I write this week mindful that for some of you these updates are not always welcome, given how inundated we all are with information about the pandemic and given how weary we are of the personal and professional challenges brought by each twist in the curvy road of this journey. 

The Latest

The last week brought more federal guidance and California directives as the Bay Area, California and most of the nation continued to see substantial COVID-19 transmission and learn more about the contagious Delta variant continuing to drive the spread. The Centers for Disease Control (CDC) released new data confirming the safety of the vaccine for pregnant women and emphasized that all people ages 12 and older should be vaccinated to be protected. The Food and Drug Administration and the CDC Advisory Committee on Immunization Practices approved the use of boosters of vaccines for a small number of certain immunocompromised individuals (less than 3% of adults) in coordination with their physicians.

We encourage anyone with questions about their condition and the advisability of a booster to first reach out to their health care provider to talk about it. We are closely monitoring federal deliberation that will lead to broader use of boosters for other populations, likely commencing with health care workers, residents of high-risk congregate care facilities and older adults. The federal guidance appears likely, as widely reported in the media, to recommend third doses of the same vaccine for everyone who received Pfizer or Moderna, eight months after completion of their second shot. Guidance regarding Janssen follow up must also be developed. The mobilization for booster shots will require re-expansion of the pipelines for the vaccine in partnership with the major health care systems and pharmacies in San Mateo County that have provided the majority of vaccines to date. We are learning from these key partners the roles they will expect to play as we develop the plan for the County. Please stay tuned as we learn more details about the federal government’s recommendations and related State guidance and how we and our health care partners will work to assure accessible vaccination pathways for everyone in San Mateo County.

In California, the State Health Officer issued an order requiring vaccination or testing of school-based workers. Health care systems and congregate living facilities across the State continued their efforts to comply with the new State Health Officer orders applicable to their settings: The first order requires workers in many different health care settings to be fully vaccinated or receive their second dose by September 30, 2021. The second public health order directs hospitals, skilled nursing facilities, and intermediate care facilities to verify that visitors are fully vaccinated or have tested negative for COVID-19 in the prior 72 hours before indoor visits. Another order includes a broader range of high-risk congregate settings in a directive to verify vaccination status or participate in routine testing.

As many residents seek documentation of their vaccination status, we are guiding them to the State’s Immunization registry to request access to official vaccine records.

Residents can also obtain a QR code of their vaccine information. The State offers support by e-mail through CAIRHelpDesk@cdph.ca.gov and by phone at (800) 578-7889. 

The State identifies multiple ways to verify vaccination status.

Our most recent experience of the virus in San Mateo County

Our 7-day lagged average reported August 16th is now 16.2 new cases per 100K in the population, slightly increased from 15.2 last week. This is an average of 126 new COVID-19 cases per day compared to 119 new cases per day last week. The rate of increase is not as steep as the past several weeks, but transmission remains high. We continue to provide groceries and rental assistance through the Public Health Support Program operated by the Mental Health Association to between 4 and 23 households a day who need this support to isolate. We continue to monitor test positivity both countywide (3.7%) and in the Healthy Places Index lowest quartile census tracts (4.9%). Our testing was reported by the State at 586 tests per 100K/day in our population. While we are hearing some residents experiencing delays in obtaining test results through one of the many pathways available, the countywide turnaround time for test results remains around one day. Our County-operated community testing sites that are located to assure barrier-free access to testing for the communities that have had highest exposure and positivity have capacity to meet demand. 

The daily number of residents requiring hospitalization due to COVID-19 climbed to 61 yesterday. The vast majority of those hospitalized are unvaccinated. We are supporting 30 people who need to isolate in hotels and need to expand hotel beds to meet the need. The hospital and hotel census remain key indicators we are watching closely to understand if there will be further actions needed to assure sufficient capacity. We are in regular communication with our local hospitals. Our team was touched and taking a measure of ongoing hope that a patient recently hospitalized with COVID at San Mateo Medical Center relayed his family’s intention to be vaccinated and share their experience with others who have not yet taken this step.

