COVID 2021

ANSWERED: When to wear a mask, when children can get the jab, and more from County Health Officer Gail Newel

Santa Cruz County Health Officer Gail Newel.
(Kevin Painchaud / Lookout Santa Cruz)

Over the past few weeks, Santa Cruz County has seen an increase in vaccination rates and a decrease in daily COVID-19 case rates. But what does that mean for the county trends and how should residents prepare for the colder fall and winter months? County Health Officer Gail Newel has answers.

1

The COVID-19 pandemic has seen its ebbs and flows around the globe, particularly with the most recent Delta variant surge in the United States and California.

While Santa Cruz County has also dealt with a surge of cases over the past few weeks, County Health Officer Gail Newel believes vaccinated Santa Cruzans are helping to lower the case count and limit potentially longer-term issues.

“I have been so grateful throughout the entire pandemic to our community of the county of Santa Cruz to help prevent community spread,” she said. “We have had lower case rates, lower death rates, and lower hospitalization rates than almost anywhere else in the nation.”

A number of Santa Cruz County nonprofits are teaching kids how to grow and cook food, and develop stronger connections...

But the county, region and country are now facing a more normal threat: flu season. Due to closures and general isolation, deaths from influenza were about 25 times lower in the 2020-21 season than the year prior, according to data from the U.S. Centers for Disease Control and Prevention. Health experts, however, are saying they are expecting the flu to roar back to its usual levels this year and are urging everyone to get a flu shot.

The U.S. Food and Drug Administration recently approved a third COVID-19 shot for seniors and other high-risk individuals, and many are wondering about the implications of getting both a booster and flu shot. But health officials say there is no danger in getting them at the same time — though people who tend to have soreness or other reactions might want to spread them out by a few weeks.

All this means, as Newel told Lookout this week, it’s not yet time to go maskless and, in fact, it might be a while before you can.

“I do believe that COVID will be with us for years to come — we’ll have to learn to live with it,” she said.

Here are some more insights from Newel’s conversation with Lookout. Responses have been edited for length and clarity.

Follow these links to the answers you’re looking for:

A nurse prepares a COVID-19 vaccination during a pop-up free clinic at the Museum of Art & History
(Kevin Painchaud / Lookout Santa Cruz )

2

What is the current vaccination rate?

Santa Cruzans still have a way to go to achieve herd immunity. By the latest numbers, 70.18% of the total county population has received at least one vaccination, with 63.27% of the total population being fully vaccinated. (The total population figure includes those under 12, who are not yet eligible to be vaccinated.) While the county has done better than statewide and national numbers, Newel said it’s still disappointing that vaccine rates are not higher.

“We wish we would have a much better vaccine uptake, but we continue to be one of the best vaccinated counties in the country,” she said.

The county goal is to get more than 80% of the population vaccinated in order to achieve some semblance of herd immunity, with a bigger goal of 85% fully vaccinated. Yet before the vaccine is approved for children aged 5 to 11, “we know that’s unrealistic,” Newel said.

While some counties have calculated vaccination rates by only those eligible for the vaccine, Newel believes it makes sense now to track the vaccination numbers in relation to the total county population.

“Everybody of all ages can spread the disease,” Newel said.

3

How is the daily case rate currently trending, and what does that mean for the county?

For several weeks in a row now, Newel noted, the county has seen significantly declining case rates and a decrease in positivity rate, even following the summer surge of the Delta variant.

“These days, all of our cases are Delta variant — the 10% that we do genomic sequencing on all showcase Delta, so we assume that’s representative of the community,” she said. “During the Delta surge, we’ve seen case rates going down; globally, that’s what they’ve done.”

As of Thursday, the county was seeing approximately 25 cases per day, with 177 new cases over the previous seven days, and a Rt number — the cases that stem from each COVID case, with a goal of below 1-to-1 transmission — of 0.75. The positivity rate is also decreasing — currently at 2.08%.

A day after the U.S. Food and Drug Administration authorized offering booster shots of Pfizer’s COVID vaccine,...

4

If we are still following the CDC tier guidelines, how is Santa Cruz County doing?

The county is following the guidelines in a sense — mainly, through Newel’s mask mandate initiated on Aug. 20. Yet as noted when the mandate went into effect, it is set to phase out when the county reaches a certain point of case transmission, which appears imminent to Newel.

“We went from red to orange a few weeks ago, and as of Wednesday, the case rate was 63 per 100,000 in the last seven days,” she said. “We need to be below 50 cases per 100,000 before we get to yellow. We’ve been coming down rapidly, so it could be pretty soon.”

Additionally, California went from red to orange on the CDC map on Wednesday, which Newel said is a positive sign. At present, California is the only state in the orange tier.

5

How is Santa Cruz doing compared to neighboring counties like Santa Clara, Monterey and San Benito in terms of vaccination rates and case rates?

Newel estimates that some central Bay Area counties — San Francisco, Marin and Santa Clara — will be among the first to improve in terms of COVID numbers, due to their high vaccination rates and tight pandemic restrictions. She says Santa Cruz’s neighboring counties of Monterey and San Benito will likely lag behind.

