SAN FRANCISCO (CBS SF) — State health officials on Tuesday announced that two greater Bay Area counties — Contra Costa and Santa Cruz — have backslid due to rising COVID-19 cases, moving from the orange tier to the more restrictive red tier.

The return to the red tier for those counties means residents there who have been enjoying a slow return to normal while dining inside restaurants, working out at gyms and watching movies in theaters will return to more severe restrictions for many business operations.

Restaurants, places of worship and movie theaters will be able to operate indoors at a maximum of 25 percent capacity or 100 people, whichever is fewer, while gyms and dance studios will only be able to open indoors at 10 percent capacity.

Additionally, starting Friday, Nov. 13, retail stores that operate indoors must scale back their maximum occupancy to 50 percent or 100 people, whichever is lower, while indoor shopping malls must reduce their occupancy and reduce the occupancy of food courts to 25 percent or 100 people, whichever is fewer and office workspaces must operate remotely.

Health officials are urging Contra Costa County residents to consider how they are protecting themselves and their families from the virus, county health officials said.

“The most critical way to protect against COVID-19 is to wear a face covering whenever you are near people who do not live with you, and whenever you go in a building that is not your home,” said Contra Costa Health Officer Dr. Chris Farnitano. “Face coverings help prevent people who do not know they are infected from spreading the virus to others. My mask protects you. Your mask protects me. Masks also provide some direct protection for the wearer.”

Officials said that most new COVID-19 cases in Contra Costa are being spread within the home, with an infected member of a household passing the virus to people with whom they live.

Data from Contra Costa show that the average daily number of newly identified COVID-19 infections has risen steadily since the county entered the orange tier of the state’s plan on October 27. On Tuesday, the 7-day average, per-capita number of new cases (the “adjusted case rate”) was 5.3 in Contra Costa, higher than permitted for counties in the orange tier for a second consecutive week. That triggered the county’s shift back into the more restrictive red tier.

Among the other counties that moved to more restrictive tiers in California, Sacramento, San Diego and Stanislaus moved from the red tier to the in purple tier.

The move back to the purple tier for those areas means that activities such as indoor dining and movie theaters — which had just started back up again with very limited capacity — will once again restricted. Gyms and places of worship will also have to operate outdoors only.

Other counties in addition to Contra Costa and Santa Cruz that moved from the orange tier to the red tier included Amador, El Dorado and Placer counties.

Counties that moved from the least restrictive yellow tier back to the orange tier included Modoc, Siskiyou and Trinity counties.

“With these increases, we are not seeing any counties move forward this week,” said California State Epidemiologist Dr. Erica Pan.

While San Francisco remained in the yellow tier, Mayor London Breed on Tuesday afternoon announced that as of the end of the day Friday, the city would be eliminating indoor dining, reducing capacity at gyms and movie theaters as well as pausing the reopening of high schools.

CHHS Secretary Dr. Mark Ghaly announced on Tuesday that the state’s 14-day positivity rate had risen to 3.7 percent where it was down to 2.9 percent on October 26.

Ghaly noted that the seven-day test positivity was at 4.2 percent, saying that California had not seen a seven-day positivity rate that high since late August or early September.

COVID-19 hospitalizations have risen to 31.6 percent in the last two weeks with 3,083 currently hospitalized, with ICU rates increasing to 29.6 percent in the same period. There are currently 859 cases in ICU.

Ghaly also acknowledged the challenge and danger of people being tired of abiding by COVID-19 safety restrictions.

“We know this is hard,” Ghaly said. “We know many people feel exhausted. They feel isolated and they are impatient. We talked about COVID fatigue. We know this is hard work, but we must do more. The virus is not over just because we are tired of it. It doesn’t put its guard down. It looks for opportunities to spread. High risk activities [large gatherings, not social distancing, etc.] give it those opportunities”

Among the Bay Area counties, Sonoma County remains in the most restrictive purple tier, with Solano, Contra Costa and Santa Cruz counties now in the red tier. Alameda, Marin, Napa, San Mateo and Santa Clara counties are still in the in the orange tier while San Francisco is the only local county in the least restrictive yellow tier.

Santa Cruz County Health Officer Dr. Gail Newel suggested the county’s recent surge in new cases is tied at least partially to residents celebrating Halloween with people from other households.

Newel also said many of the county’s new cases are in young people, who are still fully capable of transmitting the virus to more at-risk populations even if they have mild symptoms.

“We are entering an especially dangerous period of the pandemic, and we ask everyone to meet this challenge by taking measures to protect one another,” Newel said.

But for weeks, local county health directors have been sounding the alarm. The latest was Santa Clara County’s Dr. Sara Cody. Since Sunday there have been 358 new COVID-19 cases reported in Santa Clara County which was second only to the record of 385 new cases reported on July 15.

Nearly all the new cases were from test samples collected in the past week in the wake of Halloween, officials said. About half of those came in the past three days.

The all important seven-day average of new cases last week was between 131 and 139, accelerating after a slow climb that started in mid-October.

In addition, the number of hospitalizations on Sunday was up by nearly 10 percent.

“We don’t have a clear signals of particular groups or sub-populations or clear super spreader events that would explain this surge,” she said. “We are actively investigating to understand whether there may have been such events.”

With Thanksgiving just weeks away, state and local health officials are fearing an even larger spike in new cases.

“People are letting their guard down,” Newsom said during a press conference on Monday. “We’ve got to be careful. You’ve got to protect yourself and your loved ones.”

Health officials said the state has averaged more than 5,000 new daily COVID-19 cases over the last two weeks, after the rolling average hovered between about 3,100 and 3,400 for most of October.

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