Jessica Cejnar / Friday, Dec. 18, 2020 @ 11:02 a.m. / COVID-19

There's A Light At The End Of The COVID-19 Tunnel, But Next Two Months Are Critical, Health Experts Say At McGuire Town Hall


With vaccines being administered in Northern California and more doses on the way — though not quite as many as initially anticipated — the light at the end of the COVID-19 tunnel is getting brighter.

But, though they were hopeful, infectious disease experts at a virtual town hall meeting hosted by State Sen. Mike McGuire on Thursday said people need to continue to wear a mask, wash their hands and refrain from gathering at Christmas if the state is to get an upper hand on the pandemic.

“The next couple of months are critical,” said Dr. Timothy Brewer, an infectious disease professor at the University of California, Los Angeles’s David Geffin School of Medicine. “If you can avoid those indoor social gatherings, stay at home, wear a mask when you go out, that’s going to help us get through the next few months.”

Brewer was joined by Dr. Matt Willis, Marin County’s public health officer, and Lori Nezhura, California Office of Emergency Services’ deputy director of planning, preparedness and prevention. Nezhura also co-chairs the task force tasked with distributing the COVID-19 vaccine throughout California, according to McGuire

As of Tuesday, only Northern California, including Del Norte County, had an intensive care unit capacity greater than 15 percent and was not under a regional stay-at-home order. According to the state’s COVID-19 web page, Northern California’s ICU capacity was at 25.8 percent while the state average was 3 percent.

In a letter to the community on Thursday, physicians with the Rural Association of Northern California Health Officers warned residents that the ICU availability could change quickly and echoed Brewer and Willis’s calls to adhere to safety guidelines.

“Even as a region, we only have about 120 ICU beds, and 15 percent capacity leaves fewer than 20 beds; that’s for people with heart attacks, strokes, trauma, and COVID-19,” the association wrote. “We, the Rural Association of Health Officers of Northern California, are gravely concerned that this cushion of beds could be easily overwhelmed, and most counties in our region are already struggling to find hospital beds for patients requiring a higher level of care.”

In Del Norte County, 16 new cases were reported to the Public Health Branch on Thursday for a total of 134 active cases. Two people are currently hospitalized with the novel coronavirus and since the start of the pandemic, two people have died in Del Norte County, according to the county’s COVID-19 Information Hub.

At Pelican Bay State Prison, two new COVID-19 cases were reported among its inmate population, according to the county’s web page.

There are currently 80 inmates with active disease, according to the California Department of Corrections and Rehabilitation’s Population COVID-19 Tracking web page. Among prison staff, there are 18 active cases as of Thursday, according to CDCR’s COVID-19 Employee Status web page.

Statewide, California reported 1.7 million COVID-19 cases and about 28,500 deaths since the pandemic began, Brewer told Northern California residents during McGuire’s meeting. Before Oct. 30, an average of about 4,100 new cases were reported each day. Now, the state is averaging about 30,400 cases a day, Brewer said. On Wednesday, more than 52,000 new cases were reported to public health officials, he said.

The same thing is happening with deaths and hospitalizations, Brewer said. Before Halloween, about 50 people a day were dying of COVID-19. Now it’s an average of roughly 173 deaths a day in California, he said. On Wednesday, 379 people died of COVID-19 in California, Brewer said.

Hospitalizations have gone from about 3,100 COVID-19 cases a day to about 13,000 a day currently, Brewer said. As of yesterday, about 16,400 people were in hospital beds with COVID-19; 3,280 were in intensive care units, he said.

“What’s going on?” Brewer asked rhetorically. “We’re moving into the winter and cold weather, low humidity increases the transmission of respiratory viruses including influenza and coronaviruses. And we spend more time indoors. That’s why the next two months is going to be very challenging — because of the cold weather, because we’re indoors and because we’re in respiratory virus season.”

The light at the end of the tunnel comes in the form of two vaccines: One from Pfizer that was authorized by the Food and Drug Administration under an Emergency Use Authorization. The other comes from Moderna, which the FDA is expected to authorize in the next two days, Brewer said.

Both rely are messenger RNA vaccines, which, Brewer said contain codes that prompt a body’s cells to manufacture proteins. In this case the protein is the spike protein from the novel coronavirus, which the body’s immune system treats as a foreign invader to mount a defense against, Brewer said.

