January will be a grim month, health experts said.
On the bright side: Two promising vaccines are now available to deliver relief from the relentless pandemic. On the other hand, the pace of vaccination nationally has been slower than expected, and the potentially rapid spread of a mutant strain could threaten another wave of infections beyond the holiday surge.
“It feels like we’re in the abyss right now, sinking toward the bottom,” said Dr. John Swartzberg, clinical professor emeritus in the division of infectious diseases and vaccinology at the UC Berkeley School of Public Health. “We’re not going to sort of get some balance in our lives again until probably sometime in February.”
As the nation’s pandemic death toll surpassed 350,000 on Sunday, intensive care capacity throughout most of California remained hugely stressed. In Bay Area hospitals, available capacity rose Sunday to a still-precarious 8.4%, from 5.1% a day earlier, according to state health data.
“We’ve got to get through this very dark month of January to get to feeling a lot better about where we’re going with the pandemic,” Swartzberg said.
The greater Sacramento region was at 10.3% ICU availability, and the San Joaquin Valley and Southern California regions both continued to have no availability in their standard ICU units. Both regions were relying on surge facilities to get through.
As of Jan. 1, 414,684 vaccine doses had been administered across California. The state had distributed over 1.7 million doses to health systems and hospitals as of Dec. 28.
With a mutant, apparently quickly spreading strain that has become dominant in the U.K. arriving in California, Anthony Armada, CEO at AHMC Seton Medical Center in Daly City, said he’s confident the vaccine will cover any variants. Seton, which has administered 900 vaccine doses so far to priority front line responders, had six of its 14 ICU beds occupied by COVID-19 patients Sunday. A second ward of 14 beds sits empty due to a regional shortage of ICU nurses.
“If Thanksgiving is any indicator, we can only predict an ongoing situation from the recent holidays with the surge, which I anticipate will last through the remainder of this month,” Armada said.
In Santa Clara County, hospitals are so jammed that health officials on Saturday reported that some ambulances have had to wait outside emergency rooms for up to seven hours for beds to open up.
The delays mean the ambulances cannot respond to other calls, and that firefighters have sometimes been called to convey people to emergency rooms.
There were no reports as of Sunday that other Bay Area counties had experienced similar delays for ambulances. In San Mateo County, while ambulance delays have not been an issue, officials “continue to monitor the situation closely,” spokesman Preston Merchant said by email, adding, “We also see this situation as a regional one, so strains in the Bay Area could affect any hospital in the region.”
Across California, as the crisis overwhelms hospitals in the southern and Central Valley regions, Gov. Gavin Newsom said he has activated a mutual aid system for hospitals, under which paramedics and other emergency technicians can be deployed to health systems in particular need for 14 days. One recipient is Petaluma Valley Hospital, which is getting some help from Solano County.
Even as hospitals struggle to keep up with the load of patients, debate is mounting over vaccine distribution, which some are framing as a race against time with the virus.
Dr. Robert Wachter, UCSF medicine department chair, wrote in a Washington Post opinion piece Sunday that health leaders had hoped for more than two vaccines by now.
Since a single shot of vaccine still offers substantial protection — though it is unclear for how long — Wachter suggested that people hold off for a bit on their second doses of what was designed as a two-shot regime until more vaccine doses are available. In the column, co-written with Dr. Ashish Jha, dean of Brown University’s School of Public Health, he wrote: “We hoped that additional vaccines would be available by now. But only the Pfizer and Moderna vaccines have been authorized, and they’re being produced more slowly than hoped. Even more worrisome are the distribution bottlenecks that are making it difficult to vaccinate people as quickly as possible.”
It’s an issue that has sparked vigorous debate among health experts, who are increasingly worried about the potential spread of the seemingly more infectious variant that has sent disease soaring in the U.K.
Swartzberg took a different view. In an interview Sunday, he said that while he had huge respect for Wachter, “The logistics of suddenly turning around in the midst of the administration of vaccines would be very formidable, and coming back in three to four months to vaccinate those people who only got one dose, I don’t know that they logistically know how to do that and whether it could be very effective if we wind up only getting one dose to an awful lot of people.”
He also said there is “almost no data on what kind of immune response will be sustained after one dose and that worries me a great deal. We could wind up in this very short-lived immunity for protection and wind up worse off than we were before.”
Meanwhile, evidence that the mutant strain has spread in California continues to mount. San Bernardino County has found two cases of the virus variant, and San Diego County has found one. Experts have no doubt that it is far more widespread, because most virus samples are not analyzed for their strain.
Even without the mutant, fast-spreading strain becoming dominant — which experts fear could happen in the U.S. as soon as the spring — hospitals will continue their grim, resolute struggle. “The problem is that we’ll be experiencing the consequences from the holidays throughout the month of January and that’s why it’s going to be so much worse,” Swartzberg said, adding that the surge in the first two weeks of December “was a direct reflection of the Thanksgiving effect.”
San Francisco Chronicle staff writer Sam Whiting contributed to this report.
Tatiana Sanchez is a San Francisco Chronicle staff writer. Email: tatiana.sanchez@sfchronicle.com Twitter: @TatianaYSanchez
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‘In the abyss’: Why Bay Area health care experts fear January - San Francisco Chronicle
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