Starting March 15, Californians of all ages over 16 who have disabilities or certain health conditions will be eligible to make vaccine appointments, the California Department of Public Health announced Friday afternoon. Healthcare providers will be allowed to use "their clinical judgement" to vaccinate those deemed to be at the very highest risk for morbidity and mortality from COVID-19, and those whose ability to receive care would be substantially impeded by an infection.
The list of recognized conditions included cancer, chronic kidney disease, chronic pulmonary disease, down syndrome, an immunocrompromised state caused by solid organ transplant, pregnancy, sickle cell disease, certain heart conditions, severe obesity and some presentations of type 2 diabetes mellitus. This list of eligible conditions is described as "subject to change" as the department gathers and analyzes more information about how COVID-19 presents in patients with other medical conditions.
New varients are indeed here
Santa Clara County determined via genomic testing last week that it has hosted at least one incidence of the South African COVID-19 variant.
An individual and another household member who had experienced symptoms after returning from international travel in mid-January tested positive for the variant. The traveler was isolated in their apartment during the entire infectious period because they were following the county’s guidance regarding post-travel quarantine, according to the county health department, which did not provide details on where they had traveled.
“This is an important example of how public health measures can help break the chain of transmission and why it is critical that we as a community continue to avoid travel and quarantine upon return,” said Dr. Sara Cody, county health officer and director of public health, in a written statement.
This case, and another one in Alameda County that also revealed the presence of the the B.1.351 variant first identified in South Africa, were both detected by genomic sequencing surveillance at Stanford University. The U.K. variant also has been detected in Santa Clara and Alameda counties, and was also closely tied to international travel, according to Cody.
“There are a few variants of concern – the South African variant is one of those. There are different concerns about each variant,” Cody said in a press conference Feb. 10 about the newest case. “Anyone returning from travel that is more than 150 miles from the county border must quarantine for 10 days. This person … was 100% compliant with that. That is what has prevented spread from this case further into the community here in Santa Clara.”
Cody said residents need to “double down” on all the preventive measures they are taking, “because we certainly don’t want any of these variants, if they are here, to spread any further – and that’s really, really important.”
Dr. Nicholas Moss, the health officer for Alameda County, said vaccines available in the U.S. are expected to be protective against the variants, and that while there may be some “variability,” “the early evidence suggests they will continue to provide protection.”
Moss added that the U.K. variant has been of most concern in terms of increased infectiousness, and that the degree remained an open question being researched.
Even as new variants raise new concerns, overall case counts have dropped dramatically across the Bay Area, with ICU capacity hovering at or above 20% in Santa Clara County. Vaccine availability also has improved for local eligible groups as rules adapt and providers receive slightly more certainty as to their weekly dose deliveries.
Most of the major medical providers in the Los Altos/Mountain View area have officially expanded their vaccination appointment eligibility to residents ages 65 and older, a process that had until recently been unevenly implemented. The county reversed its initial restriction of access to mass vaccination sites, which had been reserved for people who were not established patients at any other health provider.
Under the new “No Wrong Door” system, anyone who is eligible for the vaccine under the current tier can book an appointment for vaccination with the county health system, which has had access to many more doses (nearly 190,000) than many of the private providers such as Kaiser (50,575) or Palo Alto Medical Foundation (36,100).
The county is operating a vaccination helpline – (833) 560-0560 – to assist people with booking an appointment once they are eligible. The website sccfreevax.org lists different vaccination options by provider, including separate booking websites for the different county mass vaccination sites. The county also launched a series of “no appointment needed” pop-up vaccination sites in areas particularly hard-hit by infection last week, which will serve anyone eligible for vaccination under the current tier.
“The state’s complex vaccine distribution and allocation system, combined with vaccine supply shortages, has led to an uneven vaccine rollout across the county depending on where people get their medical care,” said Dr. Jeff Smith, county executive for the County of Santa Clara. “The ‘No Wrong Door’ approach we are implementing is designed to get available vaccines into arms as quickly and equitably as possible in order to save lives.”
As of last week, 13.4% of county residents older than 16 had already received one dose of the vaccine, and 3.6% had completed vaccination with both doses. Forty percent of residents 65 or older had received at least one dose.
Other COVID updates from the county this week:
• Santa Clara County is opening California’s largest vaccination site at Levi’s Stadium in Santa Clara this week, with an initial capacity to vaccinate 5,000 people per day, scaling up to 15,000 per day as the vaccine supply pipeline increases.
• New guidance from the Centers for Disease Control and Prevention last week included a more strongly worded recommendation for double masking – the practice of wearing multiple layers of face covering to more effectively prevent transmitting and receiving the virus. The CDC’s recommendation focused on how a double-layered series of masks better prevents gaps and air leakage, dramatically increasing the efficacy of blocking virus transmission. Wearing a cloth mask over a disposable surgical-type mask can dramatically reduce cumulative exposure, according to a CDC report released Feb. 10, which cited a 95% reduction in exposure to aerosolized particles when contrasted with less than 50% protection from an unmodified surgical or cloth mask worn solo. For more information, visit cdc.gov/coronavirus/2019-ncov/your-health/effective-masks.html.
• Break rooms have proven to be one of the most common areas of workplace COVID-19 transmission, so new guidance directs that the rooms must be closed aside from the use of appliances such as refrigerators or coffee makers, or for legally protected solitary uses such as breast pumping or breastfeeding. Employees may eat outdoors with co-workers, spaced 6 feet apart, per the county guidelines, which added that eating alone, either in individual workspaces or outside the office, is “still the safest.”
• Local and regional agencies have been warning about vaccine-related scams targeting older residents. Unsolicited emails or telephone calls requesting personal or medical information to determine eligibility for vaccine access or trials are likely to be a scam. Any offer to sell early access to vaccination is a scam. Any request asking you to pay out-of-pocket for vaccination or to join a waiting list is a scam. So are offers to ship a vaccine dose, or provide access to a “new” vaccine that has unverifiable status with the Food and Drug Administration. The FDA maintains current information about vaccine emergency use authorizations at fda.gov, and the county provides daily updates on vaccine appointment access at sccfreevax.org. To report suspected incidents of COVID-19 fraud to the FBI, call (800) 225-5324 or visit tips.fbi.gov. For more information on scams, visit ftc.gov/coronavirus/ scams-consumer-advice.