SF cases continue to decline; Monica Gandhi explains the transition to ‘endemic’ COVID



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COVID-19 continues to show signs of receding in the Bay Area, although public health officials will continue to cautiously tell us ‘we’re not out of the woods’ likely for a few more months. And UCSF’s Dr Monica Gandhi has written an article explaining what the next few months and years could look like as the virus persists.

We learned the hard lesson in July that the whole positive trajectory and exuberant reopening of June could quickly be undone by this pandemic’s own unpredictability. So it is wise not to make any bold statements or predictions until all the evidence is in place.

But the daily number of new cases in San Francisco continues to decline fairly steadily. Last week, the city’s seven-day average of new daily cases was 76 (as of September 26), up from a high of 309 in early August. And the number of new cases among vaccinated residents continues to decline, with the daily average now standing at 7.3 cases per 100,000 vaccinated residents, compared to 14.4 cases per 100,000 unvaccinated residents. The city is now 75% fully vaccinated for all ages, and the percentage rises to 88% for all eligible ages (12 and over) with at least one dose.

Chart by SF Dept. of Public Health

Hospitalizations, both in SF and the Bay Area, are also steadily declining, although August and September saw an increase in hospitalizations and deaths from the increase in the delta. San Francisco had 64 COVID patients in hospitals as of Thursday, September 30, while the total number of hospitalizations in the state and region continues to decline alongside the drop in the number of new cases.

Chart by SF Dept. of Public Health

Measures such as mandatory indoor masking and vaccination status checks at the door of all bars, clubs and restaurants have likely helped reduce the number of cases since the Delta outbreak began in July – and a segment of the population is now doubly immune to a vaccine and a recent breakthrough infection of the Delta variant. This may mean that the local mask mandate will be relaxed again in the next few days or weeks, but that remains to be seen – and we’ll likely be encouraged to keep the masks on us for transit and Ubers for the foreseeable future.

As you should know by now, “herd immunity” will not provide perfect security against infection with this virus, but it will probably prevent most people from going to the hospital. And we’re not talking about eradicating COVID-19, which means it will likely be endemic and create small epidemics and outbreaks across the world for years to come.

“A COVID-19 epidemic in the Bay Area becomes endemic when the disease is locally manageable (for example, does not cause an excessive burden of hospitalizations or healthcare use) but is not likely to ‘be eliminated due to the inherent properties of the pathogen,’ writes Dr Monica Gandhi, infectious disease specialist at UCSF, in a new opinion piece Chronicle.

One factor that will lead to the endemic nature of COVID, Gandhi says, is the fact that the disease can still be carried by animals. So, unlike smallpox, which animals cannot carry, COVID is likely to stay in pockets regardless of the level of immunity of the world’s population. And the infectious nature of this virus in asymptomatic or presymptomatic patients will make it continually difficult to isolate.

It is therefore a disease that will need to be managed with mass vaccination, and infections will become more treatable over time with the use of antivirals – such as the oral drug, according to Merck, has already shown promise in reducing disease. severity of illness.

“The key to this normalcy is immunity, preferably through vaccination and not through natural infection,” Gandhi said. And she notes that a vaccine-resistant variant is unlikely to emerge due to the documented extent of the body’s T-cell response to vaccines.

Meanwhile, the CDC is (unrealistically) telling people once again to avoid vacation travel this year, especially for the unvaccinated.

And as the number of COVID cases declines across much of the country, the Delta surge has now hit Alaska, and the hospital bed situation has reached crisis levels. Additionally, as The New York Times reported this weekend, Alaska is a hotbed of anti-vaxx madness, with some anti-vaxxes recently wearing yellow Stars of David at town halls to compare. the vaccination campaign and the Holocaust. This state’s COVID problems are therefore likely far from over.

With critical care beds in short supply, The Times reports, doctors in Alaska have started to make the kinds of exhausting choices others across the country had to make last year during the height of the pandemic. to find out which patients will receive life-saving care and which will remain to die.

Related: Bay Area Coronavirus Information – Updated Daily

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