With county COVID numbers moving decidedly in the wrong direction, county supervisors got a sobering earful from their own public health authorities and medical doctors from Cottage and Marian hospitals this Tuesday, August 17.
When it comes to the number of hospital and intensive-care beds now available for patients with COVID, County Public Health czar Van Do-Reynoso said Santa Barbara County “is in the cusp of the red zone.” Translated, that means 64.5 percent of all hospital beds and 76.6 percent of all intensive-care beds are now in use.
The good news is that COVID cases in Santa Barbara County — particularly those propelled by the more contagious Delta variant — are not going up quite as fast as they had before the county declared its mask mandate for indoor use two weeks ago. The bad news is that they’re still going up. Either way, the numbers are startling.
As of Tuesday evening, 112 new cases had been reported, bringing the number of known active cases in the county to 823. A week ago, that same number was 467.
Severe cases requiring hospitalization have also risen dramatically, 89 percent of which involved individuals who were not vaccinated. As of Tuesday’s end, Cottage and Marian reported a total of 65 patients hospitalized because of COVID; 15 of those were in the ICU. A week ago, both hospitals only had a total of 37 patients, seven of whom were in ICUs.
The human infrastructure of health care is harder to quantify. But this Tuesday, the strain was obvious. “We’re grateful for this appreciation,” said Dr. Lynn Fitzgibbons, an infectious-disease specialist with Cottage Health, commenting on the shower of gratitude expressed by Do-Reynoso and the county supervisors, “but we’re exhausted.”
Her face said the same thing, only louder.
After 18 months of arm-wrestling a global pandemic, she said, the rules of the game have changed drastically with the emergence of the new Delta variant. It may as well be, said Fitzgibbons, a whole new disease and whole new pandemic.
The Delta virus had an R0 rate — the metric for measuring spreadability — of 6 or 7. The earlier Alpha variant was 2-3. Delta, it turns out, adheres faster the nasal mucosa. It starts replicating itself in the body before the body’s immune system can begin fighting back. Its viral load is 1,200 times higher than the Alpha variant.
People already vaccinated are susceptible to infection; even if they don’t get sick, they can still spread it. Fitzgibbons played out the chain reaction of infection for those exposed to the Alpha variant as opposed to the Delta. “It’s a few thousand cases versus tens of millions,” she said.
With school starting this week, Fitzgibbons noted, the pressing concern is over the safety of returning schoolkids. “Our staff is working so very hard right now … engaging in discussions as to how we’re going to care for the potential influx of pediatric cases,” she said. “Man, I wish we weren’t having to talk about that right now.”
Making these concerns more urgent, according to Dr. Henning Ansorg, Santa Barbara’s Public Health Officer, are new studies indicating that the Delta surge could peak this October, with students back in school and no vaccinations approved for children, even though South County school districts are requiring students, faculty, and personnel to wear masks.
The supervisors invited Dr. Fitzgibbons and her counterpart from Marian, Dr. Chuck Merrill, to speak in part because it turns out medical professionals enjoy the most credibility when discussing COVID with the public, especially with those reluctant to get vaccinated.
In Santa Barbara, 63.3 percent of those eligible have now been fully vaccinated. But that leaves 142,006 eligible individuals who have not been vaccinated. Ansorg repeatedly made the case why he believed vaccinations — coupled with indoor mask wearing — still provided the best protection available, even with “breakthrough” infections involving people already vaccinated.
Based on new studies from Scotland and Israel, he said, the existing vaccines reduce one’s odds of becoming infected from 60-85 percent. For those who do get infected, he said, the vaccines significantly reduce the severity of symptoms and the chances of being hospitalized, placed in an ICU, or dying. The vaccine also accelerates the speed at which the body sheds the virus, reducing the time of infection from 10 days to five. And masks, he stressed, greatly reduce the spread of the disease.
About 10 vaccine skeptics spoke out against the prospect of a mandatory vaccination policy — a possibility Ansorg, the only one with the legal authority to impose such a requirement, never mentioned once.
They alluded to other treatments that are more effective and less intrusive on civil rights. They extolled the virtues of natural immunity, which they argued is far more widespread than believed.
Several accused the supervisors of being unwitting pawns to a totalitarian power grab that will benefit the pharmaceutical industry. Many bristled at “the shaming and blaming” and of being dismissed as stupid and ignorant conspiracy theorists.
Terri Strickland, owner of the Hitching Post, took exception to the board’s reliance on Fitzgibbons and Merrill as de facto witnesses to rebut their claims. “We have all these smart doctors who are going to tell us what to think and what to believe,” she said sardonically. “They’re not the only doctors in the world.”
The board debate was relatively subdued, however. Supervisor Bob Nelson — the most conservative member of the board — said he “accepted the vaccine is the best protection,” but he expressed doubts about masks. He worried that masks — when worn too often — may spread the virus more than they restrict it.
More than that, Nelson worried that mask mandates may inspire more resistance in people on the fence about getting vaccinated. “Like it or not,” he said, “masks have become politicized.” As for calling skeptics and resisters names — like “anti-vaxxers and anti-science,” he said, “That hasn’t helped at all.”
Supervisor Joan Hartmann acknowledged the public health message has shifted but insisted it had to. “It’s not that we’re moving the goalpost,” she said. “It’s that we’re adapting as the virus changes.” No one hates wearing a mask more than she does, she said; they make her glasses fog up and her sinuses run. “But masks and vaccines are a small price to pay for keeping our kids in school.”
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