Consider this California’s first coronavirus wave of the endemic era.
Even with the increase in home testing not making official statistics, the state is now reporting more confirmed cases per day than it did at the peak of the summer 2020 spike and is nearing summer 2021 spike levels.
But while officials and public health experts are concerned about rising transmission rates, they don’t expect a disease onslaught to overwhelm hospitals like previous surges have.
“Most of the people we see in the hospital have very mild illness compared to the previous waves,” said Dr. John Mourani, medical director for infectious diseases at Pomona Valley Hospital Medical Center.
Many factors play a role, experts say. While the currently dominant variant is extremely contagious, it appears to cause less serious illness than previous forms of COVID-19, said Dr. Robert Kim-Farley, a professor at the UCLA Fielding School of Public Health and an expert in epidemiology and infectious diseases. High rates of immunity to vaccination or previous infection also protect people who become ill from serious illness and death, and medical treatment has improved.
“This is what endemicity looks like,” said Andrew Noymer, professor of population health and disease prevention at UC Irvine.
Compared to a pandemic — a global emergency — endemic means a virus is “always with us, circulating, and may have flare-ups from time to time, but because it’s less deadly due to vaccination and natural immunity, the severity.” don’t put as many people in the hospital,” Kim-Farley said.
Still, he said, the rising case numbers should be a wake-up call for people to get vaccinated or boosted if they aren’t already, and to take other proper precautions.
“We need to be more vigilant, especially in crowded environments, to wear a mask to reduce the rate of transmission,” Kim-Farley said. “Masking is also important for people who are at higher risk of disease, such as B. elderly or people with multiple diseases or especially immunocompromised.”
Cases double in three weeks
California reported an average of 11,200 cases per day for the week ended May 17 — the most recent week of reliable data because the numbers are based on the day a person got tested or got sick, not when their results came back and the Results take time.
That’s double the cases of just three weeks earlier and more than five times the recent low of about 2,100 cases per day in the week ended March 21.
Cases have risen in all counties in California, but increases have been sharpest in rural northern and central regions, while the Bay Area currently has the highest case rates when population-adjusted.
San Francisco added 378 confirmed cases per 100,000 residents, according to the latest state data May 11-17. Del Norte, Santa Clara, San Mateo, Sonoma and Marin counties also all had more than 300 cases per 100,000 people.
Rates were lower in Southern California: 206 in San Diego County, 200 in Los Angeles County, 143 in Orange County, 132 in Riverside County, and 105 in San Bernardino County.
Kim-Farley said a big reason the Bay Area is doing worse now might be that it did much better than Southern California in earlier waves, meaning there are more people there who are still vulnerable.
California as a whole has fared better than some other parts of the US — much of the Northeast and parts of the upper Midwest have high levels of COVID-19 in the US, according to a CDC measurement based on both case and hospitalization rates community up. California has a handful of mid-level counties, including LA County as of last week, but most of the state is still considered low.
“I think we have to look to the Northeast to see that we may be expecting further increases here in Southern California, but at the same time I’m confident that we tend to use masks more than we do in the Northeast, so maybe that’ll help scale the height of the.” increase,” said Kim-Farley. He also noted California’s higher vaccination rates among seniors and higher rates of booster shots.
Hospitalizations up but still low
Case counts in California may be back in summer tide range, but luckily hospital admissions aren’t.
In the most recent day, as California’s daily average of new cases topped 10,000, nearly 1,400 people nationwide were hospitalized with COVID-19. In earlier times, when the case rate exceeded 10,000, many more people were hospitalized:
- Almost 6,400 in the summer of 2020
- Almost 3,700 increase in winter 2020
- Around 4,000 rising in the summer of 2021
- About 3,500 during the winter 2022 surge
As of Tuesday, May 24, California hospitals were treating 1,961 people with COVID-19; The only times this number has been lower has been the last two months and about a three month period in 2021.
It’s not all good news – the number of people in hospital and intensive care units has doubled from their record low last month. In Southern California:
- In Los Angeles County, 410 patients were hospitalized, including 52 in the ICU, down from lows of 209 and 19.
- In Orange County, 129 patients were hospitalized, including 18 in the ICU, down from a low of 57 and eight
- Riverside County had 93 patients hospitalized, including nine in the ICU, down from lows of 36 and four
- In San Bernardino County, 60 patients were hospitalized, including eight in intensive care, down from a low of 28 and four
But as Mourani, the doctor at Pomona Valley Hospital Medical Center, points out, not everyone is in the hospital With COVID-19 is here to the COVID-19. For example, someone may come in for a fall or fracture and test positive, but their case is mild or asymptomatic. Other people may be in the hospital because the virus has made an underlying condition, such as diabetes or heart disease, worse.
Mourani estimated that around half of the patients with COVID-19 at his hospital lately were there specifically for COVID-19.
These patients, he said, are mostly older or have underlying conditions. And while the percentage of vaccinated COVID-19 patients is higher than it used to be, Mourani said it makes sense as a larger part of the community is vaccinated. The vaccinated patients usually get sick easily, he said.
According to the latest government data, unvaccinated people were 4.9 times more likely to contract COVID-19 than vaccinated and boosted people in the past few weeks. They are 7.4 times more likely to be hospitalized and 9.1 times more likely to die from the disease.
Accurate death data could be weeks or months away, so it’s hard to say what the current surge in cases will mean for death rates.
Mourani said he hopes the virus continues to become less deadly with less severe illness and better treatment options. (He also emphasized that treatments are most effective when started as soon as possible after a person first feels symptoms — when patients come to the hospital with severe symptoms, the disease is usually late and more difficult to treat.)
But while the Omicron variant may not be as deadly, it still kills humans. Omicron was identified last Thanksgiving, and state data shows at least 12,700 people died from COVID-19 from December through February, making it California’s second-deadliest outbreak to date.
So what next?
No one can predict how long the current wave will last, but Noymer said virus levels in Massachusetts’ wastewater are starting to fall, which could be an early sign the surge is slowing, allowing other parts of the country to follow suit.
Government data also suggests that while case numbers are still rising here, the pace of the increase may be gradually slowing.
When a disease becomes endemic, as COVID-19 is now, it will come and go in cycles. New variants will emerge, and while evolution tends to favor milder strains — if a virus kills its hosts too quickly, or makes them too sick to spread, it can’t spread — experts say there’s no guarantee it will there that some of these variants don’t be worse.
Noymer pointed out influenza: there was a catastrophic pandemic starting in 1918 and the disease eventually became milder, but there were pretty bad outbreaks in the 1950s and 60s.
“And so you can’t say it’s always going down,” he said.