“It primes the immune system, so if you get exposed to the SARS-CoV-2 virus, it’s ready to generate a rapid response and protect you from getting sick,” Brewer said, using the scientific term for the virus that is responsible for COVID-19. “Both vaccines offer about 95 percent efficacy in protecting from serious disease. What we don’t know is if the vaccine protects against infection. So that’s why it’s going to be so important while we roll out the vaccines, that we continue to do masking in public places, maintain social distancing, stay home when sick and use hand hygiene.”

Both vaccines will require two doses to be effective — according to Willis, much of the Pfizer vaccine’s protection against the novel coronavirus comes with the second dose.

Side effects include fever, chills, muscle aches and pain at the site of infection, Brewer said. There were four cases of anaphylactic shock with the Pfizer vaccine, but those were rare, he said.

There are nine COVID-19 vaccines in various stages of development, Nezhura said. In addition to the Pfizer and Moderna vaccines, two more may be approved for dispursement as early as January, she said. However, there aren’t enough of the vaccines that are available right now for everyone, so the California Department of Public Health, CalOES and the task force Nezhura co-chairs is prioritizing who gets the first doses.

California is currently in Phase 1A of vaccine distribution, this means doses are administered to healthcare workers and residents of long-term care facilities, Nezhura said. The next phase — Phase 1B — may be essential workers, those in the food and agricultural, education and child care and emergency services sectors, she said, but that still has yet to be determined.

“Whether or not that will be co-approved with other populations, such as the elderly or thsoe with co-morbidities, has not yet been decided,” Nezhura said. “All that you should learn about in the coming weeks.”

California is expected to receive about 1 million doses of the Pfizer vaccine by the end of December, Nezhura said. The state could get more than 1 million to 2.6 million doses in January, she said.

On Thursday, however Nezhura said the Golden State’s vaccine allotment is less than what they had originally been told. But it’s too early to say if it is an anomaly, though she said colleagues who had witnessed the distribution of the H1N1 flu vaccine had experienced the same situation.

“You get told you’re going to get a certain amount of vaccine and then it changes, which is why it’s been so hard to answer people definitively about how long it’ll take before we get to Phase 1A or Phase 1B or mass public vaccinations,” she said.

Though Brewer and Willis were hopeful that most Californians would have the vaccine by next summer, Nezhura was not as optimistic. She said it would depend on factors over which state officials don’t have much control, including the number of doses. Californians could be vaccinated by as early as May, which would be lovely, Nezhura said, but it could be as late as the end of 2021.

Once vaccines do begin rolling out, however, people should still wear their masks and social distance, Willis said. He echoed Brewer’s statement about it being not yet known whether the vaccine prevents viral transmission to others. There will be less risk of viral transmission as more people get vaccinated, Willis said, but California won’t be out of the woods until then.

According to Willis, in addition to distribution by local public health departments, hospitals that are part of larger networks, such as Sutter, will receive the vaccine directly from the state. CVS and Walgreens pharmacies have also entered into a relationship with the federal government to distribute the vaccine at long-term care facilities, Willis said.

When more of the vaccine is distributed to the public, Nezhura said people should see their normal healthcare providers to receive their dose. Residents may also get a notice from their local public health department or their employer urging them to get the COVID-19 vaccine, she said.

The vaccines will be free to the public, according to Nezhura. No identifiable information will be reported back to the U.S. Centers for Disease Control and Prevention as to a patient’s immigration status, she said.

Willis said there may be some sort of identification required showing that a person has received their first dose.

“These lists are not shared with anyone outside public health,” he said.

In their statement, the Rural Association of Northern California Health Officers compared the pandemic to a wildfire, pointing out that social gatherings, traveling, not wearing a mask and going out while sick is the fuel. They pointed out that while the vaccine is the hose, it’s not as effective in quenching a firestorm.

“Eventually we will be in a ‘fire recovery state’ when enough people have been vaccinated, likely in late summer or early fall,” the association wrote. “Until then, we implore you to do your part to slow the spread. As local and regional communities, we have survived many disasters. Together, we can extinguish the COVID-19 wildfire.”

Documents:

Health Officer Letter Dec. 17


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