Sonoma County is working to minimize the impacts and spread of coronavirus, decrease severe illness, and prevent deaths within the entire community. Our response, now focusing on the vaccine rollout, strategically prioritizes communities with the greatest needs using race disparity research, community voices and wisdom, and public health best practices.
The following strategies are intended to ensure that Sonoma County’s rollout of its COVID-19 vaccination program prioritizes equity in its design, process and outcomes. The strategies are built on a foundation that the county will:
- Provide transparency about the science of the vaccines and vaccination process;
- Prioritize those who shoulder the most risk;
- Include culturally responsive practices throughout each stage of the implementation process, (e.g. interpretation, translation, and language access, etc.);
- Through proactive communication and outreach strategies, explicitly acknowledge the negative and painful history of health care in communities of color that has led to distrust in health care, research, and government;
- Engage community members and stakeholders to better understand their concerns and needs and respond to these needs as much as possible;
- Communicate with the public effectively in culturally sensitive ways through trusted partners.
- Regularly evaluate our efforts, and learn and improve as we go.
The following strategies are essential to ensure the equitable distribution and access to vaccines:
Access to vaccination sites
Include geographically relevant sites and partnerships that are accessible by the communities we serve. Strategies to achieve this include:
– Partnering with community health clinics (Sonoma Valley, Petaluma Health Center, Santa Rosa Community Health, etc.);
– Supporting vaccine administration events at the pop-up testing location sites that were chosen for their geographic accessibility and cultural appropriateness (e.g. Roseland Library, Andy Lopez Park, etc.);
– Selecting additional sites that are known, regularly and easily accessed, and trusted by communities of color, linguistic minorities, and those facing accessibility issues;
– Working with community organizations and leaders to secure transportation to those locations and sites, as needed.
Integrated community component
To be culturally sensitive, respectful and responsive:
– Foster partnerships with local community-based organizations that work directly with communities disproportionately impacted by COVID-19.
– Meaningfully engage with the community and build a sense of trust around vaccination efforts to increase vaccine acceptance.
– Provide staff and resource tables at vaccine clinics; involving organizations that are trusted messengers in the community. Some examples include distribution of resources, paid sick leave, food accessibility, immigrant rights, emergency financial assistance, vaccine information, testing options, information on the CURA project and others as needed)
A vaccination site should include bi/multi-lingual teams who can assist individuals in their preferred language; and bi/multi-lingual and bi/multi-cultural staff who can support the process of registration, vaccine implementation and overall process.
Cultural responsiveness and access
– Ensure all informational materials are bi/multilingual
– Ensure registration forms are bi/multilingual
– Ensure access to indigenous language-speaking interpreters
– Support options for booking appointments through multiple avenues including through a call center (equipped with multiple languages, TTY Services), email, text.
– Ensure access to communities that are abled differently.
Allocation recommendations and guidelines
To protect the population’s health by maximizing benefit in the form of reducing mortality and serious morbidity:
- Protect individuals and groups at highest risk of health disparities
- Protect against systemic inequality by promoting equity in access
- Reserve a proportion of vaccine allocation for certain populations (i.e. farmworkers, elderly, etc.) as we move through different tiers.
Monitor inequities by socioeconomic status, race/ethnicity, zip code or Census tract, occupational status, age, gender, and comorbidities. If data show that inequities exist by any of these factors, allocate additional resources to engage in outreach and administration efforts until these inequities are mitigated.
Ensure vaccine allocation request (as permitted by the state) aligns with epidemiological evidence of COVID-19 disease burden, including COVID-19 morbidity and mortality, economic hardship, and structural and social inequities.
When further prioritization is needed within tiers, vaccine, when possible, should preferentially be offered to individuals based on their place of residence in relation to the California Health
Places Index (HPI), prioritizing communities that have been disproportionately impacted by the pandemic, their occupational risk of exposure and any underlying medical condition or disability.
Meaningfully engage with community
In order to include culturally responsive practices throughout each stage of the implementation process, proactively engage community members and stakeholders to better understand concerns by ensuring that volume of vaccine implementation is not the sole priority but instead committing to empowering residents (especially BIPOC communities) to make an educated decision about the vaccine.
Through proactive communication and outreach strategies, explicitly acknowledge the negative and painful history of health care in communities of color that has led to distrust in health care, research and government.
Communicate with the public effectively in culturally sensitive ways through trusted partners.
Outreach best practices include, but are not limited to, ensuring providers work with community-based organizations, family resources centers, and other grassroots-level organizations to provide the most current vaccine information and include them in the vaccine clinic planning process.
Transparency and equity data and metrics
As data collection methodology improves, the following metrics should be monitored in order to maintain transparency: number of vaccines distributed by race/ethnicity, zip code or census tract, occupational status, age and gender.
Sonoma County’s vaccination strategy prioritizes those most vulnerable to COVID-19 because of their age or their high risk of exposure at work. The vaccine rollout also prioritizes health equity needs including our communities disproportionately impacted by COVID-19. The County has helped create, advise and supply a network of vaccination clinics and also collaborates with large health care providers, pharmacies and clinics to provide transparency for the process of providing vaccines to our eligible residents quickly, safely and fairly. You can find a local vaccination clinic here or at myturn.ca.gov.
Sonoma County offers free community-based testing to residents through a dedicated testing site for close contacts and recurring weekly pop-ups to provide greater access to testing for all of our residents. Testing is free, and no ID is required. People tested through our County lab usually receive results through text or email within 24-48 hours. Visit our pop-up testing calendar for site locations, times, and how to sign up.
