California’s progress against the COVID-19 pandemic appears to have stalled and reversed course, as new cases, hospitalizations and deaths are once again trending upward across the state.
“It’s not subtle, that’s for sure,” said Dr. George Rutherford, an epidemiologist at UCSF. “The numbers are increasing. Cases are up over the past three weeks. We were down to as low as about 5,000 new cases per day. Now we’re up to 6,000 cases per day. Hospitalizations are up about 4% over two weeks. There have been some big spikes. To me, that is worrisome.”
Large urban areas with vaccination rates that are lower than the Bay Area’s are seeing some of the most concerning rises. That includes the Central Valley, Greater Sacramento region, and highly populated Southern California counties like Orange, Riverside, and San Bernardino counties, where hospitalizations have increased by more than 20% in recent weeks. Hospitalization rates in the Bay Area, however, are at their lowest point in four months.
California’s case rate has averaged about 15 cases a day per 100,000 people for the past three weeks, up slightly from 14 a month ago. But it’s the next few months that experts are worried about.
“We’re going to have another surge,” said Dr. Peter Chin-Hong, an infectious disease expert with UCSF. “And there will be a lot of disruptions to schools and workplaces, potentially.”
With just 63% of California’s population fully vaccinated, the risks posed by indoor gatherings and colder weather could drive a new wave of infections.
The state’s 7-day positivity rate — the percentage of positive coronavirus tests — is now 2.3%, up from 1.9% in late October. The 7-day positivity rate in some regions where hospitalizations are again struggling is higher — 5.2% in Riverside County, 5.6% in Sacramento County and 8.9% in Fresno County.
Marshall Goldstein, 11, receives a Pfizer-BioNTech coronavirus vaccine at Berkeley Pediatrics on Saturday. Children ages 5-11 are newly eligible for vaccines, which is likely to help with case counts going into another potentially challenging winter.
Noah Berger/Special to The Chronicle“COVID cases are beginning to rise -- winter months means people indoors & more possibilities for spread,” Gov. Gavin Newsom tweeted Tuesday morning.
Even in highly vaccinated parts of the Bay Area, cases have either plateaued at worryingly high numbers or started creeping back up.
Marin County, with 82% of its population fully vaccinated, has tracked a significant rise in infections — including among children 5-11, who became eligible for vaccination last week.
At the beginning of the year, people in that age group accounted for less than 5% of cases, county officials said. Now they account for about 30% of cases.
Dr. Sefanit Mekuria, a pediatrician and deputy public health officer for Contra Costa County, noted that more cases in the 5-11 age group are getting reported because reopened schools are doing more testing; in addition, while other groups are gaining protection from the vaccines over time, small children remain vulnerable.
Newsom said that unvaccinated people are seven times more likely to get infected, 10 times more likely to be hospitalized, and 18 times more likely to die.
“Frontline (workers) like myself are feeling very nervous as we head into the holidays,” said Dr. Lekshmi Santhosh, who works in UCSF’s intensive care unit and co-directs the hospital’s long COVID clinic. “We are tempering our optimism. We hope for the best — that there will be great uptake among kids, and boosters — but we are preparing for the worst.”
Matt Willis, the health officer for Marin County, told his county’s Board of Supervisors on Tuesday that case rates among vaccinated residents have been fairly stable for a few months. But “there’s a lot more wobble with unvaccinated residents. Despite the fact that there’s an ever-smaller fraction of unvaccinated, they remain particularly vulnerable.”
Carranza Domingo, 66 gets a COVID-19 vaccine at the Latino Task Force popup in San Francisco. Coronavirus case rates are slowly rising again in California, prompting officials to urge people to get their shots.
Gabrielle Lurie/The ChronicleWith the state returning to the Centers for Disease Control and Prevention’s red “high” category of coronavirus transmission after weeks in the “substantial” tier, it may be too soon to pull back on restrictions such as mask mandates, some experts said.
“This is the lesson: When things are going bad, don’t declare everything is fine and walk away,” Rutherford said. “You need to be cognizant of what’s going on around you. But all the masking and protocols are secondary to getting people vaccinated. If we’re going to live with 63% of the population being vaccinated, we’re going to have to have these surges.”
Add to that the U.S. fully reopening to vaccinated international travelers Monday for the first time since the coronavirus emerged as Europe experiences another surge and flu season hits, and things are likely to get worse.
“As people begin to move around again, you will see a lot of infection and cases,” said Chin-Hong. “Hospitalizations will increase because of COVID plus flu.”
State officials said on Tuesday that loosening any further mitigation measures, such as the indoor mask requirement for schools, are on hold until the virus is better under control. That likely will not happen until the spring.
“We’re plateauing at a much higher place than we did with previous plateaus,” said Dr. Erica Pan, the state epidemiologist, during a roundtable with health care professionals.
She said the rapid spread of the delta variant of the virus shortly after the state lifted its statewide mask mandate taught officials to become more cautious about setting firm benchmarks for lifting restrictions.
“We have learned our lesson about trying to predict things,” Pan said. “I recognize that is really challenging. As things get better, we will peel away as we can. But we want to see signs that we can.”
Alameda and San Mateo counties are the only ones in the Bay Area classified as having “moderate” virus transmission by the CDC, but the numbers are not stable.
“We still are keeping a close eye on things because it’s very possible we could be headed in either direction,” said Louise Rogers, chief of San Mateo County Health, during a briefing.
The experts agree that waning vaccine efficacy plays an emerging role in a statewide increase of breakthrough cases, especially among those who completed their vaccination series last winter and have not yet received supplemental doses.
In Marin County, about 75% of post-vaccination hospitalizations are happening in those older than 65. Only half of the county residents in that age group who completed their first round of vaccination have received booster shots. Statewide, that number falls to 32%.
“We have three things in front of us that we can do right now,” said Rutherford. “We need to get people boosted — of the things that are doable, that might be the most important. We need to get 5- to 11-year-olds vaccinated. And then we need to get people who are not vaccinated yet vaccinated.”
Chronicle staff writers Catherine Ho, Erin Allday, Nanette Asimov and Katie Licari contributed to this report.
Aidin Vaziri is a San Francisco Chronicle staff writer. Email: avaziri@sfchronicle.com
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