Santa Clara County public health officials hope to be able to inoculate 85% of the eligible population with the COVID-19 vaccine by Aug. 1, a timeline that means health-care systems would need to push out 13,000 doses a day into arms.
In announcing the mark during a County Board of Supervisors meeting on Tuesday (Jan. 12), Dr. Marty Fenstersheib, the county’s COVID-19 testing and vaccine officer, acknowledged that it will be a “difficult goal to reach.” Nonetheless, the county will attempt to reach herd immunity by mid-summer. But even if health-care systems ramp up capacity and mass vaccination sites run smoothly, major concerns such as the amount of vaccine available, the constantly changing state and federal guidance and hesitancy among residents remain.
The county has begun offering vaccinations to residents aged 75 and older, expanding beyond health-care workers and long-term care facility residents to those in Phase 1B. But it runs behind the state’s announcement earlier this week opening up vaccinations to those 65 and older. The issue is actually getting enough vaccines to match capacity.
As of last week, the county had received 166,900 doses of the COVID-19 vaccine. The county asked the state for 100,000 additional doses on Monday, but according to county executive Dr. Jeff Smith, only received 6,000.
“That’s not going to be enough,” he said. “Our limiting step at this point is access to vaccines.”
El Camino Health, which is listed as a vaccination site for those who are not patients of larger health-care systems like Kaiser, Stanford or the Palo Alto Medical Foundation, saw all vaccination appointments booked for the next two weeks within hours of opening up its online appointment system to those aged 75 and older last Wednesday, though by Thursday morning it had opened up more slots beginning next week. A spokesperson noted that vaccine supply from the county is critical to continue expanding access.
Smith added the county will continue to push the state, which has faced criticism for a slow rollout thus far, for more vaccines. Uncertainty at the federal level as to how the Biden administration might differ in its vaccination plan has led to frustration locally.
“Every other day we seem to get a different message from the state or federal government,” Fenstersheib said.
And while there has been strong demand from the public for the vaccine, there is too much hesitancy – even among health-care personnel – for comfort. Fenstersheib noted the county has seen “many instances” of people afraid of the approved vaccines due to misinformation or pressure from friends and family.
In the meantime, county hospitals remain inundated with COVID-19 patients from the holiday surge, and morgues are filling up. With 689 patients hospitalized with COVID-19, the number is 3.5 times higher than at any other point during the pandemic. Daily case rates remain five times higher than the previous peak. Health officials believe the rate of increase in both cases and hospitalizations has become less steep and might be heading in the right direction.
But the damage has already been done.
With ICU capacity hovering in the low single digits and around half of ICU beds taken up by COVID-19 patients, hospitals have deferred nonemergency procedures and ramped down outpatient operations. Dr. Ahmad Kamal, the county’s COVID-19 director of healthcare preparedness, warned that this will lead to non-COVID-19 patients not receiving the necessary care for serious health conditions – because those sick enough to seek ICU care are in immediate need of medical attention.
Even if ICU capacity increases from here on out, it won’t be enough. Kamal expects the county to incur a prolonged “debt” in deferred medical care.
“We will be paying off this debt for months and years to come because these people are going to get sicker and their needs are going to increase,” he said. “They’re not going to go away.”
The only solution is to mitigate the strain on already maxed-out hospitals that are “performing a high wire act,” said Dr. Sara Cody, the county’s public health officer. Even as Cody cited a New Yorker article praising the Bay Area for faring better in preventing COVID-19 deaths than New York City and Los Angeles, she offered remorse for the 1,000-plus deaths in the county alone.
“I wish we could have prevented more hospitalizations and prevented more deaths,” Cody said. “I feel that each one of these deaths was preventable in some way.”