Read and Watch: Everything we learned from Santa Cruz County public health officials’ update Friday

County health officials gave a grim update on COVID-19 in Santa Cruz county Friday: Health Officer Dr. Gail Newel said during a press conference that “the data that came in this week surprised even me with its severity. It’s higher than we’ve ever seen.”

Besides diving into the numbers, health officials detailed vaccine rollout efforts countywide and the challenges they’ve faced so far. Here are the highlights from the hourlong event:

Holiday surge and outbreaks

The county is currently in the throes of some of the highest case rates and positivity rates since the pandemic began last March. As of Friday, Santa Cruz County has 3,017 active cases, meaning more than 25% of all cases reported since the pandemic began are currently active. Meanwhile, the 14-day average of daily new cases reported in the county ascended to 203.6, a new all-time high.

After days of positivity rates of more than 20%, the 14-day average positivity rate finally dipped to 18.6%, though it is still considered extremely high. There have also been 113 deaths reported in the county, of which nearly 70% are attributed to nursing home residents.

Newel said the spikes in Santa Cruz County started on Halloween and have continued growing through holiday season.

"(The holiday surge has perhaps) hit Santa Cruz County harder than the rest of the state,” she said. She added that on top of the impact of the holidays, there were numerous outbreaks at residential care facilities that caused the surge.

As of Friday, Newel said the county has received notice of 125 “open exposure events,” or outbreaks with at least one case and usually multiple cases. The settings of these outbreaks are grocery stores, banks, gas stations, coffee shops, hospitals, fire departments, congregate living facilities, the Santa Cruz County Jail, and more. Of those, at least 19 are confirmed and ongoing.

Hospital ICU capacity at 0% since Thanksgiving

Dr. Mimi Hall, the director of Santa Cruz County Health Services Agency, said hospital capacity has been a concern for public health officials as cases began to spike.

“We have been, locally, at 0% ICU capacity since Thanksgiving. That is highly, highly concerning,” she said Friday.

Santa Cruz County, and the rest of the Bay Area region, has been under a stay-home order since Dec. 17. The stay-home order was triggered when the region’s ICU capacity fell below 15%. The region’s ICU capacity as of Friday is at 3.4%.

With hospitals in neighboring counties also full, county emergency medical services medical director Dr. David Ghilarducci said, unlike normal times, the capacity to transfer patients to hospitals outside of Santa Cruz County is “very limited because the problem is everywhere.”

In more hopeful news, Newel said officials from the California Department of Public Health said that the Bay Area region “is not expected to reach 0% ICU capacity in the next 4 weeks, even with the stressors expected in the coming weeks (as the Christmas and New Year’s surge continues).”

Ghilarducci explained that anti-viral treatments like remdesivir are effective to treat COVID-19 patients initially but once they arrive in the ICU, doctors are left to treat them with “traditional methods like respiratory or ventilatory support and to protect their organs.”

Public health officials said while they were “very worried” about having to move to a hospital surge capacity plan last week, numbers this week seem to have improved as they believe they might be in the middle of the Thanksgiving and Christmas surges. They said they will continue to monitor the situation in the coming days. Meanwhile, Newel said she has temporarily lifted the ban on elective surgeries.

Vaccine rollout

To date, the county has received 16,725 doses of the COVID-19 vaccine — 6,825 Pfizer doses and 9,900 Moderna doses. In Santa Cruz County, there are about 15,000 people who fall under Phase 1a and Ghilarducci said the county needs a total of about 29,000 doses to complete both doses of the vaccine for the people in that group.

The county is reserving half of the 16,725 doses to provide a second dose to those who have already received the first.

“Vaccine remains in limited supply,” Ghilarducci said. The county is receiving small shipments of its total allocated amount but the doses have been coming in sporadically. On Jan. 12, the county received its largest shipment yet — 9,000 doses. However, next week, Ghilarducci said they will receive only 200.

The imbalance is making it difficult for public health officials to plan mass vaccination clinics, Ghilarducci said. However, with a larger amount of vaccine doses on hand, “the county is really committed to getting all our vaccine out the door and administered within the next 10 days,” Hall said.