“In general, the higher the vaccination rate in the jurisdiction, the lower the transmission rate,” Newel said. “We have a high level of vaccination rate compared to other counties and states, which explains our lower transmission rate as well.”

6

When is it likely for children aged 5 to 11 to get vaccinated?

There hasn’t been too much concrete information about the next group to get vaccinated, but Newel is keeping her ear to the ground. Newel said that, according to some inside sources at the FDA and the CDC, the vaccine could be approved for youngsters as early as the end of October, or perhaps closer to the end of 2021.

While Newel acknowledged that many families would feel more at ease once their children can be vaccinated, she noted there’s been almost no transmission of the virus in classroom settings. Instead, most childhood transmission has been through youth sports, extracurricular activities, or out in the community.

Pfizer has recently completed clinical trial data for this age group and are seeking reapproval from the FDA, which could mean an even quicker timeline than anticipated.

Luci Guardino, 11, receives her first dose of a COVID-19 vaccine
Luci Guardino, 11, receives her first dose of a COVID-19 vaccine as part of a linical trial at Kaiser Permanente sites in Northern California.
(Kaiser Permanente)

7

Should I reconsider my travel plans?

Many put off trips in the first half of 2021 due to the pandemic, and Newel says people might want to continue holding off on unnecessary travel for a few more months.

“It depends on the destination and the risk there, not just of the risk of COVID itself, but of their hospital capacity,” Newel said.

She said she recently cancelled a trip to Hawaii for medical meetings, citing Gov. David Ige’s request that visitors not come to the islands until after October because of the 0% capacity in the state’s intensive care units.

8

How does ICU capacity look both locally and statewide?

The county and the state of California can relax slightly in regard to ICU capacity, Newel said, with available beds steadily increasing and some upticks in staffing. However, there is still a staffing shortage statewide and nationwide, with tremendous burnout among the health care workforce.

“Many people have retired early or are on stress leave or other medical leave or just taking time off to get things settled at home,” Newel said. “Our staffing shortage has definitely impacted our hospitals’ abilities to take care of our community members.”

Thankfully, Santa Cruz County’s three hospital systems have seen a limited number of patients with COVID, but more community members are coming in for delayed care that has exacerbated chronic diseases.

9

What should people know about current guidelines, especially with regard to wearing masks, distancing, and general connection with people outside their pandemic pod?

Don’t throw away your masks just yet, Newel said, as they are still strongly encouraged in all indoor settings, especially with people outside of your direct household.

“I ask that people gathering indoors continue to wear their mask, even after the order is rescinded,” she said. “It’s such an easy thing to do, and it’s so impactful and protective. Of course, we don’t want to lose sight that the best way to prevent COVID and flu is with vaccinations.”

But if you’re outside, breathe in the fresh air.

“Outdoor settings are very low-risk,” Newel said. “Unless you’re in a super crowded situation, I’m not so worried about outdoor events and gatherings.”

Newel noted that with an estimated 100,000 visitors over Labor Day and 50,000 the following weekend, the county did not see an uptick in the case rate.

10

Would I be OK eating indoors?

As much as possible, Newel urged Santa Cruzans to eat outdoors. If people must eat indoors at a restaurant or at home with those outside of their pandemic pod, they should aim to do so in only well-ventilated areas and remember to wear their masks at all times except for while eating and drinking.

11

What about boosters, especially for the 65-plus population? What about flu shots?

Newel said boosters are already available for this portion of our community, and are especially imperative for those living in residential care facilities. The FDA also recently approved a third shot of the Pfizer vaccine for people 65 years and older as well as those in other high-risk categories.

“Those are the populations really at risk, and they all got their vaccines the earliest,” she said. “So, those vaccines are starting to wane now, especially if they have Pfizer or J&J.”

As for the interaction between a booster and a flu shot, health experts say there isn’t cause for concern.

“In general, there isn’t any evidence that getting a flu vaccine and a COVID-19 vaccine at the same time poses any added risk,” Dr. Ed Belongia, an infectious disease epidemiologist and vaccine researcher at the Marshfield Clinic Research Institute in Wisconsin, told the Dallas Morning News.

12

Based on the trends, what could the coming months be like for Santa Cruz County?

While there’s no way to 100% predict the future, Newel believes hope is on the horizon for Santa Cruz County.

“I do believe we’ll hit 80 to 85% vaccination pretty shortly after the approval of vaccine for 5-to-11-year-olds — I think we’re poised and ready to get that done,” she said.

Yet Newel also believes COVID will exist for years to come. Newel noted that the infamous Spanish flu pandemic more than 100 years ago took over three years to circulate the globe before dissipating, and she believes COVID could be more persistent.

“I think we’ll have to learn to live with it — with vaccination and testing, it will become easier to live with,” she said. “I foresee, at some point, many of us will be testing before we leave home in the mornings. I think we’ll learn as a human race how to live with this, because I see it circulating in our global population probably for the rest of our lives.”