The County also advocates for increased state testing resources, such as the state-run testing sites in Santa Rosa, Windsor and Petaluma.
Find out how to get tested here.
When someone tests positive for coronavirus in Sonoma County, whether at a hospital, state testing site or our own lab, the County will follow up to conduct a case interview. These interviews help identify people who have had close contact to a person with coronavirus. The County’s team of contact tracers will contact those close contacts to provide testing options, quarantine or isolation details, and links to resources for support. Our team provides free testing for anyone who is a close contact.
Our contact tracing team is made up of nurses, trained contact tracers, and social service workers to meet the needs of the community, including bilingual, bicultural staff.
In order to provide resources and testing to the areas most impacted, the County’s epidemiologists analyze local coronavirus data and make program recommendations. This team, in partnership with the same GIS experts who bring you our fire maps, also maintains the coronavirus dashboard to share important, transparent and timely data.
The County knows that in addition to providing all coronavirus information in English and Spanish, the Latinx community needs different, culturally relevant information at times, and receives information using different channels than English speakers.
The County relies on data, bilingual and bicultural staff and stakeholders to inform Spanish language communications. We coordinate with Latinx stakeholders to disseminate information using trusted voices, Spanish media channels, and innovative methods like videos in Latinx supermarkets.
Additionally, the County partners with community organizations like On the Move and the CURA Project, which is a collaborative of 15 local grassroots organizations. Community organizations educate and provide residents with services like financial support and incentives, information, personal protective equipment, and other assistance for farm workers, laborers, and other Latinx and indigenous-speaking communities.
The County and nonprofit partners are offering residents who meet financial thresholds and who lack access to paid leave emergency financial assistance to help offset the cost of staying home during the quarantine and isolation period. This assistance is available to residents regardless of immigration status.
The County offers individuals quarantine and isolation support if they are unable to isolate or quarantine safely at home because they live with other people who are vulnerable to COVID. The County has vouchers or hotel rooms with medical services, meals and laundry for free during isolation and quarantine.
The ACS is for individuals who have coronavirus that do not require hospitalization, but still require some level of monitoring by medical staff such as Registered Nurses and Medical Assisted Personnel; and those who are pending coronavirus tests who are unable to isolate at home. The ACS is located in a Healdsburg hotel with a capacity of 60 rooms.
The County shares public health recommendations and resources from local, state and federal partners using a wide array of tools. Most notably, the County uses SoCoEmergency.org, social media, media partnerships, print advertising, digital programmatic advertising, radio, TV and streaming services to provide information and encourage safe behavior.
The Sonoma County Health Services Department and Economic Development Board (EDB) provides information to employers to increase worker safety. Increasing worker safety and decreasing the spread of COVID-19 is a key component of a safer economy. Tools include the one-stop resource shop SoCo Launch, the Sonoma Safe self certification to help businesses create required coronavirus workplace safety plans, and much more. Additionally, EDB sends regular newsletters with updated information directly to businesses, holds webinars with subject matter experts and is a point of contact for the business community.
When the County learns of three or more people testing positive at one workplace, our public health nurse teams will launch an outbreak investigation to support employers in containing the outbreak and preventing further transmission. We help employers identify close contacts among staff, support employees through isolation and quarantine, and provide free testing to contacts at the end of their quarantine to clear them to return to work. We also work with employers to identify mitigation measures to prevent outbreaks in the future.
The County’s non-congregate sites, often referred to as NCS, offer temporary shelter to individuals who have not been diagnosed with coronavirus, but are considered at high risk of serious complications should they contract the virus. Individuals who are unsheltered and are over the age of 65 or have underlying medical conditions meet the criteria for placement at NCS locations. The County has the capability to shelter about 60 people at non-congregate sites, with the ability to serve an additional 100 people if needed.
The Public Health Lab has redirected all resources and expanded capacity to test for coronavirus with new equipment, additional staff and supplies. The Lab provides guidance on specimen collection and testing procedures, monitors regional lab resources and provides aggregated testing results to the state. The lab currently has capacity to process 750 specimens per day.
County Response to COVID-19 Risk among People Experiencing Homelessness
The County is working closely with local homeless shelters to determine their capacity and how many people are anticipated to need placement in alternative locations. Priority for placement in alternative locations, such as motels/hotels, will be given to people who are 65 years or older, medically compromised, pregnant, and who are ill and being tested for COVID-19.
Both the Cities and the County are working to secure alternative sites for overflow from shelters.
The County has created guidance for shelters on mitigation strategies and a process for screening, and medical assessment and testing.
The County will also work through its street outreach teams to identify vulnerable and symptomatic individuals who are living outside, using a similar process as used in the shelters.
In addition to accommodations in hotels and motels, the County is creating an isolation site for homeless individuals who have tested positive for COVID-19. Individuals who are placed at this site will be supported by medical staff and there will be resources on site for them such as food, water, and security.
The following are resources for service agencies providing care for people experiencing homelessness:
- CDC Resources to support people experiencing homelessness (3/22/2020)
- Homebase Response Online Resource Guide (3/27/2020)
Non-congregate and alternative care sites have been established in Sonoma County for those who are at high risk of complications if COVID-19 is contracted as well as those who need a safe shelter that have tested positive for COVID-19 and have mild to moderate symptoms.