COVID Refuses to Go Away: A summary of the latest info locally and beyond

[Photo by Ryan Hutson]

Looking at the numbers of local deaths from COVID since the start of 2022, Humboldt County lost five fully vaccinated community members to the virus, and 23 community members who were “not fully vaccinated.”  Since data collection began, the county has tallied a total of 22 deaths in vaccinated individuals, far outnumbered by the 127 unvaccinated individual lives lost to COVID-19 across the county. Humboldt County‘s COVID-19 dashboard graph reflecting vaccinated and unvaccinated deaths shows that all 22 deaths of fully vaccinated residents occurred since June 2021. And during that same time period beginning June 1, 2021, 83 not fully vaccinated people have also died.

While emerging science casts concerns over the ability of the virus to potentially evade antibodies, in the face of new Omicron variants boasting improved spike proteins, regional health officials have issued some advice and adjusted guidance in an effort to meet the moment, on the verge of a COVID’s third summer of unrelenting viral loads.  

The most recent Public Health Order from CDPH makes an adjustment to the definition of a close contact in an effort to prevent any rise of hospitalizations and deaths resulting from increased COVID-19 community spread.  A public notice issued by RANCHO, the Rural Association of Northern California Health Officers, reiterated the concern surrounding fast-moving airborne Omicron subvariants widely circulating across the state. 

The recently updated definition of a close contact now acknowledges that COVID-19 is an airborne disease, rather than one spread by respiratory droplets.  This distinction is of great importance when attempting to address the inadvertent spread of the virus in public spaces where many people are gathered. Because an airbourne virus is able to spread more easily, the probability of greater or even exponential community spread becomes more likely, and by clearly defining those scenarios where a person needs to prevent spread of the virus by isolating, health officials hope to limit community spread of the new Omicron variants. 

The most recent Order by CDPH also states, “In addition, as the SARS-CoV-2 virus has recently evolved to have a shorter incubation period (e.g., average 2-3 days), CDPH recommendations regarding relevant time periods for restricting movement by quarantine have been updated to acknowledge this shorter period.” (See below) Looking to be proactive, community members can certainly maintain the early pandemic protocols of masking and physical distancing, as well as heed the advice of Public Health, which reiterates in the Order, “Unvaccinated persons continue to be more likely to get infected and spread the virus which is transmitted through the air and concentrates indoors.”  

As mitigation methods have not vastly improved since the turn of the century, good old fashioned hand-washing and basic hygiene standards in combination with masking, distancing and plenty of ventilation are recommended.  

“We must remain vigilant against variants of the disease especially given high levels of transmission in other parts of the world… COVID-19 remains a concern to public health and, in order to prevent its spread, limited and temporary public health requirements remain necessary at this time,” reads the CDPH Order issued June 8th, 2022. 

RANCHO Recommends…

In response to the ongoing prevalence of SARS-CoV-2 in rural communities, the Rural Association of Northern California Health Officers (RANCHO) – comprised of 11 different Health Officers – has provided a press release highlighting current COVID concerns and how to handle the ongoing COVID-19 scourge of cases in the region. 

Having seen in 2020 and in 2021 the ways in which COVID-19 was capable of impeding day-to-day functions of rural communities, RANCHO issued another press statement raising the alarm, as COVID continues to take a toll on local businesses and families as Northern California heads into a summer that was expected to bring reprieve from strict public health guidelines and give way to a more normal Nor Cal summer season of fairs and concerts, BBQs and Farmers Markets.

The report writes, “RANCHO counties are unique, apart from other rural areas in California, primarily due to our remote nature and mountainous terrain. As such, it is important that we take proactive measures to ensure our populations have the information they need to protect themselves, their loved ones, and their communities.”  Looking at an increase in cases, which has in the past routinely been followed by an increase in hospitalizations and in turn, deaths, RANCHO addressed the need for ongoing vigilance in the face of increased community spread at a time when people are enjoying summertime in northern Cali. 

Noting that an increase in cases has been known to impact hospitals in the region, local schools which have struggled to comply with COVID-19 precautions for the safety of families, local businesses whose employees regularly fend off the virus while on duty, and, of course, congregate living settings such as our nursing homes, housing shelters, and jails, regional health officers felt compelled to issue a statement regarding the rapidly circulating Omicron variant.

The report states, “Northern California counties generally lag behind the rest of CA for increased cases.”  RANCHO notes that the evolving surge is attributed to newer variants of Omicron, which have been found to be even more easily passed from person to person than previously, with the BA.4 and BA.5 subvariants currently out and about in circulation.  “The emerging variants are proving to be highly infectious and able to infect vaccinated persons in larger numbers than previous variants.” 

Addressing the question of vaccination, RANCHO wrote, “We also know that unvaccinated persons are 6 times more likely [to be] infected with COVID-19 and 9 times more likely to be hospitalized than vaccinated persons. Unvaccinated persons are also 11 times more likely [to die]  from COVID-19 complications than vaccinated persons.”  