Vaccination update

We continue to urge that COVID-19 vaccination is the most important action to take to protect oneself and the community and we continue to see progress each week. The State immunization registry report of August 15th showed that 91.0% of our total eligible County population aged 12 and older have received a COVID vaccine (606,476). Of those who have received any COVID vaccine, a large percentage, 89.2%, have completed their vaccination series. We have decreased our estimate of the number of unvaccinated eligible San Mateo County residents from 65,000 when I reported to you on August 10th to around 60,000. 

We also see that we have reached 77.7% of those ages 10 and over in our lowest quartile Healthy Places Index census tracts overall and we continue to focus on raising the lowest of these. We are encouraged by the progress of our targeted efforts and those of our community partners, each day, to lift every community and population up to at least 80% vaccination rates. We are excited to note the continued progress each week specifically in East Palo Alto and North Fair Oaks census tracts where rates are nudging 80% due to efforts by many partners! 

Geographic Community (updated 8/15/21)	# of 1st and single dose vax given by any entity in past 7 days	% vax with 1st or single dose	Estimate # eligible unvax
Broadmoor	7	68.4%	1,495
East Palo Alto	169	76.3%	5,840
El Granada	5	64.6%	1,967
Loma Mar*	1	68.0%	55
Moss Beach	3	51.6%	1,502
North Fair Oaks	76	77.8%	2,671

*Vaccinations by city are calculated by geocoding and aggregating self-reported addresses by city and town. Population estimates are less precise for areas with small populations.

Through our ongoing work with partners in targeted communities, we have received 59 total requests for pop-up clinics so far. These are taking place throughout the county at a regular pace and move us closer to achieving our vaccination goals. 

Of the total county residents who have been vaccinated, 58.2% are people of color, 36.5% are white, and 5.3% are of unknown race/ethnicity. We continue to focus our efforts on increasing vaccination rates among Black, Hispanic and Pacific Islander communities in which rates are still below 80%. With the Health Plan of San Mateo and the County Manager’s Office, we are launching a paid advertising campaign to reach the remaining 60,000 unvaccinated residents, of whom approximately 47,000 are Health Plan of San Mateo members and well over 20,000 are our clients/patients. With Spanish-language TV and other media and direct mail, the campaign will supplement ongoing grassroots and targeted outreach efforts.

Race/Ethnicity Groups under our goal of 80% vaccinated

Note: Due to data collection and reporting limitations these estimates are imprecise and likely reflect under-reporting of reach in each racial/ethnic group given the number of residents who self-identify as “other,” “multi-race” or for whom race/ethnicity data was not collected by the vaccinating entity. 

Race / Ethnicity	% age 12+ vax as of 8/8/21	% age 12+ vax as of 8/15/21	% increase since 8/8/21	Estimate # eligible unvax
Black / African American	61.2%	62%	.8 percentage points	6,461
Hispanic	54.5%	55.5%	1.0 percentage points	79,972*
Multiracial	44.6%	45.2%	0.6 percentage points	13,273
Native Hawaiian / Pacific Islander	60.3%	61.2%	0.9 percentage points	3,717

*This is an over-estimate of the number of Hispanic residents to be reached as it exceeds the total number of residents to be reached; however, we see this is as our largest community under-reached by COVID-19 vaccination among the groups that are still below 80% vaccination rates.

We also see from the data dashboard that certain age groups are still below 80% vaccination. We continue to focus on reaching the 85+ population, where we’ve reached 64.4% (8,825 remaining unvaccinated). Since the 12-15-year-old group became eligible, 70.8% have already been vaccinated with their first dose of Pfizer, and 58.9% have completed the series. We continue to partner with County Office of Education and schools to provide convenient vaccine opportunities for youth and their families. 

We applaud all that our school partners are doing to layer safety precautions to protect students as schools open for in-person instruction last week and continuing this week. The County Office of Education has updated the Pandemic Recovery Framework again to reflect all of the most recent guidance. We are so grateful for all Superintendent Magee, her team and district and school partners are doing across the County protect and prepare students and schools this school year all in service of their inspiring goal: to bring joy and connection back into the classroom by creating caring, welcoming, and engaging learning spaces.

All Together Better,
Louise F. Rogers