‘Wait and see’: Health officials “cautiously optimistic” as COVID cases drop in Bay Area, state.
The rates of new coronavirus cases and hospitalizations fell sharply in the Bay Area and across California over the past week after hovering at worryingly high levels through the summer.
With the state’s positivity rate dipping to 3.5% on Wednesday — less than half the 7.2% it reached during the August peak — health officials feel cautiously optimistic that the fourth wave of the pandemic is waning three months after the state’s June 15 reopening, when most restrictions were lifted.
Since Sept. 7, the Bay Area has averaged 16 new daily cases per 100,000 residents, down from 30 per 100,000 recorded during the first week of the month. Hospitalizations are also falling. There are now 785 people hospitalized with COVID in the region, down from a peak of 1,130 in late August.
But as winter approaches, in-person school
resumes, and many offices reopen in the shadow of the highly contagious delta variant, it’s hard to predict if the encouraging trends will hold.
“We’re going to have to wait and see,” said Dr. Grant Colfax, director of the San Francisco Department of Public Health. “One thing we’ve learned from this virus is to be humble, be prepared to be resilient, and be flexible.”
There have already been setbacks: On Tuesday, California became the only state in the nation to advance from the Centers for Disease Control and Prevention’s “high” community transmission category to “substantial.”
By Wednesday, it was back in the worst tier, though California continues to have the lowest seven-day case rate in the nation, federal statistics show.
Rates of infection among the state’s unvaccinated residents continue to be much higher — 71.03 per 100,000 per day for the week ending Sept. 4, compared with 8.9 per 100,000 for vaccinated Californians during the same period. As long as there are substantial numbers of unvaccinated people, there won’t be an easy off-ramp for the pandemic.
“While vaccinated people can be infectious, they are still less infectious than people who are unvaccinated,” Dr. Erica Pan, the state epidemiologist, said Tuesday.
California will likely continue to see surges with diminishing impact over time as the state reaches a level of immunity that provides strong protection against hospitalization and death through vaccination or infection, said Dr. Julie Parsonnet, an infectious disease expert with Stanford.
“The virus is not likely to disappear,” she said. “What we are likely to see is cycles of infection. The peak of those in terms of serious disease is going to keep dropping. I’m hopeful this will become a low-grade endemic disease.”
One concern is the uptick in new cases in children, especially those under the age of 12 who are not eligible to get vaccinated against COVID-19. But unlike other parts of the country that have seen hospitals overwhelmed by delta variant cases, California has remained stable.
“Yes, we are seeing an increase in pediatric cases,” said Pan. “But it has not dramatically changed our pediatric hospitalizations.”
Children have accounted for less than 3% of all virus-related hospitalizations in the state, she said. There have been 33 pediatric COVID-19 deaths since the start of the pandemic, compared with an average of under 25 in the most recent severe flu seasons.
“It’s definitely more serious than flu in California,” Pan said, saying children under 2, and in some instances under 5, are at highest risk for severe outcomes related to the virus.
COVID-19 vaccines for younger children are unlikely to change the overall trajectory of the pandemic in California, though experts welcome the news that federal authorities could approve shots for 5- to 11-year-olds by late October; and for those under 5 by the end of the year.
“Young children are not big transmitters of COVID so I don’t think it will have a big impact on the epidemiology of the disease,” Parsonnet said. “Children are still much safer against COVID than adults. They are less likely to be hospitalized and less likely to die.”
Nearly all Bay Area hospitals contacted by The Chronicle reported that the number of pediatric patients remains low, even with schools reopening for full-time in-person instruction.
Pan cautioned that vaccination administration statewide has dropped off in recent weeks, which could lead to a reversal of some of the progress officials are seeing. She said fatigue is also setting in, hampering contact tracing efforts: “People are not answering their phone anymore when the public health department calls.”
The experts agree it will take more work to get California back to the low case numbers and hospitalizations it saw in May, before the state reopened.
“I’m hopeful we will continue to see a decline in cases and hospitalizations,” said Colfax. “When you look at how much the city has opened and the activities that have returned, the broader picture of where we are right now compared to where we were even in previous surges, is something to be cautiously optimistic about.”