In regards to natural immunity, which is recognized by CDC as providing some protection to some variants, the written statement from RANCHO adds, “Although there is some immunity provided after infection, it is not sufficient to prevent spread or variant progression.” The statement emphasizes that vaccination is the most reliable protection against long COVID, hospitalization, and death, adding that people who “become infected and are vaccinated, or receive vaccination after infection are best protected to ward off immediate and long lasting COVID-19 complications, including severe illness, long COVID, hospitalization, and death.” 

A screenshot reflecting data June 8th, 2022, presented by CDPH on the California COVID-19 Dashboard, showing Humboldt County’s current number of “COVID-19 hospitalized” patients, which began to spike in late May, and continued through June, and now July.

Reiterated by Humboldt County’s Public Health team which issues a weekly press release updating the public as to local COVID-19 stats and policy changes, if any, several of the recommendations coming from RANCHO in anticipation of summer in Rural Northern California addressed safety at public events and family gatherings. 

According to a Humboldt County Press relapse dated July 6th, “During this wave of increased COVID-19 cases, your Northern California Health Officers recommend:  

• “Get Vaccinated and Boosted if you are eligible. Infants 6 months or older and toddlers are now eligible to receive the COVID-19 vaccine. 
• Test before going to an indoors event or party or traveling on public transportation. If you have symptoms or test positive, stay home. Call your provider for effective treatments if you test positive for COVID-19. 
• Gather outdoors to make it harder for COVID-19 to spread to others. 
• Mask indoors in public places. Open windows to improve ventilation and upgrade HVAC filters to Merv 13 or the highest possible. Updated masking guidance from CDPH is recommended.”

This board includes Humboldt’s third Health Officer to grapple with the COVID-19 pandemic, Dr. Candy Stockton, who was named Humboldt County’s new Health Officer recently, and is expected to get started officially some time in the next week or two, according to the press release announcing her hiring.  Dr. Stockton hails from Humboldt County as a fourth-generation local, and is board certified in Family and Addiction Medicine. She also served as the Medical Director for Shingletown Medical Center in Shasta County for nine years, so she is not unfamiliar with rural healthcare, and she has spent nearly five years as the Chief Medical Officer for the Humboldt Independent Practice Association in Eureka. 

COVID-19 VARIANTS OF OMICRON VARIANTS 

In an article pre-published this week, currently in peer review process, the journal Nature published a scientific review in a report titled Antibody evasion by SARS-CoV-2 Omicron subvariants BA.1.12.1, BA.4 and BA.5.

Which suggested that Omicron variants are capable of “immune escape,” a term that describes the virus’ ability to dodge neutralizing antibodies from vaccination, and likely from previous infection.  

Genetic Engineering and Biotechnology News analyzed the finds presented in the study titled “Antibody evasion by SARS-CoV-2 Omicron subvariants BA.2.12.1, BA.4, & BA.5” and quotes Doctor Eric Topol saying, “[T]he Omicron sub-variant BA.5 is the worst version of the virus that we’ve seen.” 

According to the July 7 article, the online scientific news source writes, “The latest omicron subvariants of SARS-CoV-2—including BA.4 and BA.5—now make up the majority of COVID-19 cases being sequenced in the United States.”  In comparison to previous strains of COVID-19, these Omicron variants are creating debate as to how an influx of undetected cases may impact communities with limited access to medical infrastructure.

In regard to the new variants and their apparent ability to skirt antibody response, the article points out, “It takes immune escape…already extensive, to the next level, and, as a function of that, enhanced transmissibility—well beyond Omicron (BA.1) and other Omicron family variants that we’ve seen.” 

According to the research presented in Nature, a team of experts on infectious disease and immunology including David D. Ho, MD, director of the Aaron Diamond AIDS Research Center and professor of medicine at Columbia University Vagelos College of Physicians and Surgeons, “studied the ability of antibodies from individuals who received at least three doses of an mRNA vaccine, or got two shots and were then infected with omicron, to neutralize the new subvariants.”  

The report, steeped in scientific terminology and unfamiliar acronyms, states clearly in the Abstract, “These novel subvariants carrying additional mutations in their spike proteins raise concerns that they may further evade neutralizing antibodies, thereby further compromising the efficacy of COVID-19 vaccines and therapeutic monoclonals.”  

The suspected reason for this new and dangerous ability to spread is attributed to the additional mutations in their spike proteins, which have been “hypothesized to allow the variants to further evade neutralizing antibodies,” according to the article.  

LOCAL DATA & VACCINE UPDATE

Meanwhile, to focus locally, Humboldt has been coping with a surge of positive cases spanning several local communities impacting social gatherings and private business as people find themselves ill or identifiably exposed to a confirmed case of COVID-19.  

From Starbucks to the the county courthouse, locals are feeling the pressure of an ongoing case surge which began in late May, and continues to circulate in the community while summer fun is being had, pandemic-era guards are being lowered and masklessness has become increasingly more regular in public.   

