LAKE COUNTY, Calif. — The Board of Supervisors on Tuesday heard from two physicians — both of whom have acted as the county’s Public Health officer at various times — on the ongoing impact of COVID-19 on the community.
Dr. Gary Pace, Lake County’s former Public Health officer, is filling in while the county continues its search for a permanent successor and again this week gave an update to the board.
Since Pace updated the board last week, Lake County has dropped out of first place for its case rate and was listed as No. 4 statewide on Tuesday, with a case rate of 53 per 100,000. Del Norte (79), Tuolumne (63) and Nevada (54) were the top three counties on Tuesday.
Lake County’s case rate topped out at 62 per 100,000 last week, according to state data.
Pace said Lake County’s vaccinations are increasing slowly, with about 100 vaccinations being given a day, up from about 50 a day about a month ago.
He said there are still about 20,000 people in Lake County who are eligible to be vaccinated but aren’t. On Tuesday, 53.2% of county residents were vaccinated, with about 38.7% age 12 and older still unvaccinated.
Pace said the testing rate continues to rise, and was at 17.6% on Tuesday. He said test positivity rises first, followed by the case rate and then hospitalizations.
He said cases can be anticipated to continue to rise in the coming weeks, and showed the county’s epicurve. That graphic illustrated that the most recent week of reported cases had the third-highest number of cases since the pandemic began, and the highest caseload since early January, when the pandemic surge peaked in Lake County.
The case rate breakdown Pace presented showed that 50% of cases are in people aged 20 to 44. As of Tuesday, there were 18 hospitalized COVID-19 patients, with six in intensive care, and Pace said those numbers are continuing to rise.
“We’re starting to get very concerned about the hospital situation,” Pace said.
He said the local hospitals are full and the regional hospitals are filling up as well. Sonoma County, where many seriously ill Lake County patients are transported, had 70 COVID-19 patients in hospitals on Tuesday, with 17 in the ICUs.
Pace said vaccines remain the most important intervention, explaining that those who are vaccinated can get infected, but they are less likely to get severe symptoms or die. Unvaccinated people are eight times more likely to get infected and 25 more times to get hospitalized.
“Very likely it’s going to get bad in the fall and winter again,” said Pace, who encouraged people to get vaccinated and wear masks, explaining that universal masking is considered the prudent thing to do.
With school now starting, Pace noted that before the Delta variant, children didn’t get sick as often and, if they did, they didn’t get very sick and didn’t spread it much. Now, he said children are more likely to get infected and to get sicker than they did previously. The state is requiring masking within the school.
“I think it’s going to get complicated this fall with Delta now in ways that we’re just now starting to get our heads wrapped around,” Pace said.
Pace encouraged people to be tested and to isolate themselves if they are exposed to someone who is ill. He said the state has taken away contact tracing resources, so Public Health is having trouble keeping up with it.
“The virus is changing, the guidance is evolving,” he said, explaining that the community probably will not reach herd immunity in the near future.
“I think that’s not the way to think about it anymore,” he said of herd immunity, adding that now it’s about trying to keep society open and minimizing the impact, while keeping the hospitals functional. Pace said the vaccine and masking are the big tools we have to do that.
Dr. Evan Bloom, an emergency room physician and chief medical officer at Adventist Health Clear Lake Hospital, also has served as acting Public Health officer for the county of Lake. He spoke to the board on Tuesday about what they’re seeing at the hospital.
He said that morning the hospital had seven COVID-19-positive patients. While that may not seem like a lot, Bloom said Lake County’s two hospitals, both critical access hospitals, have a total of 50 beds available and are normally running pretty close to capacity.
In the case of Adventist Health Clear Lake, those seven COVID-19 patients accounted for almost 33% of beds in the hospital taken up by a singular diagnosis, he said.
“That’s unheard of. That doesn’t happen. But it has been happening with COVID,” said Bloom, explaining that it puts enormous pressure on staff, hospitals and patients, who may have to wait longer in the emergency room.
Like Pace, Bloom emphasized that vaccination is the best strategy. “I’m asking for your partnership. We have to do this together as a county,” said Bloom, adding that we need to continue to care for each other.
Bloom said that, as an ER physician, he’s seen very few breakthrough cases, while the unvaccinated are getting very sick.
Supervisor Jessica Pyska thanked Bloom for his candor, and asked how hospital staffers are handling excess work.
He said he was amazed at the staff, and how they have been coming back for more than a year to care for patients.
Pyska followed up by asking Pace if people should go forward with being vaccinated even if they have had COVID-19.
Pace said the immunity from the vaccine is stronger and broader than the infection. “By using the vaccine we seem to have better protection,” he said, with fewer people getting reinfected after the vaccine compared to previous infections. He also noted that the virus keeps mutating.
Supervisor EJ Crandell asked about breakthrough vaccinations, which Bloom said he has seen.
“It’s not a particularly common phenomenon, but I’ve seen it more than once,” said Bloom, explaining that when these infections occur, post-COVID immunity goes away quicker and is not as strong as the vaccine, which he said has been shown in evidence-based and population studies.
Health Services Director Denise Pomeroy told the board that Public Health continues to have a lot of slots open for COVID-19 testing, that hours are expanding and that they are only filling up about half of their vaccination appointments. Information on local testing and vaccination services can be found here.
Board Chair Bruno Sabatier said he wanted the county to work on messaging across all potential platforms to reach people about the importance of vaccinations.
During public comment, Clearlake Mayor Dirk Slooten reiterated his plea made at Thursday’s council meeting for people to get vaccinated, noting he’s offering $100 to every city of Clearlake staff member who isn’t yet vaccinated if they get the shot by mid-September.
Both he and his wife, Karen, were vaccinated in February but his wife, who has a compromised immune system, got a breakthrough infection at the start of July.
Slooten said his wife’s doctor told her that she likely would have died had she not been vaccinated. And, last week, one of her cousins, who was unvaccinated, died of COVID-19.
Getting the vaccine, Slooten said, is the ultimate solution.
Pyska asked businesses to take actions to protect themselves and staff, stating that the only way forward in the short-term is to mask, and to get vaccinated for the medium- and long-term.
Pace said side effects and negative outcomes are being tracked very closely, noting nothing is risk-free. He said professional organizations are extremely concerned about side effects. “We’re weighting out risk versus benefit at any point in time.”
While no one in the Western Hemisphere is coming in contact with the polio virus, “You will come in contact with COVID,” said Pace.
During public comment, the board also heard the allegations from some community members that they are conspiring with the pharmaceutical and medical industries to push vaccinations.
Sabatier said that big ploy theory is weird. “We can’t just shrug our shoulders at 4.1 million deaths,” he said, referring to the worldwide COVID-19 death toll.
Bloom said he receives no money from any pharmaceutical company and that their recommendations are based on science, specifically, evidence-based research.
The primary study that they want to see is a randomized, placebo-controlled, double-blind study which Bloom said is the gold standard. Those studies, he added, are going on right now on a range of issues connected to COVID-19.
He also noted, “Correlation is not causation,” explaining that just because something happened to someone who got the shot, doesn't mean the shot is the cause of the outcome. Bloom said studies leap through many hoops to avoid the correlation issue.
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Doctors update supervisors on COVID-19 cases, impacts on hospitals
- Elizabeth Larson
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