July 12, 2022 – Message from Ch

As we have had to embrace the many aspects of reducing the risk of COVID-19 as part of our daily lives, we want to inform you and the public of the changing context underlying our current situation so that everyone can protect yourself and the community as much as possible.

We continue to emphasize the importance of keeping up with the vaccinations you are eligible for, as vaccines continue to offer significant protection against severe illness and death. Since everyone 6 months and older is now eligible for vaccination, we are seeing health care providers and pharmacies offering many ways to get vaccinated. To date, 4,836 residents under the age of 5 have already received their first injection in the past few weeks and our public dashboards now include this age group and reflect an update to population data.

Our situation is greatly influenced by the BA.5 variant, which is now dominant in California. As the variants outpace their predecessors, we see that they are even more transmissible and able to evade the immune response to both vaccination and previous infection, prolonging this period of high transmission in the community.

As of June 30, we are at CDC “high,” which reflects significant community transmission as well as increases in hospitalizations for COVID-19 for San Mateo and San Francisco counties. The number of patients hospitalized in San Mateo County with COVID-19 as of yesterday was 42. We have seen the number of people hospitalized with COVID-19 in San Mateo County increase and fluctuate to count between 30 and 50 since the end of May compared with levels that were closer to 20 in early May. Fortunately, ICU utilization remains relatively low and our hospitals have been able to manage these hospitalization rates.

We continue to strongly recommend wearing a high-quality mask indoors and increasing ventilation – such as opening windows and doors where possible – to prevent infection. Residents are urged to test if they are symptomatic and contact their doctor or if they test positive to access available treatments.

As regular surveillance testing has declined and at-home antigen testing when symptomatic has become more common, we have seen the level of community PCR testing drop from about 600 tests/day per 100,000 population a month ago to 465 tests/day in 100,000 population. This leads to a different meaning for the level of test positivity captured by testing, more typically after symptoms or exposure. The key metrics we look at regularly to understand the impact on the community are the number of hospitalizations and our vaccination coverage.

The public will see a change in our dashboard that shows vaccination coverage by race/ethnicity and age after incorporating annually updated population data from the California Department of Finance. This data includes information from the 2020 Census and shows some significant changes in our population by race/ethnicity. The number of residents who are American Indian/Alaska Native, Black/African American, Hispanic (any race), Native Hawaiian/Pacific Islander, White is lower than estimates from previous data. This translates into a higher vaccination rate than previously reported. The number of residents who are Asian or multiracial is higher, implying a lower vaccination rate than previously reported. Including the under-five population also changes vaccination rates for each racial/ethnic group. These improved data will continue to guide targeted work with undervaccinated groups.

Our main public message about vaccination is the importance of keeping up to date. For those aged 50 and over, it is especially important to get a second booster to minimize the risk of severe effects from COVID.

The FDA, CDC and the state of California have already approved Pfizer and Moderna’s COVID vaccines for children over 6 months of age, providing flexibility for health care providers. In addition, the FDA is recommending the addition of an omicron component to the COVID booster vaccines that will likely be available in the fall.

With many routes to vaccination through health care providers and pharmacies for most residents, our focus at County Health is on underserved groups. For the under-5 population, this includes personalized support for certain pediatric practices serving children covered by Medi-Cal and vaccination clinics at Early Start locations in East Palo Alto and South San Francisco.

All together better

Louise F. Rogers

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