The warnings were stark and the early evidence looked worrisome, as Bay Area COVID cases took off after Thanksgiving. But whether due to “hybrid immunity” or individual precautions, the winter surge has proved tamer than feared and metrics are clearly improving. That doesn’t mean we’re entirely out of the woods: variant proportions reported by the CDC continue to show gains for the immune evasive XBB strains, though they still trail the BQ family in the West. And nationwide hospitalizations are also falling — a reassuring sign of a weakening pandemic.
UCSF’s Wachter says he will mask “likely forever” in some situations
In his most recent COVID-19 risk analysis for his social media followers, UCSF’s Chair of Medicine Dr. Bob Wachter said he is once again ready to let down his guard. “I’m changing my behavior. In the Bay Area, I’m now OK with indoor dining & removing my mask for small group gatherings,” he said in a long Twitter thread posted on Thursday. “I haven’t changed, the risk has.” He said with infection rates falling below 10 cases per 100,000 people in the region and hospitalization levels relatively low in San Francisco, the “trend line certainly supports the premise that there’s less virus around than last month.”
For the 65-year-old, vaccinated and boosted Wachter, who believes he has never had COVID, that means he can engage in what he considers riskier behavior, such as playing poker indoors with a group of vaccinated friends, dining indoors, or attending small gatherings. He said he would likely wear a mask for his weekly grocery trip to Safeway but not to pop into a corner store. And for more high-risk settings like public transit, theaters, and other large gatherings, Wachter reasoned that he would “plan to wear a mask (always a KN95; why not wear a good mask if you’re going to mask?), likely forever. I’m comfortable taking it off briefly to eat on a long flight, but will try to keep it on when I can.”
He emphasized that these were decisions he was making based on his individual risk assessment and that everybody should weigh their own comfort levels against the threat of infection, long COVID, and other complications the disease could bring. “Just because we’re all tired of this doesn’t change the risks & thus doesn’t change the way I think about managing them,” Wachter said.
Lack of awareness is top reason for low booster uptake, CDC finds
Seeking to find out why a majority of Americans are not taking advantage of the updated bivalent COVID-19 vaccine boosters that have been available since September, the U.S. Centers for Disease Control and Prevention conducted an online opt-in survey of 1,200 previously vaccinated U.S. residents. The results found that the most common reasons for not getting a bivalent booster dose were lack of awareness about eligibility or availability and overconfidence in immunity. The reasons varied by age group.
“The most common reasons cited for not receiving the bivalent booster dose were lack of awareness of eligibility for vaccination (23.2%) or of vaccine availability (19.3%), and perceived immunity against infection (18.9%),” a report on the survey said. “After viewing information about eligibility and availability, 67.8% of participants who had not received the bivalent booster dose indicated that they planned to do so; in a follow-up survey 1 month later, 28.6% of these participants reported having received the dose.”
COVID declines in the Bay Area as winter surge loses momentum
The Bay Area appears to have avoided another devastating winter COVID-19 surge, at least for now. The pace of new infections has substantially slowed across California after peaking in late November, despite the holidays and recent storms that kept people indoors. At the same time, concentrations of SARS-CoV-2, the coronavirus that causes COVID-19, have fallen off sharply in most Bay Area wastewater samples during recent weeks. The good news is moderated by the looming threat of a new coronavirus subvariant — the highly contagious XBB.1.5 omicron offshoot, which has reversed positive COVID trends on the East Coast. XBB.1.5 has accounted for a far lower percentage of cases in the West so far, but its share is rising and public health experts can’t predict how it may affect the population here. Read more about declining cases and hospitalizations in California and whether the Bay Area managed to dodge an anticipated winter surge.
