In addition to positive Covid-19 cases more than doubling in Marin communities over the past month, the largest prison outbreak in the state has occurred within the walls of San Quentin, which is turning to local hospitals for assistance. Public health officer Dr. Matt Willis moved to roll back re-opening plans last week, following the single-highest new case count last Thursday. “Taken together—the spikes in cases statewide, regionally and in our own community, increased hospitalizations and I.C.U. stays, and a large prison outbreak that is still uncontrolled within our borders—we need to take a more cautious approach for now to follow emerging trends over the coming days,” Dr. Willis said last Friday. On Monday, indoor dining, barber shops and campgrounds were allowed to resume, but the re-opening of short-term rentals, hotels, gyms, nail salons and other personal services was postponed indefinitely. Other Bay Area counties made similar decisions last week, and yesterday, the state mandated that 19 counties—including Santa Clara, Contra Costa and Solano—discontinue indoor activities and close bars for three weeks. On Monday, Governor Gavin Newsom reported a 45 percent increase in the total number of positive cases over the past week. The positivity rate—the percentage of tests that come back positive—is 5.5 percent, up from around 4.4 percent two weeks ago. (The national positivity rate is around 7 percent.) Statewide hospitalizations have risen 43 percent in the last two weeks, though existing capacity has sufficed: hospitals are 58 percent full, with just 7 percent occupied by Covid-19 patients. West Marin cases remain low, not even hitting the reporting threshold for a total count; each of the villages has under 10 cases. Countywide, the positivity rate is 5.8 percent, which has gone up steadily since the beginning of May, when it was at a low of 1.4 percent. Latinos continue to account for the majority of cases, at 75 percent this week, and people aged 19 to 34 are slowly becoming the largest age demographic, at 30 percent, behind people 35 to 49, at 20 percent. “The driver in this particular dynamic is that essential frontline workers, the backbone of our economy, are being infected out there in the community on the frontlines and bringing it back home,” Dr. Willis said at a forum on Tuesday. Providing quarantine housing and income replacement so that sick people can stay home are essential tools, he said. Some pilot funds have been distributed in Marin toward this effort, including more than $900,000 designated in May and another $100,000 in June. Meanwhile, the outbreak at San Quentin threatens to overshadow efforts to contain the virus within the community at large. Early this week, more than 1,000 inmates and 100 staff were infected, and the numbers are growing quickly. San Quentin started setting up air-conditioned tents for additional housing and medical triage on Monday at the request of Dr. Willis, after more than 40 inmates had been transferred to regional hospitals. Marin hospitals had taken in nine inmates Tuesday evening, bringing the number of hospitalized Covid-19 patients to 23; capacity has yet to be stretched, considering across three hospitals Marin has a total of 420 hospital beds and that inmates are being sent elsewhere in the state as needed. “Most of us have the freedom to practice physical distancing, to cover our face, to make choices about where and when we want to engage,” Dr. Willis said. “These outbreaks are an important reminder about what happens when people aren’t able to exercise that freedom due to the conditions in which they live. So please, where we can, do your part to limit transmission in the areas where we have control.”