consider a close contact? ›

A close contact is anyone who: has had face-to-face contact for more than 15 minutes [cumulative over the course of a week] with someone known to have COVID-19 while that person was or may have been infectious including in the 48 hours before their symptoms started.

What is the current definition of close contact? ›

You are generally a close contact of someone who has COVID-19 if: you are living with someone who has COVID-19; or. have spent a lot of time indoors with someone who has COVID-19; or. under exceptional circumstances determined by states or territories.


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