How bad could California’s winter coronavirus surge get?

Public health researchers concerned because COVID appears to follow a seasonal pattern

By Soumya Karlamangla

New York Times

As you probably remember, the winter coronavirus surge in California last year was nothing short of catastrophic.

Emergency rooms were so full that ambulances often had nowhere to drop off patients desperate for treatment. Hospitals needed refrigerated trucks to manage the overflow of bodies in their morgues. In less than three months, California’s death toll from COVID-19 more than doubled.

So, with our second pandemic winter nearly upon us, will disaster strike again?

Coronavirus cases in California have been ticking up since late October. The state is preparing for the possibility of a winter surge — what Gov. Gavin Newsom last week called his “biggest anxiety.”

But unlike last year, 76% of Californians have gotten at least one dose of a coronavirus vaccine. That means that while the holiday season may again lead to more transmission of the virus, the consequences will be less ruinous, experts say.

“I don’t think we’ll have the same huge peak we had last winter, but I do think we will see another peak,” Dr. Timothy Brewer, an infectious-disease expert at the University of California, Los Angeles, told me. “And the big difference will be because of the large number of people vaccinated.”

Why numbers will keep climbing

Getting your COVID-19 shots remains the best way to protect against serious illness. And as of last week, all Californians can now receive booster doses to enhance immunity.

But the fact remains that some 9.5 million Californians are totally unvaccinated against the coronavirus. And that’s where things get tricky.

Even in a place like San Francisco, which has one of the highest vaccination rates in the state, tens of thousands of people — roughly a quarter of the city’s population — aren’t fully vaccinated, according to a New York Times vaccination tracker. And some residents who have gotten their shots may have had their immunity wane in recent months.

“From an individual perspective, I feel really safe,” said Dr. Kirsten Bibbins-Domingo, a public health researcher at the University of California, San Francisco, who added that she and her family had gotten their boosters. “But I don’t feel like the city where I live, the state where I live, will be out of the woods. That I don’t feel confident about.”

Bibbins-Domingo and others worry that hospitals could still be overloaded, mostly by unvaccinated individuals, as the virus takes off this winter. Unvaccinated Californians are nearly 10 times more likely to be hospitalized with COVID-19 as those who are fully immunized.

The next few months concern public health researchers because the coronavirus appears to follow a seasonal pattern — similar to how the flu proliferates in the winter — that causes a peak in California in the summer and a bigger one around the end of the year.

Plus, the arrival of chillier weather pushes people to socialize indoors, where it’s easier for the virus to spread. And during the Thanksgiving and winter holidays, families and friends from multiple households tend to congregate, further increasing the chances of coronavirus transmission.

These conditions could mean that regions with large numbers of unvaccinated people, such as the Central Valley and far Northern California, could see disastrous overflows in their hospitals, experts say. (Already, these regions have the highest level of transmission in the state.)

Adjusting to living with the coronavirus

Still, even if California logs as many new coronavirus cases as it did last winter (which seems unlikely), the death toll won’t approach the same heights because so many people have protection conferred by the vaccines.

In recent days, some experts have been calling for California to focus on hospitalizations instead of case numbers, since most people who become infected won’t also become seriously ill.

Brewer recommended that vaccinated Californians think about holiday precautions differently than they did last year, when officials asked everyone to stay home.

He instead suggested figuring out what COVID-19 precautions can make your gatherings safer. The most important thing, he said, is to make sure that everyone you spend time with is vaccinated. Then perhaps consider avoiding parties with hundreds of people.

“I think what people need to realize is that this virus is not going away,” Brewer told me. “So going into the holidays, people need to recognize that the coronavirus will be out there. There will be transmission. There will be cases, and the question just is: What is your comfort level in terms of trying to go on with your life?”

This article originally appeared in The New York Times.

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