COUNTY REPORTS NUMBER OF COVID-19 CASES STAYS STEADY

Some hospitals report rise in staff calling in sick

Coronavirus continues to generate a steady number of new cases, but there is as yet no sign that Memorial Day activity will send numbers straight up as was the case during the winter Omicron surge.

The latest COVID-19 report from the county health department, released Thursday afternoon, shows that the number of new case notifications from local labs and health systems has remained greater than 1,100 over the past week, pushing to nearly 2,000 last Thursday before falling as low as 1,151 Saturday, then building again, reaching 1,646 Wednesday.

That’s just 26 cases more than the daily report was one week ago, suggesting that, while plenty of people are becoming infected, existing levels of immunity from vaccination and previous natural infection are keeping the virus from building the kind of exponential momentum it did in late December and early January.

The region’s cumulative coronavirus case total is now greater than 800,000, though that count underrepresents the true number of local infections because home testing is now widespread, and results usually are not sent to public health departments for inclusion in weekly reports.

As was the case with the Omicron surge, the current wave of infections is gradually putting more people in hospital beds, though not at anywhere near the rate seen with original waves in 2020 through mid-2021.

On Wednesday, there were 237 confirmed and suspected patients with COVID-19 in local nonmilitary hospitals, slightly more than the 215 listed one week earlier.

Though its hospitals are far from inundated with coronavirus patients, UC San Diego Health moved to the red tier of its “new normal” plan this week, resuming weekly testing of staff who work in person at its facilities and also for patients undergoing medical procedures.

Dr. Chris Longhurst, the university health system’s chief medical officer, said that the program, which largely uses the amount of virus particles detected in local wastewater to determine its tier levels, represents a commitment to changing defensive posture as the risk changes.

“This is the reality we’re going to be living in for a few years unless there is a universal vaccine developed or something like that,” Longhurst said. “We’re going to continue to see these surges ... we’re going to be taking extra precautions for a few weeks and, when the numbers come down and the surge ends, we’re going to move back to yellow or green.”

Local coronavirus-related hospitalizations have continued to creep up over the past few weeks as the latest Omicron subvariants spread throughout the region. But a significant increase in the number of new infections has not caused a subsequent explosion in severe enough illness to require the kind of intensive medical therapies best delivered under 24-hour care.

Generally, Omicron and the versions of the virus that have come after it, does not produce the same kind of multiorgan attack seen previously. Those still getting sick enough to require a hospital stay, said Dr. Thomas Lawrie, a pulmonologist and critical care specialist with Sharp HealthCare, tend to be older, are much more often unvaccinated and generally suffer from several chronic diseases such as diabetes, high blood pressure and kidney disease.

While everyone who remains unvaccinated can significantly improve their odds by getting vaccinated, anyone who has those particular chronic illnesses, he said, should be extra cautious.

“They’re going to have a worsened hospital course, and they may advance more quickly to needing high-dose oxygen, mechanical ventilation and ICU stays,” Lawrie said.

As was the case with the winter surge, health systems are more concerned about staffing than about being crushed under the weight of too many COVID-19 patients with severe symptoms. All reported that, as expected, the number of staff calling out of work because they have themselves tested positive is on the rise. Officials at Rady Children’s Hospital in San Diego said this week that while it has not yet been necessary to cancel scheduled medical procedures due to lack of staff, that day could come before the current surge abates.

Lawrie had a similar take.

“It hasn’t truly impacted our operations yet, but, of all the things we worry about in the health system, I would suspect that’s it, that we’re at risk for a sickout,” he said.

Longhurst seemed a bit more optimistic as the weekend approached, noting that local wastewater data, which shows the bulk amount of virus particles detected, has not increased nearly as sharply as it did last winter. A slower rise, he said, provides time for one group of infected employees to make it through their illness and return to work.

“We’re seeing cases go up, but slowly, and so we’re not seeing this massive sickout,” Longhurst said.

Twelve additional COVID-related deaths are listed in the county’s weekly report. Five were fully vaccinated, and seven were not. Eleven had underlying medical conditions.