COVID remains on high plateau; vaccine/booster decreasing risk
The surge in COVID cases which started in mid-July has developed a peculiar plateau-like pattern at a high number of cases, as opposed to a significant decrease as was typically the case with previous surges, according to the Merced County Public Health Department.
The other COVID characteristic that stands out currently is the number of children getting the disease since the onslaught of the Delta Variant, although pediatric cases are decreasing.
The unvaccinated remain the most at risk of serious disease and fatalities.
“Unfortunately, the COVID pattern is kind of the same in the last several weeks,” said Dr. Kristynn Sullivan, Merced County’s supervising epidemiologist. “Usually by now, we wouldn’t have such a high plateau. It has come down, however, so instead of between 100 and 200 cases, we have 100 cases per day.
“We are still seeing that kind of odd plateauing that we haven’t seen before.
“Typically, there was a rapid growth and then a peak, and then a steady decline into low growth again.
“Now we’ve seen a rapid growth, a leveling, and a stair step down, and we’re now in the third stair step. The case numbers are jumping around in the 80s, 90s and 100s.
“Our pediatric cases are going down. On our dashboard, we have the number of probable active pediatric cases (age 0 to 17) reported in the last 14 days. The pediatric cases were making up 30 percent to 32 percent of our overall cases, and now they’re making up 25 percent to 28 percent of our overall cases.
“Active pediatric cases decreased from 660 at the height of the surge in late August/early September to 440 as of Oct. 5.
“Total active cases, which are those reported to Public Health in the last 14 days, have been over 2,000, but now they are at 1,567.
“The hospitalization numbers in the county are stable. Yesterday [Oct. 4], we had 36 Merced County residents hospitalized due to COVID and we’ve been having between 35 and 45 since probably mid-August.
“We are seeing an increase in deaths due to COVID recently. But a lot of people recover as well, and a lot of people are hospitalized for a long time, and are then released but have significant health concerns.
“The vast majority of people who are dying of COVID are unvaccinated.
“In Merced County, from Nov. 1, 2020 to Sept. 27, 2021, there were 398 deaths from COVID and only 11 deaths were of those fully vaccinated, which is 2.7 percent. So, vaccination is still by far the best protection anybody can give to themselves against COVID. If more people get vaccinated, it decreases the number of cases.
“30 percent of our cases currently are breakthrough cases, but only 10 percent to 20 percent of the hospitalizations are of those who are vaccinated, and only 3 percent of the deaths are of those who are vaccinated. We’ve had people who are fully vaccinated who die of COVID, but it’s so many fewer.
“There’s no such thing as perfect medicine. Inherent in being a human is having risk, but the vaccines are very good at decreasing that risk.
“The vaccination rate in Merced County as of Sept. 30 was 42 percent of the total population, and 52 percent of the eligible population which is age 12 and over. 66 percent of the eligible have received at least one dose.”
There were 34 businesses or entities in Merced County on the active outbreak list as of Oct. 5.
Dr. Sullivan told the Times, “Most high schools are in outbreak. We haven’t seen a huge increase or decrease recently.
“Foster Farms in Livingston is currently on the outbreak list with its third outbreak, but it has a pretty high vaccination rate and they’re doing a lot of testing, so the current outbreak is much less significant than the first outbreak.”
Dr. Sullivan told the Times, “There are two categories of shots: Third dose and booster. The third dose is part of the primary series. For Pfizer and Moderna, to complete a series you had to have two doses. The third dose is for a very small subset of the population whose immune systems aren’t operating at full capacity and needed a little bit of help to get the full protection of the two shots. That subset includes people who have a compromised immune system, such as an active cancer patient undergoing treatment, a recent organ transplant recipient, someone with uncontrolled HIV, or someone on a medication that suppresses their immune system.”
Pfizer boosters are now FDA approved under Emergency Use Authorization.
Only people who have received the Pfizer vaccine previously, as opposed to Moderna or Johnson & Johnson, and who completed their two-dose series at least six months ago are eligible for the Pfizer booster dose.
The CDC is currently evaluating data to make additional recommendations for those who received the Moderna or Johnson & Johnson vaccine, but no boosters are currently authorized for either.
The CDC advises that the following individuals should receive a booster six months after their second dose of a two-dose Pfizer-BioNTech series:
People 65 years of age and older; residents in long-term care settings; and people aged 50 to 64 with an underlying medical condition.
Dr. Sullivan told the Times, “Only people who received Pfizer are eligible for the booster at this point. It has only been approved for emergency use by the FDA for Pfizer. You have to have gotten Pfizer for the first two doses to get the Pfizer booster.
“It is for people who had the full protection of the first two doses, but Pfizer begins to wear off. After six months, it shows a decline in effectiveness, making it possible for people to get COVID and transmit COVID, especially those over age 65.
“The booster is recommended by the CDC for people who are 65 plus; people who are 50 to 64 with an underlying condition that puts them at higher risk for severe COVID, such as diabetes, heart disease, obesity (BMI of 30 or more), and high blood pressure; and the third category is people who live in a Skilled Nursing Facility.”
In addition, the CDC advises that the following individuals may receive a booster six months after their second dose of a two-dose Pfizer-BioNTech series:
People aged 18 to 49 years with underlying medical conditions; and people aged 18 to 64 years who are at increased risk for COVID-19 exposure and transmission because of their occupational or institutional setting (such as healthcare workers).
A primary care physician will be able to advise people in these groups who have questions about whether they qualify.
Dr. Sullivan told the Times, “The underlying conditions triggering eligibility for those aged 18 to 49 are those that have been linked to more severe COVID, such as obesity with elevated BMI of 30 or more, high blood pressure, heart disease, diabetes, cancer, chronic kidney disease, chronic lung diseases, dementia, Downs Syndrome, heart conditions, HIV, being immuno-compromised, liver disease, pregnancy, being a smoker, sickle cell disease, a history of stroke, and substance use disorders.
“The reason the booster shot is not universal at this time is the FDA decided there’s not enough research yet to say with certainty that there is a real benefit for people who aren’t in those categories to receive a booster. There is evidence to suggest that as to the specific groups the CDC said should or may get the booster, they do need to get the extra protection and that’s based on data which is mostly data from breakthrough cases. There is no evidence showing whether or not others need to get the booster shot.”
Booster shots for those eligible are available through local healthcare providers and pharmacies.
Booster shots can be scheduled by going online to MyTurn.ca.gov or by calling 1-833-422-4255.
Dr. Sullivan said, “Each clinic has to opt in to use the My Turn website. A clinic may have opted not to use the website but may still offer the booster.
“So, eligible people who want the booster shot should contact their primary care provider to see if they have it.”
When asked if it was just as safe to get vaccinated at pharmacies in Merced County as at clinics or at doctor’s offices, Dr. Sullivan said, “They have pharmacists who are trained to formulate medications and who have a lot of training around drugs and a vaccine is just another type of medication, so they are fully qualified to draw up the vaccine. At a pharmacy, there may be a wide variety of medical professionals qualified to give the booster.”
People do not need to get their booster shot from the same location where they were originally vaccinated.
People need to have their vaccine card when arriving to receive a booster shot.