San Diego County continues to receive good news on the coronavirus vaccination front, with an additional 16,712 children ages five to 11 receiving their first doses over the past week, bringing the total to more than 44,000 in just three weeks, according to the latest county report.
But while the increasing numbers help plug a previously wide-open gap in the region’s wall of immunity, the overall COVID-19 situation remains mixed as Thanksgiving arrives.
One year ago, everyone surely believed that a widely available vaccine would make the fourth Thursday in November 2021 the first post-COVID turkey day.
But, encouraging vaccination among younger kids notwithstanding, the vaccine still has not delivered a clean win, meaning that the virus is still in play at a moment when, last year, things got very bad very quickly.
At the moment, the C in COVID-19 might as well stand for caveat.
Wednesday’s countywide update indicates that there were 255 confirmed and suspected COVID-19 patients in local hospitals Tuesday, significantly less than the 518 listed on Nov. 23, 2020.
That lower hospitalization total is despite the fact that the Delta variant version of the virus that is now dominant is more than twice as transmissible as the types that dominated during the holidays last year.
Though it has not prevented infection in all cases, the vaccine has reduced the odds of severe consequences. And yet, the number of positive tests arriving daily remains elevated, even compared to where it was this time last year when there were significantly more COVID-related hospitalizations.
But a comparison of the county’s 13 coronavirus triggers — a list adopted in 2020 as a kind of early warning system of viral transmission — shows that’s not the case. As of Wednesday’s weekly update, the region averaged 13.1 new positive tests for every 100,000 residents. That number was 10.7 on the same day one year ago.
This year, unlike last year, flu activity, another closely watched trigger, also appears in red. With stay-at-home orders removed since June, and much less masking and distancing than was previously the case, most experts expect a more significant flu season this winter.
All-in-all, this Thanksgiving has a bit of a yin-yang character. Vaccination, which was not yet a thing in November 2020, has clearly made COVID-19 less likely to fill hospitals. And yet the virus itself, now present in its more transmissible Delta variant form, has kept this from being the post-COVID turkey day many hoped for.
It seems that for every gain, there is a corresponding setback.
Sure, the vaccine, though it is not able to prevent all illness outright, has significantly reduced the number of people who end up sick enough to end up in hospital beds. Simultaneously, though, health care is caught in a labor shortage, with many burning out and leaving their jobs over the summer and a few later deciding to walk away rather than comply with statewide vaccination mandates for health care workers.
A post-holiday increase in cases and hospital stays is widely predicted, noted Chris Van Gorder, chief executive officer of Scripps Health.
“Our projections indicate we will see a rise in both infections and hospitalizations after the holidays and because of an increase in indoor activities once again, but not to the extent we had last year due to the large number of vaccinated,” Van Gorder said.
Last year, Thanksgiving was the jumping off point for the deadliest COVID-19 surge of the pandemic. The number of COVID-19 residents in hospitals passed the 1,000 mark by Dec. 12, peaking at more than 1,800 one month later and nearly forcing health care facilities to begin rationing intensive care resources.
It’s not just that vaccination is expected to keep things from getting that bad this winter. Van Gorder said that needs to be the case because the system simply is not ready for a similar surge.
“Staffing is tight everywhere, and at every hospital in San Diego,” Van Gorder said. “Our people are tired of COVID-19 like everyone else, and our hospitals remain very busy.
“I think it’s fair to say we could not handle a surge like last year because none of us have the staff, nor do we have the beds.”
For his part, the executive said he plans to host Thanksgiving outdoors and make sure all who attend are vaccinated. He hoped for a similar approach countywide.
“Every day for the last 20 months, I’ve seen what COVID can do and the heartbreak it brings to families,” Van Gorder said. “A little extra precaution is still warranted in my opinion.
“The idea is to have a safe and enjoyable Thanksgiving.”
It seems clear, though, that the sheer size of gatherings will increase significantly.
Holiday travel is expected to be not far off a record set in 2019, and grocery stores across the nation report significant demand for traditional turkey and trimmings in recent weeks.
John Sparkenbach, district manager for Ralphs grocery stores throughout San Diego County, said customer counts are up about 5 percent over last year, indicating that more families are doing their Thanksgiving shopping in person this year than last.
The size of orders has also increased.
“You can tell that, definitely, customers are buying more,” Sparkenbach said. “You can see that they’re definitely going to have much larger gatherings than they did last year.”
Just who’s coming to Thanksgiving dinner and who’s not creates its own tension.
About 25 percent of the 3.1 million people age 5 and older eligible to be vaccinated are not yet fully inoculated, and the issue has become the latest polarization point in the nation’s long-running culture war.
Many families are struggling with whether or not to restrict Thursday’s gatherings to those who are vaccinated and that creates family fault lines, said Dr. Michelle Carcel, a San Diego psychologist. Just as the vaccine, and the recent approval of booster shots for those at greatest risk, provides an elevated level of confidence to gather, it simultaneously highlights divisions that follow long-running divides around issues such as politics that most try hard to avoid when sitting around the same table.
The vaccine, Carcel said, is a particularly difficult divide because it literally involves the health of everyone who attends.
“For a lot of people, the vaccine is very important and significant as a health measure that, based on what we’re seeing in the research, has fantastic efficacy in comparison to those who are unvaccinated and catch COVID,” Carcel said.
Bending on vaccination, then, feels a little different than on, say, political disagreement. Those who insist on vaccinated-only gatherings must find ways to avoid judgment even as they make a decision.
“Even if we don’t agree with that other person’s perspective, we need to be able to say, ‘I may not agree with you, but I love you, and even if we can’t see each other in this setting, we can find an alternative in the future that might work,’” Carcel said.