For Santa Cruzans who are above the age of 65 and were moved higher up on the list earlier this week, county health officials said it would be a wait. Ghilarducci said the vaccine rollout plan that was crafted months ago was disrupted by the change and that it was an “impossible task” to inoculate all older adults who fall in the first tier of Phase 1b when the county has not yet received enough doses to vaccinate those with highest priority.

Mass vaccination at Sutter: With a larger amount of doses on hand, the county was working with Sutter Health to mass vaccinate people in Phase 1a Friday. The goal, Hall said, was to exhaust the doses that were on hand.

Meanwhile, the county will also work with Dominican Hospital, Watsonville Community Hospital, Sutter Health, Wellpath (a group that handles inoculations at Santa Cruz County Jail), Salud Para La Gente, Project Homelessness Connect, county clinics, and the Pajaro Valley Community Group to help inoculate more people.

The ‘four-legged stool’

Moving forward, the county will not be the only entity to receive and disseminate vaccine doses. The allocations for the area will be divided into four groups or a “four-legged stool,” explained Ghilarducci. The four places doses will be sent to and distributed are:

• Santa Cruz County Public Health Department
• Multi-county entities (MCEs) — Kaiser Permanente, Sutter Health and Dignity Health
• Federal Pharmacy Partnership
• Independent providers

You can read more about this four-pronged approach to vaccine dissemination here.

In mid-December, the county received more doses than the other three groups and so officials said they shared doses to reach the widest possible group of people. However, Ghilarducci said moving forward, most people will receive their vaccine from their primary healthcare provider and if someone falls within Phase 1a, they should contact their provider to receive the vaccine.

The county will focus its efforts on communities that are inequitably impacted by COVID-19, Hall said. County officials do expect vaccine inventory to increase as doses are sent to the various agencies that will be in charge of disseminating them.

Biggest challenges the county is facing during vaccine rollout

Ghilarducci said there were four big problems the county health department is facing during vaccine rollout.

• Insufficient vaccine supply.
• A state registration system is not functioning correctly, making it difficult for county officials to keep track of who has received the vaccine and how many doses.
• While public health officials agree that those over the age of 65 must be fast-tracked to receive the vaccine, the county cannot meet expectations yet.
• There has been no state or federal support.

What about farmworkers and people who cannot travel to get the vaccine?

County officials said they will be focusing their vaccination efforts on those inequitably impacted by the vaccine — primarily members of the Hispanic/Latino communities and residents of the city of Watsonville.

As of Friday, more than 50% of all COVID-19 cases in the county were among people from the Hispanic/Latino community, though they only make up about 33% of the total county population. Comparatively, more than 50% of the cases were recorded in Watsonville, though residents of that city only make up 18% of the county’s total population.

Hall said there were a number of different modalities the county will use to deliver the vaccine to those who cannot travel to get them including bussing farmworkers to distribution facilities or conducting on-site vaccinations.

Newel stressed that no documentation will be needed to receive a vaccine. The only information needed will be the person’s name, age and address and it will not be cross-checked.

COVID-19 variant strains

There are various identified strains of COVID-19 including one called B.1.1.7 that has public health officials very concerned. The Centers for Disease Control and Prevention announced Friday that they believe that this strain will be the dominant strain in the U.S. by March. The strain, which has already wreaked havoc across the U.K has already been found in various U.S. states, including California.

Ghilarducci said this new variant has proven to be more contagious than COVID-19 and highly communicable. While it doesn’t appear to be making people sicker than COVID-19, its ability to spread more quickly means more people will catch the virus and there will be more deaths as a result.

Ghilarducci said they also weren’t sure exactly how public health recommendations will change as the variant becomes more widespread, which appears to be inevitable, with the CDC predicting it will become the dominant strain by March.

“Maybe six feet [of distance] becomes ten feet, maybe we recommend different kinds of masks,” he said. But none of those changes have been made yet.

However, a surveillance plan is in place and a UC Santa Cruz lab will be testing wastewater in the area for the variant strain.

Watch the press conference below:

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