After months of decline, COVID-19 cases are failing – and in some places being stolen – across the Gulf Coast and California, worrying public health officials during the holiday season are threatening and prompting urgent pleas for Californians to get vaccinated or get a boost. shots.
Although widespread vaccinations would make a winter increase much less deadly than last year, the current increase in cases in some places is a preview of what California might experience as people gather more often indoors and travel for Thanksgiving and winter holidays.
The possibility of an increase in winter cases comes at a critical and confusing time of the pandemic. Warrants that forced people to stay home as long as possible were canceled, and a majority of Californians were vaccinated, leaving public health officials with limited tools to prevent a new wave of distribution in addition to advising people to get the shots and behave responsibly.
“These are uncertain and troubling times right now because we can’t be sure where we are and where we’re going,” said Dr. John Swartzberg, an infectious disease specialist at UC Berkeley’s School of Public Health. “We have to be very prudent about how we behave as individuals and how we behave from public health.”
In Alameda, Contra Costa, Marin, San Francisco, San Mateo and Santa Clara, infection rates have either flattened or begun to rise over the past few weeks, according to data from the public health departments of those counties. Statewide, cases and hospitalizations have declined for months, but now seem stubbornly fixed, with the seven-day average test positivity increasing from about 2% in late October to about 2.4% in early November.
Unvaccinated people make up the majority of COVID-19 cases and an even larger share of hospitalizations, with a rate of about 22 unvaccinated people hospitalized per million versus 2 per million for vaccinated people, according to the California Department of Public Health.
In a statement to this news organization, the department wrote that it is monitoring trends of COVID-19 “signaling a possible winter increase.”
“The state is preparing to respond to various scenarios if we experience another increase in cases,” the department said. “We’ve learned over the last two years that COVID-19 benefits when we lower the guard.”
With 66% of eligible Californians fully vaccinated, protection against the worst of the disease will help. to prevent against the more than 20,000 hospitalizations that shook the state last winter. But immunity from shots received last winter and spring may be declining, and fewer Californians than expected have received boosts so far.
In the Gulf region, public health officials are struggling on how to sound the alarm to pandemic-weary residents as they remain measured on the effects of the potential increase. That means continuing to convince unvaccinated people to get the shots, said Dr. Matt Willis, Marin County’s top public health official, while constantly reminding vaccinated Californians that the pandemic has not gone away.
Willis is confident that any increase in cases will encourage more people to get vaccinated in the coming weeks. But for many, the role of public health in dictating daily behavior is “diminishing,” he said.
“The change we’re in now is where we’re trying to offer people the information they need to navigate, which is ultimately personal decisions around risk. And it’s hard, ”Willis said. “What are we trying to do here?” Are we preventing cases? Do we prevent deaths? Hospitalizations? What is our northern star? ”
Willis, Swartzberg and other public health experts agree that preventing the healthcare system from being overwhelmed by COVID-19 cases remains the main goal for the next stage.
s of the pandemic. But with minimal research available on the implications of long-term COVID, that priority could eventually shift back to preventing all cases, including successes, said Dr. Naveena Bobba, San Francisco’s deputy director.
For now, however, there is a clear consensus on how Californians should approach the coming months, experts said: Unvaccinated people should get the vaccine, while older people and those with underlying conditions should get a boost.
On Thursday – after a similar announcement in Santa Clara County – California health officials told providers to give boosts to any adult who wants to.
Dr. Jocelyn Freeman Garrick, deputy director for emergency medical services in Alameda County, acknowledged that public health guidelines in California and the nation have been “extremely confusing,” as vaccines have become widely available. But behavior will still play a key role in how winter turns out, she said.
People should prioritize meeting with only those who are vaccinated, she said, and wearing masks indoors when people’s vaccine status is unclear. Health officials also encourage coronavirus testing before attending a large event, meeting outside when possible and staying home when sick.
“We were optimistic a year ago, and then came the Delta variant,” Freeman Garrick said. “We don’t know if there are new, emerging variants that will affect our district and state that could contribute to the increase in cases.”
More than ever, Californians need to practice being flexible as the reality of COVID-19’s longevity deepens, said epidemiologist Swartzberg.
“We don’t just wake up and accept it – it’s a process of adjusting to it,” Swartzberg said. “That’s what we’re going to live with: an endemic, contagious disease with the ability to significantly harm and sometimes kill people.”