San Francisco Chronicle

10 days: Isolate upon arrival — 2nd vaccine gets panel’s backing

- By Nanette Asimov, Catherine Ho and Erin Allday

As California set a singleday record for coronaviru­s deaths, San Francisco imposed a 10day quarantine on travelers arriving from outside the region.

New coronaviru­s cases hit a record high of 52,330 in a single day across California Wednesday, and the state recorded 51,209 new cases on Thursday. In the Bay Area, new cases topped 4,500 on Wednesday and 4,000 on Thursday, down from the bleak alltime high of 6,775 on Monday. The number of open ICU beds statewide fell to its lowest level Thursday, just 3%. That means just 1,260 intensivec­are beds were available for the state’s medical emergencie­s, down from more

than 4,500 in April.

Bay Area hospitals were doing better, but still hovered at dangerousl­y low levels. ICU availabili­ty rose slightly to 13.1% Thursday from 12.9% the day before.

California also set yet another record for singleday deaths. Across the state, 394 people died of COVID-19 Wednesday, topping the previous highest count of 295 lives lost to the virus, set just a day earlier. On Thursday, an additional 288 people died of COVID-19 across the state.

“Cases are accelerati­ng at a staggering rate, and we want to take every step possible to stop them,” San Francisco public health Director Grant Colfax said Thursday in announcing the travel order that takes effect at 12: 01 a. m. Friday.

With the frightenin­g trends Thursday came hope, however, as Bay Area hospitals vaccinated hundreds of health care workers, and the FDA’s independen­t advisory panel said that another vaccine, by Moderna, should be approved for adults. Final FDA approval could come as soon as Friday. It would be the second vaccine — after one from Pfizer-BioNTech — to gain approval for emergency use against the coronaviru­s.

The vaccines are similar, both using a new technology for vaccine developmen­t called messenger RNA, or mRNA, that injects modified, synthesize­d genetic material that prompts an immune defense. Tests have shown both to be at or near 95% effectiven­ess. But there are important difference­s: Pfizer’s is good for those 16 years old and up while Moderna’s is for those 18 and up, and Pfizer’s needs to be refrigerat­ed at a lower subzero temperatur­e.

“Today, even as this crisis accelerate­s, at last we have a ray of hope as we start to vaccinate,” said Dr. Sara Cody, the Santa Clara County health officer, at a news briefing at the county fairground­s, where a vaccinatio­n clinic opened. “We cannot normalize the devastatio­n that is around us, but we can have hope and see a path forward and a way out of this current crisis. We can see that this pandemic will not last forever.”

While counties wait desperatel­y for vaccines to arrive, their hope is that stayathome orders will reduce cases. The state’s orders were triggered this week for the nine Bay Area counties and Monterey and Santa Cruz counties after ICU availabili­ty fell below 15%. Six of the counties had earlier voluntaril­y adopted the restrictio­ns, which includes a ban on outdoor restaurant meals, gatherings and store occupancy above 20%.

“We have reached a point where COVID-19 is so widespread in California that just leaving the house is a risky behavior,” Dr. Mark Ghaly, California secretary of Health and Human Services, told The Chronicle.

With its quarantine, San Francisco joined one other Bay Area county, Santa Clara, which ordered a similar restrictio­n Dec. 2.

Under the quarantine, people traveling into San Francisco from anywhere beyond these counties — San Mateo, Santa Clara, Alameda, Contra Costa, Solano, Sonoma, Napa, Marin and Santa Cruz — are required to stay home and interact with no one outside of their household except in an emergency or if they need medical care. Doctors and first responders are among those exempted.

Violating the travel ban is technicall­y a misdemeano­r, Colfax said at a news briefing, adding that the county isn’t expecting to fine people but hopes people will comply “because it’s the right thing to do.”

“I know this is hard, and yet another sacrifice,” Colfax said. “But we are at a state that was unfathomab­le just a year ago. We have lost more people in this country due to COVID-19 than Americans who died in World War II.”

As of Thursday, COVID-19 claimed 310,699 people across the country, more than the 235,000 American soldiers who died in that war.

The travel quarantine is among many efforts the state and Bay Area have taken to try to crush the rising case counts, including a littlenoti­ced 10 p. m. to 5 a. m. curfew imposed days before Thanksgivi­ng and set to expire Monday.

“The curfew did nothing,” said Dr. Stephen Shortell, former dean of the UC Berkeley School of Public Health. “It’s really the shelter-at-home measures now that will help in preventing things from getting worse than they already are. But that will depend on our ability to follow them.”

But Shortell and Dr. John Swartzberg, an infectious disease expert at UC Berkeley, both expressed doubts about how committed the public is in following the largely voluntary restrictio­ns.

“I’m pretty discourage­d,” Swartzberg said, but emphasized that that was not because masking, social distancing and staying home don’t work. Those methods work well at keeping the virus at bay, as demonstrat­ed in the Bay Area last spring, he said.

Now, “for whatever reason, including COVID exhaustion,” he said, “people are not being as careful as they need to be.”

Both experts said the new restrictio­ns are essential to try to halt rising case counts but should have been imposed at least a week earlier. And both agreed that California­ns across the state are in for a rough ride over the next month or more.

Yet the arrival of vaccine offers hope of vanquishin­g the pandemic in 2021.

Santa Clara County began vaccinatin­g Thursday, starting with about 210 doses administer­ed to nursing home staff. Hospitals were expected to receive their own vaccine shipments Thursday and Friday.

Cody, the Santa Clara County health officer, said the county would vaccinate “as quickly as we can” at the fairground­s. “The limit is the number of vaccinator­s and appointmen­ts that we have,” she said.

The county is reporting an average of more than 1,000 coronaviru­s cases a day, Cody said, and its hospital and intensive care capacity is concerning.

“It’s going to be a difficult several months in front of us, but we can march forward with hope,” Cody said. “I’m delighted to know that one day I too will be vaccinated.”

Staff at skilled nursing facilities were among the first group to be vaccinated because nursing home residents have made up such a high percentage of deaths in the county, said Dr. Marty Fenstershe­ib, the county’s COVID-19 testing and vaccine officer.

Nursing home residents make up about 5% of all cases in the county but 45% of deaths. When outbreaks occur, they are almost always traced to staff members who unwittingl­y bring the virus into the facilities.

In San Francisco, UCSF said it was poised to vaccinate 500 people a day through the weekend. On Wednesday, 220 people were vaccinated, the hospital’s chief pharmacy executive, Desi Kotis, announced.

“We are getting a great response,” she said. “People at the front lines are getting vaccinated.”

 ?? Photos by Jessica christian / The chronicle ?? Marin County Fire medics Kevin Stone ( left center) and Matt Cobb prepare doses of the vaccine as nurse Philip Tow ( right) readies a dose for Nenita Antonio.
Photos by Jessica christian / The chronicle Marin County Fire medics Kevin Stone ( left center) and Matt Cobb prepare doses of the vaccine as nurse Philip Tow ( right) readies a dose for Nenita Antonio.
 ??  ?? Stone administer­s a dose of the Pfizer COVID19 vaccine to nutritioni­st Elisha Calitina outside of the Tamalpais Marin assisted living facility in Greenbrae, where she works.
Stone administer­s a dose of the Pfizer COVID19 vaccine to nutritioni­st Elisha Calitina outside of the Tamalpais Marin assisted living facility in Greenbrae, where she works.

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