Merced County Times Newspaper
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‘Hunker down until COVID-19 vaccine is widespread,’ says Merced County health official.

‘It’s almost impossible to not know someone
who has been COVID positive at this point because it’s so widespread.’

– Dr. Kristynn Sullivan,
Merced County’s supervising epidemiologist.

 

NEWS UPDATE:  The attached graphic contains the most recent COVID-19 data as of Dec. 16, which arrived after the County Times went to press this week.

COVID-19 cases continue to surge in Merced County.

The county’s and region’s ICU capacity is a concern, so the MercedCounty Public Health Department advises following the state stay-at-home order by hunkering down until the time when the new vaccine is widespread.

The order requires regions in California with less than 15 percent of ICU’s available, such as the San Joaquin Valley including MercedCounty, to follow the closure rules for three weeks — minimum —and then the order will be reevaluated.

Total COVID-19 cases since reporting began were at 15,457 as of Tuesday, Dec. 15, an increase of nearly 1,000 cases over the previous four days.

“It’s almost impossible to not know someone who has been COVID positive at this point because it’s so widespread,” said Dr. Kristynn Sullivan, Merced County’s supervising epidemiologist. “It is too early to tell if the closure order effective Dec. 7 has changed people’s behavior or worked to flatten the curve because it takes about two weeks to see results. It’s good the number of cases hasn’t kept exponentially increasing, but our volume is still very high.”

She continued, “It is really serious, and we don’t want to have people learn how this affects people by having this happen to someone in their family.

“We need to continue hand hygiene, social distancing, all the same things. When people don’t do those things, we see the repercussions of it.

“The more things people choose to do outside the house is a potential new exposure.

“This is the continuation of the Thanksgiving Day spike, and was anticipated. I think the situation will probably stabilize, and then we’ll have to worry about Christmas.

“For counties with the stay-in-place order due to the lack of ICU capacity such as Merced County, the recommendation is for no gatherings. The idea behind the stay-in-place order is to encourage people to really not leave their home except for an essential reason so we can flatten the curve and not overwhelm the hospitals. This was successful in March and we were able to open back up, but now because of our cases taking off, the curve is higher than it ever has been statewide and countywide, so we have gone back to the previous restrictions.

“Because of COVID fatigue, I think most people have decided what they’re going to do and not do, but we are still continuing with the same messaging.

“This is because our overall state hospitalization numbers are not looking great, and we’re looking at surge.

ICU Capacity

“The ICU has been relatively stable as a region, below 5 percent, and that’s been for about a week.  But it is very, very low capacity.

“We had been seeing 7 or 8 beds last week in our ICU capacity as a county, but now we have fewer than that — 5 ICU beds as of Dec. 14 — and that is trending in the wrong direction.

“Our hospitalizations have been increasing as well.  Last Friday [Dec. 11], we had 32 COVID patients hospitalized at Mercy Merced, and today [Dec.15], they reported 39.

“Fatalities are increasing as well.  There have been 210 deaths from COVID as of Dec. 15, and that is 3 more than last Friday [Dec.11].

COVID Stats

“The positivity rate is 13.3 percent which is pretty stable over the last week; our cases per 100,000 per day are 45.7 percent, which is about the same. We’re getting a credit because we’re testing higher than the state median so our actual cases per 100,000 are a little higher than that. Our equity quartile test positivity rate is 13.1 percent, and that’s pretty stable in the last week.

Outbreaks

“As our cases go up, our outbreaks are increasing. I think there were five more today [Dec. 15]. We have 51 outbreaks as of Dec. 15.”

Vaccine News

The U. S. Food and Drug Administration recommended the Pfizer-BioNTech coronavirus vaccine for emergency use on Dec. 10, and it was approved for emergency use on Dec. 11.

When asked how the vaccine will roll out, Dr. Sullivan told the Times, “There are 4 CDC tiers. We’re focused on Tier 1. The rest of the tiers will be finalized as we move on and have more vaccine.

“The first allocation of Pfizer came to California earlier this week. Merced County will be getting its first allocation later this week. Each county gets an allocation based on the size of the county, which is a proportion of the State’s total allocation.

“The State of California gives us vaccine to distribute based on California’s tiers which are the CDC tiers.  The only tier which has been finalized is Tier 1.

“In Tier 1, we will allocate the first round to the people at highest risk — health care workers working directly with COVID positive patients in hospitals such as in ICU’s; janitors cleaning COVID positive rooms; health care workers who are 65 or older themselves or have underlying conditions; medical first responders, such as paramedics, ambulance workers, and EMT’s; other essential workers, like law enforcement, people who work in grocery stores and meat packing plants and such places; and residents and staff members of Skilled Nursing Facilities.

“After all those higher risk populations, the next tier will be more general population types — people who are at risk because they’re 65 plus or have underlying conditions will be at the top of that tier.

“The general population is down quite a few tiers.

“Assuming the Moderna vaccine gets approved by the FDA, Moderna and Pfizer will both be distributed at the same time.

“We don’t know how long natural immunity lasts when one recovers from Coronavirus, so the recommendation is that people who previously had COVID will still get vaccinated.

Surge Plans

“We’re looking at ways to increase care such as setting up field hospitals, but such things are not ideal for the delivery of optimal care.

“The field hospitals are set up by the state as part of its overall surge plan.

“Our local hospitals could utilize those to send some of their less sick patients, giving the local hospitals more space available within their own walls.

“Field hospitals are for lower acuity people who need a little support, but the issue when we go into surge is that it’s pretty easy to create a new bed but hard to find and keep people to staff that bed.  We need to increase staffing resources but since there is a surge everywhere in the country, those health care workers are harder to get and that means the existing workers have to care for more patients, and that is harder to manage. So it gets very difficult for the hospitals to effectively manage the COVID caseload, and then as the beds fill, it becomes difficult for non-COVID patients who were in severe car crashes or had a stroke or heart attack. Those haven’t stopped because COVID is now filling the beds.”

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