COVID-19 update evokes emotions

The dire public health emergency facing the divided Tuolumne County community came to an emotional head Tuesday as county public health officials and the hospital’s chief medical officer updated the elected Board of Supervisors on the latest COVID-19 surge that had claimed the lives of at least six people in the past week, including an unvaccinated man in his 20s who died Monday at Adventist Health Sonora.

“He was the same age as my son,” Michelle Jachetta, the county public health director, told the board in a public meeting Tuesday morning. “These are our neighbors, friends, and family members. They are not just numbers.”

More coronavirus deaths in Tuolumne County were expected to be announced later Tuesday, as the county’s case rate has reached another all-time high, Jachetta said.

Between 80% and 90% of the new cases have been among unvaccinated individuals, and no vaccinated individuals have been placed in intensive care or died, said Dr. Alex Heard, Adventist Health Sonora’s chief medical officer.

The roughly 90-minute update, streamed on multiple public platforms, came less than 24 hours after violence erupted at an anti-vaccine protest in Courthouse Square (see story, this page) and showcased opposing points of view that have split county residents on how to confront a deadly virus that is now killing young, healthy people with no underlying conditions.

Health professionals versed in science updated elected leaders who asked questions casting doubt on vaccines and questioning county mandates on masks, testing, and proof of vaccinations. Some members of the public riffed on international conspiracy theory and one claimed she gets sick when she’s around vaccinated people.

“I’m at a loss, there’s so much misinformation here,” Ryan Campbell, the board chairman and District 2 county supervisor, said. “We’ve had six people die in the past week. We have to do something about it. We don’t have many tools at our disposal. But as an employer, the county can at least require employees to wear masks and get tested once a week.”

The update was a non-action item, and the board took no action on possible mandates for county employees on Tuesday.

At the start of the update, Jachetta said the county’s case rate, 54.9 per 100,000 population, far exceeds the rate of 10 per 100,000 that would

have placed Tuolumne County in the most-restrictive purple tier under the old Blueprint for a Safer Economy.

Jachetta also broke down COVID-19 hospitalizations between May 1 and Aug. 16 by age groups. In the group for children under age 18, three individuals had been hospitalized and none were ever placed in intensive care. For individuals between the ages of 18 to 49, a total of 17 had been hospitalized and two were placed in intensive care. Among those between 50 and 65, 16 individuals had been hospitalized and two were placed in intensive care. For those 65 and older, a total of 37 had been hospitalized and 10 were placed in intensive care.

Later Tuesday, Jachetta emphasized there may be a data lag, and because of the constantly evolving status of hospitalized individuals, there is a possibility that a person may have been in the ICU and county public health was not aware of it.

Asked for clarity on how the surging pandemic is impacting the only hospital in Tuolumne County, Heard said, “We are full. Our ICU is full. Over the last two weeks, we have seen cases peak since the beginning of the pandemic. We're thinking about delaying all elective surgeries. Our staff are exhausted. They've been doing this for 18 months. They are the tip of the spear, working with the sickest patients.”

Unprompted, Heard added, “This is a time when we as a community should be pulling together, rather than dividing.”

David Goldemberg, District 1 county supervisor, asked for more details on how full the hospital is.

“We're full,” Heard said. “They're not all COVID patients. All beds are full. Every morning I come in, a couple people are waiting for hospital beds.”

Anaiah Kirk, the District 3 county supervisor, asked Heard if there were any patients in intensive care who had been vaccinated against coronavirus. Heard responded, “Not in the last three weeks.”

Putting off elective surgeries to further accommodate COVID patients is a concern at Adventist Health Sonora, because delayed surgeries often become more pressing, urgent needs, Heard added.

Heard also said such surgeries comprise a significant portion of hospital revenue and are an “economic engine” for the hospital, which is one of the county's largest employers.

Kirk asked if hospital mandates requiring health care workers to present proof of vaccination by Sept. 30 are a worry, and whether the mandate could result in an exodus of health care workers who refuse to get vaccinated.

“It's a deep concern we have every day,” Heard said. “People who are unable to get vaccinated may be leaving health care.”

“Could the mandate undermine the health care system?” Kirk asked.

“It could,” Heard said. “We are waiting to see.”

“It's very polarizing right now,” Kirk said.

Kathleen Haff, the District 4 county supervisor, said she agrees the community needs to come together. She proceeded to ask questions about COVID-19 treatments that are not being distributed, and why individuals who have caught coronavirus and gained natural immunity are not being acknowledged.

“Nobody should worry about asking questions that might hurt my feelings,” Heard said. “Most treatments over time have not affected the mortality rate at all, and some have had negative effects ... Immunity, there's evidence that having had COVID does present immunity. It comes down to, do we believe in natural immunity and trust it, or do we want the belt and suspenders approach with vaccinations?”

Heard estimated that to reach herd immunity in Tuolumne County, some 26,000 more residents need to get vaccinated or get sick with COVID-19. As of Tuesday, 44.6% of the county's population was fully vaccinated.

For COVID-19, the percentage of the population that needs to be infected to achieve herd immunity is estimated to be about 70%, assuming lasting immunity is possible, according to the American Lung Association.

Heard said that right now “the COVID genie is out of the bottle, and it's here to stay.”

Looking forward, Heard said predictive models put together by the acting county health officer, Dr. Eric Sergienko, and state public health indicate the current surge could peak in Tuolumne County between this Friday and Sunday.

Goldemberg noted that with at least five deaths in the past week, “This hardly sounds like a surge coming to an end quickly.”