A spike in COVID cases since mid-July has been an ongoing concern for the Merced County’s Department of Health, especially as the number of children developing the disease has increased with the onslaught of the Delta variant.
Unvaccinated people remain at the greatest risk of serious illness and death.
The positive case rate is the percentage of those who will be screened for COVID-19 and will test positive for the virus. It should be 8 percent or less. On September 13th it was 9.8 percent.
Dr. Merced County’s Supervising Epidemiologist Kristynn Sullivan told the Times, “We have seen an increase in cases since mid-July.
“We still have well over 100 cases a day, and ideally it should be less than 20 a day. June had single-digit days, and since rising in July it rose rapidly, then stabilized between 100 and 200 cases per day.
“The highest single day of the surge was 239 cases. We had 198 cases on September 12th.
“Hopefully this wave is on a plateau, but we’re still seeing very high hospital admissions. As of Friday, September 10, there were 44 Merced County residents in Merced County hospitals.
“Regionally, we have 8.2 percent ICU capacity, from San Joaquin County to Kern County. The ideal is 15 percent or more.
“Surge plans are introduced when the capacity is less than 10 percent. Surge plans may dispatch more staff or use other areas of the hospital that are not the intensive care unit as an intensive care unit. For example, hospitals could convert their post-operative area into an intensive care unit, or they could create an additional floor with beds.
“From August 13th to September 13th we had 38 deaths. We had our first pediatric death in a child less than a year old. Fourteen deaths were in the age group 65 plus and in the age group 50 to 64 there were 15 deaths. The 35 to 49 age group had eight deaths.
“Usually the majority of deaths were in the over 65s group, but now we see that the majority are in the under 65s age group. 62 percent of the deaths last month were under the age of 65. “
COVID in children
Atwater High, Merced High, El Capitan High, Buhach Colony High, Golden Valley High, and Livingston High all had COVID outbreaks on September 7th.
In the Merced City School District, the Burbank Elementary, Peterson Elementary, and Sheehy Elementary had outbreaks on September 13.
Dr. Sullivan told the Times, “We’re seeing a lot more school breakouts in this wave. The Delta variant affects children more, but we also think that it is because children cannot be vaccinated and are therefore more susceptible. Anyone over the age of 12 can be vaccinated, but not anyone under the age of 11.
“Next, the 5- to 11-year-olds are eligible for the vaccination. Pfizer has collected this data and will submit it to the FDA for approval for emergency clearance.
“It takes a long time to collect the data, and with the 5-11 year olds, they had to change the dosage and find out which dose would be optimal. The age group 12 and older have the same dosage, but for the little ones they have to find out the least side effects and optimal protection. Therefore the data part took longer.
“The FDA then has to review it, and that takes several weeks. They’ll be quick to pursue it as a high priority item because they want vaccines available before winter and flu season, but they’re not going to take short cuts and make sure it’s safe.
“Much less is known about the long-term effects of COVID in children as the recent waves haven’t affected children very much, but there is some evidence. There is a very rare condition called Multi System Inflammatory Syndrome which is the most serious side effect of COVID on children. A few months after the COVID infection, they may have a fever, abdominal pain, diarrhea, headache, neck pain, rash, tightness, and chest pain and feel extra tired, and we have had a few cases in Merced County. It may require hospitalization, which we would particularly like to avoid with children. There have been 4,461 cases in the country. Only 41 children died from it.
“There are a lot of things we’d like to know more about, but it’s still a pretty big unknown, as it wasn’t until the time they went back to school that children got COVID on a large scale.
“The Variant makes the situation different. Last year when the kids went back to school they were on hiatus and we saw very little transmission in elementary schools, although we saw more in high schools where there is more intermingling. But we’re seeing a lot more transmission in schools this year, and we believe this is mainly because the Delta Variant is so much more portable.
“A school outbreak consists of three cases in the same class, an afternoon program, or a sports team, and there must be no external exposures that would explain the transmission. So there are three interrelated cases within one school location.
“We had some outbreaks in three cases and some that went beyond. It depends on how quickly we can get the test results back and connect, and how quickly we can close the classroom or sports team.
“I know there are a lot of concerns about schools, but schools are the only place where a lot of effort is made – quick contact tracing, lots of testing, and universal masking. Schools are probably still one of the safest places for our children.
“The greatest risk for children is still the loss of a parent, guardian or grandparent.
“The numbers are astronomical because we have had many deaths from COVID. The Lancet, one of the leading academic journals in the country, researched how many children have lost their caregivers. From March 1, 2020 to April 30, 2021, 1.5 million children worldwide died of a primary or secondary caregiver. A primary caregiver is a parent or guardian. A secondary caregiver would be like having a grandparent living in the house. “
Similar to statewide results, according to the Merced County’s Department of Health, COVID cases, hospital admissions, and deaths occur primarily in those who are not vaccinated.
The vaccination rate in Merced County for people 12 years and older is 44 percent fully vaccinated and 60 percent received at least one vaccination.
Dr. Sullivan told the Times, “The vaccination rate is increasing. We now have a fully FDA cleared vaccine so some people are more confident, but at the same time we continue to worry that we could have a fourth wave in winter if vaccination rates stay low.
“A high proportion of unvaccinated people makes variants worse because there are more options for the variants to stay alive in the population and keep in touch with vaccinated people, and then the variants that work best become to the vaccinated individuals can spread more dominantly, and that’s what happened with the delta variant.
“It’s like a race in which everyone is vaccinated against the variants. We see that the variant won this particular stage of this race.
“The details of the booster have yet to be finalized – does it make sense for the general population or should it be for the immunocompromised people who can already get it? It remains to be seen whether it is recommended for health care workers who are heavily exposed to COVID or for people who are over 65 years old and have a less powerful immune system. The details have yet to be worked out and there are many steps to be taken before we can fully determine who the booster is for.
“Research shows that the effectiveness of preventing COVID infection is sometimes not as strong, but the two doses even seven to eight months later are still very strong in protecting vaccinated people from severe COVID or death . Scientists are debating whether a booster would help and who it would help.
“The original goal was for the booster to be available by September 20th, and the FDA will meet on Friday to review the data.
Shortage of staff
“Right now there is a real shortage of staff, and that is everywhere. Other states are far worse off than us. Idaho has just introduced crisis standards where the health system is so busy that they have to triage treatment to keep some people out of care. There are also some of these in other federal states. So other states have much higher hospital admissions than we do.
“People have left the medical and public health sectors because they have been tired from the past 18 months. It just means that there is more staff shortage. We compete for these resources with the whole country.
“Merced County can sometimes get employees to come, but it costs a lot more money and they sometimes leave a lot faster. Sometimes the state intervenes and helps, but it looks like we’re on a plateau in cases, and that’s an indication that the worst of the wave may be over. “