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Dozens of fully vaccinated staff at two San Francisco hospitals have developed COVID-19 in the past six weeks, almost all of them infected in the community – not at work – as the Delta-fueled fourth wave took off across the city.
Thirty-five staff at San Francisco General Hospital are sick after testing positive for the coronavirus, chief medical officer Dr Luke Day said. Three quarters of them are fully vaccinated. While that number is only a small portion of the 7,000 staff, it is about as many staff infections as those reported at the height of the winter wave.
At UCSF, around 140 staff – out of a total of 35,000 employees – have been infected since mid-June, said Dr Ralph Gonzalez, director of innovation for UCSF Health. About 80% of people who tested positive were fully vaccinated.
None of the infected staff were so sick that they had to be hospitalized. Both hospitals say they have plans in place to cover those who are sick or unable to work due to exposure to COVID.
But administrators are concerned about potential staff shortages as that increase increases. And with growing evidence that the delta variant can more easily infect even those who are vaccinated and can spread among this group as well, they are begging the public to wear masks again and resume some of the other social distancing precautions they are taking. largely dropped out six weeks ago, when the state dropped most public health mandates.
“Everyone who works in health care knows how difficult it is. We all felt like we were finally going to take a break from this pandemic, ”said Dr. Lisa Winston, medical director of infection control at San Francisco General. “My hope is if we can continue to raise vaccination rates and wear our masks when we are in public places and maybe get away a bit. The more we can all do, the better our chances of avoiding the most painful things. “
Cases among hospital staff reflect what is happening in the wider community, as people ditched their masks and began to rally again when the state reopened on June 15, as did the highly infectious delta variant. silently began to dominate.
Cases have doubled about every two weeks in the Bay Area since then, and although infection rates are much higher in unvaccinated people, post-vaccination breakthrough cases appear to be more common than experts. health had not expected.
But it’s clear that vaccines still prevent most infections, Gonzalez said.
“We are still seeing a strong protective effect of the vaccine,” he said. “Instead of 140 cases (among staff), it would be 600 or 700 if you use the unvaccinated infection rate.”
And Day said vaccines work “remarkably well” in preventing serious illness.
“People can still get COVID from vaccines,” he said. “But the cases are much milder, you don’t get hospitalized and you don’t die from it, and that’s the goal of the vaccine.”
Hospitalizations for COVID have increased at San Francisco General and other Bay Area medical centers. More than 600 people were hospitalized for COVID in the Bay Area on Thursday, a nearly four-fold increase since June 15. Hospitalizations quintupled in San Francisco, from 16 six weeks ago to 83 patients on Thursday.
In San Francisco General, 17 people were hospitalized with COVID as of Thursday afternoon – well below the winter peak, when up to 70 people were hospitalized and 1 in 4 = patient there had COVID. But just six weeks ago, only one person was hospitalized with COVID, Day said.
“In the last week and a half we have seen our numbers increase by 100%,” he said.
The San Francisco General and UCSF have both dusted off their surge plans and reinstated policies to preserve hospital capacity. They resumed screening tests for the coronavirus on all patients admitted to hospital, regardless of their vaccination status.
Gonzalez of UCSF said the increase in infection rates among staff was an early signal that a fourth increase could occur in San Francisco. In late June, less than two weeks after the state reopened, the hospital saw an increase in staff requesting coronavirus tests because they were showing symptoms of COVID. Now, he said, they have had to add staff to the workplace safety team to meet the demand for tests and case investigations at the hospital.
Cases in both hospitals have been reported among all types of staff, including doctors and nurses. Almost everyone has been infected in the community – whether it’s going to bars or restaurants, shopping, traveling, or meeting with friends. Like everyone else in this pandemic, hospital staff took advantage of the reopening of the state to remove their masks and reconnect with friends and family.
“We encouraged the staff to take time off and take vacations to rejuvenate,” Day said. “We are part of our communities, we are not immune from this, and even with best practices and best intentions, you can contract this virus. “
Dr. Marissa Raymond-Flesch, a pediatrician specializing in adolescent care at UCSF, fell ill with COVID in mid-July, shortly after taking a week off and vacationing at home in San Francisco. Her husband and 2-year-old son were also infected.
Raymond-Flesch and her husband are both fully vaccinated, “and I’m so grateful to have been vaccinated,” she said. “I think being vaccinated probably kept me from going to the hospital, because I had a surprisingly symptomatic infection.”
She was not hospitalized but experienced “terrible” muscle pain and fatigue, and lost her sense of taste and smell. Her husband had a bad cough and respiratory problems. Her son had mild symptoms, “for which I am very, very grateful. He had a bad cold and was very tired, and had mild fevers. “
“Now he keeps asking, ‘Mom, can we get some fresh air? »», Said Raymond-Flesch.
She said after more than a year of being extremely careful not to get infected – for her own protection and to keep her family safe – it was overwhelming to be tested positive, and in turn to see her husband and son get sick too.
“We’ve been so careful – it’s hard for me to stress this enough. We are a family that has never really gone out without masks, ”she said. “We were just starting to get out of the world a bit more. We had been to the zoo. We started having small, small meetings with vaccinated friends.
Hospital administrators and staff have said in some ways that it is especially difficult for healthcare workers to cope with a further increase, having been on the front lines and treating the sickest patients for so long. But they recognize it’s a tough time for everyone after getting a taste of what looked like post-pandemic freedom.
“We have to get back to the things we know how to do. We know how to mask ourselves, we know how to distance ourselves socially. We know how to work on Zoom, ”said Raymond-Flesch. “And it’s hard, it’s really hard to come back to those places. And not knowing how long we’re going to have to do this. I feel it now too.
Erin Allday is a writer for the San Francisco Chronicle. Email: [email protected] Twitter: @erinallday
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