Supervisors: ‘Just get us the damn vaccines!’
‘We’re essential enough to feed the state, and the world,
but we’re not essential enough to keep from dying.’
Dr. Rebecca Nanyonjo-Kemp,
Merced County Public Health Director
By BEVERLY BARELA,
JOHN MILLER &
Patience with the state’s vaccine rollout gave way to frustration at Tuesday’s Merced County Board of Supervisors meeting with at least two leaders making desperate pleas in plain English.
“Just send us the damn doses,” said Supervisor Scott Silveira. “We don’t need help dispensing them. … With our providers, with the pods we have been able to set up, if you let us ramp up our delivery system, we could do 15,000 doses a week. Not just by ourselves, but with our community health partners … everybody that’s onboard and wants to get things done. … Just give us the doses.”
Board Chair Daron McDaniel echoed Silveira’s statements: “We have a plan in place, just get us the damn vaccines.”
Meanwhile, the county’s public health director, Dr. Rebecca Nanyonjo-Kemp, went as far as to say the state’s lack of transparency with the COVID-19 vaccine distribution is deliberate, and that the hard hit San Joaquin Valley has received limited vaccine resources compared to other regions.
“We’re essential enough to feed the state, and the world, but we’re not essential enough to keep from dying,” Nanyonjo-Kemp said.
According to County Public Health numbers:
• Merced County, with 287,000-plus residents, has received the third lowest amount of vaccine per resident in the state.
• A total of 10,775 residents in the “Phase 1A” category were fully vaccinated as of Jan. 25. This includes healthcare workers, nursing facility residents and seniors age 65 and older.
• 1,408 people were vaccinated last week at new local clinics set up in Merced and Los Banos. Another round of vaccination clinics for about 750 residents is set for this week.
• COVID-19 is on track to become Merced County’s leading cause of death over the last three years. As of Tuesday, 332 residents have died from pandemic-related deaths compared to 380 deaths attributed to all types of cancer.
Although it makes sense for regions with more residents to be allocated more doses, according to Nanyonjo-Kemp, the state is showing favor to regions that have more healthcare professionals.
As of Jan. 12, she noted, Merced County‘s roughly 287,000 residents were secured 7,600 doses while Pasadena’s roughly 141,000 residents were allocated 22,800 vaccine doses.
“We are on track for five years to reach herd immunity (80 percent of the population vaccinated), while Pasadena stands at 10 months,” she said. So far, about 3 percent of Merced County has been vaccinated.
The Board of Supervisors sent a Jan. 21 letter to Gov. Gavin Newsom that called for him to clarify the method behind the vaccine distribution and to address the equity issue with regard to Merced County’s status.
Dr. Kristynn Sullivan, Merced County’s supervising epidemiologist, told the Times: “Our elected officials from top to bottom are advocating for more vaccine, so that’s coming from Congressman Jim Costa, State Assemblyman Adam Gray, State Senator Anna Caballero, and all the local supervisors. So far, there has not seemed to be much of a change. There has not been a response, to my knowledge.
“Disease burden and fatality rate would be more reasonable drivers for vaccine allocation. We have the ninth worst death rate from COVID per capita in the state, and we have the third worst allocation in the state of any county.
“The [recent] vaccine clinics were spearheaded by Yadira Vazquez, the assistant public health director, and she got them up and running in three days. About 50 staff members per day operate the clinics, which is most of our staff.
“The vaccine clinics fill up really fast. We had over 1,200 slots last week, and those filled up in about two hours.”
The county sent out alerts for the clinics on a Sunday, and they were visible mostly online through social media and email services. There were complaints posted through social media sites from family members of seniors who were not “internet savvy” enough to register for a clinic appointment on their own.
Registration for future clinics can be made through the county’s newly launched website, www.vaccinatemercedcounty.com. Those registered will receive email alerts when more appointment slots will be offered.
Despite the low number of vaccine doses available, the clinics that were held last week proved to be relatively quick and efficient. County leaders praised the process at Tuesday’s board meeting, as did the fortunate residents who were vaccinated.
“It was a much more simple and organized process than we expected,” agreed Cathy Paskin, age 68, and Eric Tressler, age 71. Both received vaccinations with no adverse reactions.
Steve Spendlove, 65, said he didn’t even feel the shot. “It was like the sharp place on a fingernail pressing gently on a soft place on your skin. There was nothing to it. … I got my shot, and then they ran out of vaccine for the day. … On my card is the date for my second shot which is three weeks later. … As far as I was concerned, it was well done. …
“As the day wore on, I started to feel a little arm soreness, and by the evening, I felt mildly, vaguely unwell and that was gone the next morning, and the next morning my arm was barely sore.”
Dr. Sullivan added, “Public Health keeps back part of its allocation for second doses, so anyone who gets the first dose is contacted and an appointment is scheduled to get the second dose when it becomes their time.
“There may be a higher level of protection than 50 percent with the first dose alone, but what we know for sure is it is about 95 percent after two doses. That protection takes effect about two weeks after the second dose.
“As people are getting desperate to get vaccine, we’ve heard about potential scams. It’s important for your readers to know: You don’t have to pay for the vaccine, and anyone trying to charge for vaccine is perpetrating a scam.”
One local doctor who is offering a legitimate alternative to going to the clinics is Dr. Sima Asadi. The longtime local pediatrician addressed the Board of Supervisors on Tuesday, saying her office is certified to administer the vaccine, and they have administered doses to 800 people so far. The doses are provided by Public Health when available and providing that volunteers like Asadi have patients ready to receive them.
