COVID-19 news is mixed around the globe and around the country, with waves of new infections showing up in areas that previously seemed to be doing well. Vaccination clinics are up and running, and hospitalizations and case rates are down from the dramatic highs seen at the end of last year.
UC Davis Health experts say the only way to reach any level of herd immunity is to get more people vaccinated.
But in recent weeks, progress has slowed in the Sacramento region. In California's color-coded system that assigns each county to a "tier" according to COVID-19 positivity rates and cases, Sacramento County has been stuck in the "red tier" since mid-March, while other counties have moved down to "orange" or "yellow" levels. The red tier indicates substantial spreading of the virus continues and that requires stricter indoor capacity limits at certain businesses. At UC Davis Health, the rate of positive COVID-19 tests has hovered between 2 and 5 percent for weeks.
Health system experts note a similar stagnation among the numbers of COVID-19 patients in the hospital. "We've been treating patients with COVID-19 for more than a year now, and our staff has weathered the surges," said J. Douglas Kirk, chief medical officer for UC Davis Medical Center. "The number of patients currently in the hospital is dramatically lower, having leveled off in recent weeks. We encourage people to get a COVID-19 vaccine and remain vigilant with masks and social distancing to prevent new waves of infections."
Plateaus
Stuart Cohen, chief of infectious diseases, has observed the plateau. "Within the hospital, we're ten times lower than we were at the absolute highest, but over the last two to three weeks, it seems the number of cases has been relatively flat," he said.
Timothy Albertson, professor and chair of internal medicine, said at the peak, there were around 130 patients at the medical center for COVID-19 treatment. He referred to the current static situation as a "steady state level". "It's good in a sense that we can handle that," Albertson said, "but I'm not seeing it go down to the lows that we saw after the summer wave."
Currently there are 11 hospital patients being treated for active COVID-19. Five coronavirus patients are in the ICU.
The numbers may change, but the illness has not
— Stuart Cohen
The virus "surges" over the past year have honed the medical staff's approach to treating patients with COVID-19. "We have a year of experience in managing people," said Cohen. "So, we are much more likely to take care of people more quickly and we have a handful of drugs that are somewhat effective."
As for the patients who are hospitalized right now, "they are just as sick as they were, there are just fewer of them," Albertson said.
Breaking through: vigilance and vaccines
To further reduce the number of hospitalized patients, both Cohen and Albertson say wearing masks and observing social distancing is crucial, as is getting more people vaccinated. "When we look at who's getting infected, even within the health system, it's unvaccinated people," said Cohen. "They're generally picking it up when they're in groups with other people."
"We're going to get as close to the concept of herd immunity only through vaccines," said Albertson.
The vaccines turned things around when it came to COVID-19 infections among UC Davis Health staff, said Ann Tompkins, the interim director of employee health services. Before the COVID-19 vaccines were available, Tompkins said at the peak, in late November last year, there were 140 new positive tests in one week among staff members. That meant hundreds of workers out, as quarantine requirements stretched absences over a period of weeks.
To prepare for the vaccines' release, she worked with health system administrators and staff to put together not only a vaccination clinic for employees, but also sub-zero storage facilities. "The second we received the vaccine, we had to get them in people's arms. We just couldn't wait an hour," she explained.
Tompkins used the hospital's seasonal flu vaccine clinics as a model. Workers set up inoculation stations at an auditorium. The vaccination site ran from 5 a.m. to 10 p.m., seven days a week. "We were passionate about having easy access to the vaccine to the people who wanted it," Tompkins said.
And after employees were vaccinated? Absences due to positive COVID-19 tests are down to single digits. "Last week we had nine, this week we had one," Tompkins said. "If I took an average from Feb. 1 to now, our average would be three a week."
Vaccinating the community
The focus now is on vaccinating the community. At the beginning of April, Californians age 50 and over could obtain the vaccine. Mid-month, the list of those eligible expanded again. "We're seeing 16 to 18-year-olds show up for the vaccine now that we are open to them," said Michael Condrin, chief operating officer for ambulatory care. "We're planning with Sacramento County as well in the event that 12-to-15-year-olds may be approved soon as well."
Appealing to those hesitant to get the vaccine has been top of mind for health professionals. "Education provided by trusted community members and experts who look like the reluctant in a safe setting is key," said Thomas Bullen, a UC Davis Health pediatrician.
To date, UC Davis Health has administered over 128,000 doses of vaccine to patients, community members and employees. Currently, the health system is working with community organizations to help with vaccination clinics that reach the medically underserved. UC Davis Health also has a vaccination site for the general public at the Scottish Rite Center on H Street in Sacramento. Reservations are required and can be made through the state's centralized booking system MyTurn.CA.GOV.