Pace of hospital admissions shows signs of slowing nationally
The pace of new COVID-19 hospital admissions is slowing across the U.S. after peaking in early January, according to preliminary figures published Thursday by the U.S. Centers for Disease Control and Prevention. The current seven-day average of new hospitalizations is 5,014, down from 5,997 in the prior week, marking a 16.4% decline. The rate of admissions is 76.7% lower than it was at the same time last year during the winter omicron surge. The agency does not know if the positive trend will continue. In this week’s forecast ensemble, the CDC “predicts that the number of new daily confirmed COVID-19 hospital admissions will remain stable or have an uncertain trend,” with 1,400 to 10,800 new confirmed COVID-19 hospital admissions likely reported on February 10.
State testing sites begin to close this month
California is set to close dozens of state-run COVID-19 testing and treatment sites ahead of the planned end of the the pandemic state of emergency in February. CalMatters reported Thursday that sites operating under 50% capacity are scheduled to close before the end of January. Forty-four OptumServe sites will be shuttered this week, and 48 mobile “mini-buses” will begin closing in two weeks, according to the California Department of Public Health. “A final plan for demobilizing the remaining sites is being prepared, but we have not set a completion date,” the department said in a statement.
Last week, Gov. Gavin Newsom released his January budget proposal, which moves $614 million in unspent COVID-19 response funds to the state’s general fund and drastically reduces the amount of pandemic money for the upcoming year. Most counties will be forced to absorb the responsibility of maintaining public sites. That includes Santa Clara County, where state-run sites are slated for closure in the coming weeks, according to emergency operations spokesperson Roger Ross. The county will continue to run three mass vaccination sites and has already begun folding the COVID-19 response into the health department’s normal operations. “Unfortunately, it appears we will be dealing with COVID for the long haul,” Ross said.
Another study finds vaccine cuts the risk of long COVID
Unvaccinated people have a higher risk of reporting COVID-19 symptoms lasting 28 days or more, indicative of the condition known as long COVID, according to a study by the Uniformed Services University of the Health Sciences Infectious Diseases Clinical Research Program. In a cohort study of nearly 2,000 individuals, researchers found that COVID-19 is associated with increased health care encounters through 6 months after infection, and vaccination was associated with a lower risk of long-term symptoms. The results were published Wednesday in JAMA Network Open. “Participants with COVID-19 were more likely to seek medical care for diabetes, pulmonary, neurological, and mental health-related illness for at least 6 months after onset compared with their pre-COVID baseline health care use patterns,” the authors wrote. “In addition, unvaccinated participants were at higher risk of 28 or more days of symptoms and of medical encounters associated with pulmonary and neurological diagnoses.”
At least 65 million people worldwide have symptoms associated with long COVID, according toin Nature Reviews Microbiology, based on the estimated global rate of 10% of infected people and the more than 651 million documented cases. The researchers of the report suggested that the number is likely an undercount. “There is a broad misconception that everyone makes and retains SARS-CoV-2 antibodies, and many clinicians and researchers are unaware of the limited utility of antibody tests to determine prior infection,” they wrote. “Between 22% and 36% of people infected with SARS-CoV-2 do not seroconvert, and many others lose their antibodies over the first few months.”
Utah surgeon gave kids saline shots instead of vaccine, prosecutors say
A plastic surgeon in Utah and three of his associates were indicted on conspiracy charges last week after prosecutors say they dumped nearly 2,000 doses of the COVID-19 vaccine down a drain, distributed fake vaccination cards — and, at the request of some parents, injected children with saline to convince the young patients that they had been vaccinated, reports The Salt Lake Tribune. Court documents show that Dr. Michael Kirk Moore Jr. and his neighbor Kristen Andersen identified as members of an unnamed private organization “seeking to ‘liberate’ the medical profession from government and industry conflicts of interest.” All four defendants and the Plastic Surgery Institute of Utah were indicted on three counts: conspiracy to defraud the United States; conspiracy to convert, sell, convey, and dispose of government property; and the conversion, sale, conveyance, and disposal of government property and aiding and abetting. They will make their initial appearance in court on Jan. 26.
