Quick Take
Although Santa Cruz County health care facilities aren’t seeing the same “tripledemic” that strained services last winter, COVID, flu and RSV are still making the rounds. Flu numbers are increasing quickly, while COVID has not hit the county particularly hard yet. Although the latest subvariant of interest, JN.1, shows the ability to be more infectious and better evade vaccines, county deputy health officer Cal Gordon said that vaccines still appear to provide good protection against serious illness.
Winter respiratory virus season continues even as the holidays begin to wrap up, but so far, Santa Cruz County has been spared from a “tripledemic” of COVID, flu and respiratory syncytial virus (RSV) throwing a wrench into family gatherings again this year.
Last winter, COVID, flu and RSV numbers peaked around the same time in December, which caused people to crowd emergency rooms to seek tests for all three viruses. Health care experts attributed that phenomenon partially to higher transmission of all three illnesses after a prolonged period of lower exposure to common winter viruses because of years of pandemic lockdowns and social distancing. Some elective surgeries had to be delayed due to a clogged health care system, recalls Santa Cruz County Deputy Health Officer Dr. Cal Gordon.
“The good news is that I don’t think we’re getting the same level of impact as last year,” he said. “Time will tell, but at this point, we are doing better comparatively.”
Gordon said health care facilities are seeing a lot of RSV cases, but that it is “very possible” the virus has peaked, as its prevalence in wastewater is beginning to dip at the state level.
“The local pediatricians are seeing a lot of RSV and their emergency departments are seeing it,” he said. “It has not impacted our delivery system, but it is a stress.”
Gordon said that flu numbers have increased the most over the past few weeks and he expects that to continue until possibly late January, though it’s difficult to tell this early. However, he added that the flu vaccine rolled out earlier this year appears to be effective against the influenza A strain spreading the most this winter.
Interestingly, COVID has not taken off significantly in Santa Cruz County thus far, said Gordon, even as a new Omicron subvariant, referred to as JN.1, is rapidly spreading globally and nationally. Last week, the Centers for Disease Control and Prevention estimated that JN.1 was responsible for 44% of cases across the country, up from 21.3% just two weeks prior.
“Flu and RSV are definitely in the community in a big way, as is COVID,” he said. “But there’s a good chance that COVID will continue to rise through this winter.”
Gordon said the county’s effective reproduction number for COVID is currently below 1. The figure represents the average number of secondary COVID cases caused by a primary case, calculated over a five-day moving average. If the rate is below 1, spread is decreasing, and if it’s above 1, spread is increasing.
JN.1 is likely spreading so quickly globally because of additional mutations of the virus, allowing it to be transmitted more easily and also evade the vaccines’ protection. However, Gordon said the subvariant has not appeared to cause more severe illness. The reformulated vaccine from earlier this fall is still effective and antiviral medications like Paxlovid still work to combat infections.
That said, uptake is quite low for the latest version of the COVID vaccine. California Department of Public Health data shows that only 16.2% of Santa Cruz County residents and just 10% of residents statewide have received the latest jab. Gordon said that can be attributed to a couple reasons: cost and barriers to access. Since this year’s rollout was the first COVID vaccine to not be covered by the federal government, uninsured people had to pay for the jab. Further, most places do not offer walk-in vaccinations anymore.
“Oftentimes you have to make an appointment to get vaccinated, and there’s a bit more effort required,” he said, adding that pandemic fatigue could be contributing to fewer people seeking out appointments. “I think there is a subgroup of people that would like to be over COVID.”
And although the national flu vaccination rate is much higher, about 42%, Gordon said that the flu isn’t likely to be the biggest problem.
“Unfortunately, it’s really COVID that’s probably most harmful for those who are elderly or at risk,” he said.
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