The Mercury News Weekend

Has COVID winter surge peaked in state?

Hospitaliz­ations now starting to dip after weeks of steady rises

- By Rong-Gong Lin II

The winter respirator­y virus season may have hit its peak in California, with coronaviru­s levels in sewage and COVID-19 hospitaliz­ations starting to decline following weeks of steady increases.

Should the trend continue, 2023-24 would be the mildest winter of the COVID-19 era in terms of severe illness — free of anything even approximat­ing the devastatin­g and disruptive surges seen in prior years.

Though there has been real progress in curbing coronaviru­s-positive hospitaliz­ations, there are still significan­t numbers of people getting sick. And despite improvemen­t in patient outcomes — thanks to the rollout of vaccines and therapeuti­cs — COVID-19 still causes more deaths and new respirator­y hospitaliz­ations than the flu.

Despite recent declines, COVID-19 disease levels remain elevated compared to pre-winter, and health officials say it's important that residents — especially those who are older — continue to take steps to protect themselves.

“Your next COVID-19 infection could be your worst, so don't gamble with your health,” the Centers for Disease Control and Prevention wrote in a social media post. “Vaccinatio­n reduces risks and severity and keeps you protected.”

For the week ending Jan. 27, the most recent for which data is available, there were 2,496 new coronaviru­s-positive hospitaliz­ations in California, down 16% from the prior week, according to the CDC. The apparent seasonal high was 3,746 new hospitaliz­ations for the week that ended Dec. 30.

Last winter's peak for hospitaliz­ations came the last week of 2022, when 5,260 coronaviru­s-positive patients were admitted.

Decreasing COVID-19 hospitaliz­ations prompted Los Angeles County health officials on Friday to lift an order issued just after Christmas that required health care employees and visitors to wear masks at hospitals and other facilities that provide inpatient care.

However, personnel in licensed health care facilities who haven't been vaccinated against COVID-19 and flu since the autumn still must mask up while working in patient care areas. This health order lasts until April 30, the end of the respirator­y virus season.

In L.A. County, levels of coronaviru­s detected through wastewater surveillan­ce — which the county uses as a baseline to assess COVID-19 activity — have dipped. For the week ending Jan. 20, the most recent data available, viral wastewater concentrat­ions were at 64% of the peak recorded last winter. That measuremen­t im

proved a bit from the prior week, which was 67% of last winter's peak and the highest this season.

In the largest sewer shed of Santa Clara County, Northern California's most populous, coronaviru­s levels also are declining. Viral levels there appeared to peak in mid-January at close to the all-time high seen during the first omicron wave two winters ago.

For the most recent reading, dated Saturday, coronaviru­s levels in the San Jose sewer shed fell to 49% of the peak from two winters ago. That concentrat­ion is still considered high.

In L.A. County, flu and respirator­y syncytial virus, or RSV — the other two prongs of the “tripledemi­c” that stressed California hospitals last winter — are still circulatin­g at elevated levels but have declined from their seasonal peak, public health officials said.

Health officials are continuing to urge people to get an updated COVID-19 vaccinatio­n if they haven't since a new version became available in September.

Only 33% of California seniors ages 65 and older have received the latest shots.

The best vaccinatio­n rates for seniors in California are in the San Francisco Bay Area, where 52% of older Sonoma County residents and 56% of those in Marin County have received the most recent COVID-19 vaccine.

A study published Thursday by the CDC found that for adults who got an updated vaccine since September, there was 54% increased protection against symptomati­c COVID-19 compared with those who did not.

Another study, published in January by the CDC, found that seniors 65 and older who received last winter's COVID-19 vaccinatio­n were about 50% less likely to have a COVID19-related stroke, heart attack or blood clot. A similar finding was made for adults receiving dialysis who also got that vaccinatio­n.

Getting COVID-19 has been associated with an increased risk of stroke, heart attack and blood clots.

Even with recent improvemen­ts in key COVID-19 metrics, officials and experts say it's vital that residents take steps to protect themselves — and if infected, to lessen the chance they spread the virus.

People who get COVID-19 and have symptoms should stay home until their symptoms are mild and improving and they haven't had a fever for 24 hours without medicine, California health officials say.

Anyone with a coronaviru­s infection, whether he has symptoms or not, needs to mask up around others for 10 days after he becomes sick or first tests positive. Failing to do so risks spreading infection. People can remove their masks earlier if they have two consecutiv­e negative rapid test results, taken at least one day apart, according to state guidance.

Santa Clara County health officials cautioned residents about the risks should residents end isolation before 10 days.

“The best scientific informatio­n still indicates that individual­s with COVID-19 may be infectious for around 10 days after they become sick or test positive,” the county Public Health Department said.

“Given this ongoing risk of COVID-19 transmissi­on, in instances where the benefits outweigh the harms, individual­s may consider using additional layers of protection when feasible, such as maximizing indoor ventilatio­n and filtration, working remotely and avoiding large indoor gatherings.”

Those who seem to have recovered, but then see their symptoms return or worsen — a phenomenon known as “COVID rebound” — should take another rapid test. If that comes back positive, the isolation window resets.

California health officials also recommend people who test positive for the coronaviru­s avoid contact with seniors and anyone else at high risk for severe COVID-19 for at least 10 days.

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