“I can do this in a way that major institutions cannot,” she told the leaders. “When somebody comes to me for a vaccine, they have a piece of paper to fill out. It’s name, date of birth, ethnicity, gender and a cell phone number — DONE. … There’s no long registration process, no computers. Basically I’m old school. This is a crisis. And in a crisis when somebody hands me a blue, limp baby (which is my day job), I’m not logging into a computer. I’m not sitting there spending half an hour having meetings, discussions, subcommittees. I’m fortunate that way. Because if you get into that side of it, it slows you down.”
Cases In Decline As State Lifts Restrictions
The COVID surge of November, December and the first half of January is beginning to slow because the number of new cases per day is decreasing.
Nevertheless, Merced County’s COVID-19 case rate is still high.
“COVID fatigue is rampant,” Dr. Sullivan said. “A lot of people are really invested in the rules, and a lot are just not.”
She emphasized the importance of continuing to follow the protocols — masking, social distancing, washing hands frequently, and limitations on family get togethers.
Perhaps the most encouraging news is that on Jan. 25, the state lifted the regional stay-at-home order imposed on Dec. 3 which was triggered when ICU capacity at hospitals plummeted to below 15 percent.
Dr. Sullivan informed the Times, “The stay-at-home order was lifted because the state changed how it calculated the ICU beds available, and they included staffed surge beds. The state changed ICU capacity to include those surge beds so it gives them a more complete picture of the capacity of the hospital.
“Surge beds are the beds a facility can add on when there are more people in the hospital than normal. For an ICU surge bed, a hospital may use another part of their facility to expand their ICU. It might be the part where people recover after surgery that has similar equipment to an ICU — that might be where they expand to.
“Typically, Mercy Merced has 20 ICU beds, and Memorial Hospital Los Banos has four.
“They might be able to have an additional five staffed surge beds, and that’s why the numbers changed so dramatically. It’s a more accurate way of looking at it.
Because they’re not set beds, they can add them and take them away as needed, but it meant that our regional capacity which was at 0 went to 15 percent on Jan. 25 and today [Jan. 26] was at 12 percent.
“Equipment, such as ventilators, has not been the biggest issue. After the first surge, California stockpiled a lot of ventilators. The issue continues to be staffing. Both hospitals requested supplemental staffing and received some from the State. “When the hospitals need more staff, typically the supplemental staff comes in to relieve the existing staff so they can have more reasonable rotations.
According to Dr. Sullivan, “We are finally beginning to see a decrease in our cases, which is great.
“The last few days, we’ve had 150 to 175 new cases per day, which is a nice drop off from our high when it was 250 per day.
“We’re finally seeing the ceasing of the holiday surge. We’ve weathered the holiday surge. The next big holiday we’re worried about is Easter, and maybe Super Bowl Sunday, but maybe not.
“Daily cases per 100,000 residents is 60.5, and to move into Red Tier, that needs to be 7.
“We have started finally to see a tapering down in our positivity rates. Our positivity rate is 13.6. That has to be below 8 to move into Red.
“It will be at least a month and more likely closer to two or three months to move into Red.
“However, if we’re able to vaccinate more people, it could definitely go faster.
“First, cases go down, then hospitalizations go down, then fatalities go down.
“Our hospitalizations have been pretty stable. We’re still seeing ICU hospitalizations.
“Hospitalizations for COVID patients at hospitals within Merced County was 51 as of Jan. 26, which is pretty stable. It has been in the 40s and 50s for the last couple of weeks, but at the peak of the surge, it was in the 60s.
“However, January is on track to be our deadliest month so far, so fatalities have not decreased yet. Overall, we’re at 332 fatalities as of Jan. 26.
According to Dr. Sullivan, “There is a large list of outbreaks. The number is about the same. We have been clearing them when eligible for clearing, and they do seem to be falling in number a little bit like our cases, but we’re still getting quite a few.
“During the surge, we saw a lot of places that previously had an outbreak have an outbreak again. This is because the people who live in the community also work in the community.”
All counties in California have now returned to operating under the state color-coded tier system, with the majority, including Merced County, falling within the strictest tier, Purple.
If the circumstances warrant it, however, county health officials in each county can apply more extreme restrictions.
Prior to Jan. 25, the San Joaquin Valley Region, which includes Merced County, was subject to the stay-at-home order which prohibited restaurants from offering outdoor dining and closed many businesses, such as hair salons and gyms. The order was withdrawn as to the Region, so in Merced County, as well as all the other counties in the region, restaurants were immediately allowed to open for outdoor dining.
Hair salons, nail salons and barber shops, which were to have been closed under the stay-home order, were able to resume their services indoors with safety protocols.
Retail stores could expand their capacity, increasing from 20 percent under the regional order to 25 percent under the Purple Tier.
Shopping malls and swap meets could open indoors with modifications, up to 25 percent capacity, but common areas and food courts remained closed.
Applauds For Espinoza
At Tuesday’s board meeting, supervisors and department heads presented former Board Chair Rodrigo Espinosa for his work during 2020 and the pandemic that hit his district particularly hard, including the city of Livingston where the county’s largest employer, the Foster Farms plant, is located. Leaders also recognized the fact that Espinosa recently struggled with the coronavirus himself and was hospitalized for a time.
“We know you had a lot of challenges,” said current Board Chair Daron McDaniel. “It was a difficult time. You got through it. And you led us through it. You did a very good job at that.”
Said Espinosa, “People are frustrated every day. When the pandemic started I thought ‘This was nonsense.’ But it’s not nonsense. I didn’t get covid for a long time. … And I did get it. … Somebody came over and visited me. But that’s all it takes. You never know. It’s unprecedented when you do get it, the way your life changes. You don’t want to end up in the hospital, but I did. I spent seven days. The first day I thought I was going to go crazy. Even though I didn’t feel that bad, your oxygen levels go down, and you have no choice but to take the medicine they give you. And thank God that I recovered. God gave me another chance to live.”