A graph presented by Humboldt County’s COVID-19 Dashboard shows the current spike in cases rivaling the Omicron surge of early 2022.  Screengrab July 8, 2022.

Looking at the local data reflecting case counts, there was a sharp increase of COVID-19 cases detected in June, closely followed by a relative increase in hospitalizations.  While the vaccination train keeps chugging along, with the booster shot caboose still trailing behind, local residents are now able to vaccinate children at the age of 6 months and up.  The county offers free vaccination, and plans to offer “Public Health young child clinics” in order to make these vaccine doses available to families with young children. 

Here, we see the rate of vaccination by ethnicity, showing Humboldt’s progress per ethnic group. Screengrab July 8, 2022.

Although hesitation is being expressed by some parents in regard to vaccinating young children, the FDA stated that the vaccine is safe, and touts its effectiveness.  

FDA Commissioner Robert M. Califf, M.D. said, “Many parents, caregivers and clinicians have been waiting for a vaccine for younger children and this action will help protect those down to 6 months of age.  As we have seen with older age groups, we expect that the vaccines for younger children will provide protection from the most severe outcomes of COVID-19, such as hospitalization and death.”  The FDA Commissioner added, “Those trusted with the care of children can have confidence in the safety and effectiveness of these COVID-19 vaccines and can be assured that the agency was thorough in its evaluation of the data.”

The new baby vaccine, Pfizer’s three-dose vaccination series for children age 6 months to 4 years and Moderna’s two-dose vaccination series for children age 6 months to 5 years “has generated immunity at levels similar to the immune responses seen among young adults,” according to a press release from Humboldt County Public Health. 

Parents can also contact their family pediatrician or health care provider to set up an appointment or learn more about vaccine options. Pharmacies are not authorized to vaccinate children ages 2 and under.  More information about both vaccines is available at vaccinateall58.com. 

PROBABLE COVID, OR FOR SURE COVID? 

For the purposes of understanding updated terminology related to categorization of COVID illness in the population – going into the third summer of COVID-impacted activities – it is good to know what may be considered an official case of the Rona, and how to best avoid it putting a damper on your summer plans.  

New standards were established this year, helping to clarify what would be considered a “probable” or likely case of COVID-19 in an individual, as opposed to those cases that have been deemed “confirmed cases” in the community.  

A COVID case may be considered “probable” if any of the following fit the scenario: 

• “If a person tests positive via antigen (Ag) test for COVID-19, 
• If a person has been diagnosed with COVID-19 disease by a health care provider,
• If a person has symptoms of COVID-19 disease after being directly exposed or were in close proximity to a person having a PCR-confirmed test result,
• Or, If a person whose death certificate lists COVID-19 as a cause or significant contributing factor of their death, in the absence of a positive PCR test result.”

For clarification, the California Department of Public Health’s recommendations on isolation and quarantine for community members infected with, or exposed to COVID-19, a “Close Contact”  is defined as “someone sharing the same indoor airspace (e.g., home, clinic waiting room, airplane etc.) for a cumulative total of 15 minutes or more over a 24-hour period (for example, three individual 5-minute exposures for a total of 15 minutes) during an infected person’s (laboratory-confirmed or a clinical diagnosis) infectious period.” 

Then, if you are in that category of exposure, and therefore need to isolate or quarantine, the “Infectious Period” is defined differently depending on your level of exposure.  

For example, with symptomatic and infected persons, the “infectious period includes 2 days before the infected person had any symptoms through Day 10” after symptoms began to appear, “or through Days 5-10 if testing negative on Day 5 or later, and 24 hours have passed with no fever,” apart from fever-reducing medications, and that symptoms have improved, or in the al;ternative, “for asymptomatic infected persons, 2 days before the positive specimen collection date through Day 10 after positive specimen collection date (or through Days 5-10 if testing negative on Day 5 or later) after specimen collection date for their first positive COVID-19 test.” 

Also, for purposes of contact tracing potential exposures, “infected persons who test negative on or after Day 5 and end isolation are no longer considered to be within their infectious period.” It is still recommended that those folks continue to follow CDPH isolation recommendations, “including wearing a well-fitting face mask through Day 10.” 

An official case of COVID-19 is considered confirmed only after “positive PCR test results or detection of SARS-CoV-2 by genomic sequencing” and so, does at a minimum, require a PCR test like the ones available at no cost from the county, like at the Wharfinger Building in Eureka, where walk-ins are welcome, and PCR as well as rapid testing is available on a first-come first-served basis. 

Times and locations of testing sites can be found here, and vaccination clinics are updated and listed in each press release, here, as well as by appointment.  

This article is written by Ryan Hutson, a local freelance journalist. Follow Ryan at Humboldt Freelance Reporting on Facebook, Insta and YouTube. To support Ryan’s award winning reporting, please consider donating here.