As we have needed to accept the many aspects of COVID-19 risk mitigation that are part of our daily lives, we want to keep you and the public informed about the changing context that underlies our current situation so that everyone can protect themselves and the community as much as possible.

We continue to reinforce the importance of remaining up to date with the vaccinations you are eligible for, as the vaccines continue to offer significant protection against severe illness and death. With everyone 6 months and older now eligible for vaccination, we are seeing healthcare providers and pharmacies offering many pathways to get vaccinated. To date 4,836 residents under the age of 5 have already received a first shot in the last few weeks, and our public-facing dashboards now incorporate this age group and reflect an update to population data.

Our situation is influenced significantly by the BA.5 variant that is now dominant in California. As the variants outcompete their predecessors, we see that they are even more transmissible and able to evade the immune response of both vaccination and prior infection, prolonging this period of high community transmission.

As of June 30th, we are in the CDC “high” tier, reflecting substantial virus transmission in the community as well as increases in COVID-19 hospitalizations for San Mateo and San Francisco counties. The number of patients hospitalized in San Mateo County with COVID-19 was 42 as of yesterday. We have seen the number of San Mateo County hospitalized with COVID-19 increase and fluctuate to a census of between 30 and 50 since late May compared to levels that were closer to 20 in early May. Fortunately, intensive care unit utilization remains relatively low, and our hospitals have been able to manage these hospitalization levels.

We continue to strongly recommend wearing a high-quality mask in indoor settings and increasing ventilation – such as by opening windows and doors where possible – to help prevent infection. We urge residents to test if symptomatic and to be in contact with one’s physician or if positive to access the treatments that are available.

As regular surveillance testing has subsided and at-home antigen testing when symptomatic has become more frequent, we have seen the level of PCR testing in the community decline from around 600 tests/day per 100K population a month ago to 465 tests/day per 100K. This leads to a different meaning for the test positivity level captured with testing more typically following symptoms or exposure. The key metrics we are looking at regularly to understand community impacts are the hospitalization numbers and our vaccination reach.

The public will see a change to our dashboard that displays vaccination reach by race/ethnicity and age after we incorporated annually updated population data from the California Department of Finance. These data incorporate information from the 2020 Census and show some significant shifts in our population by race/ethnicity. The number of residents who are American Indian / Alaskan Native, Black / African American, Hispanic (any race), Native Hawaiian / Pacific Islander, White is lower than what previous data estimated. This translates to a higher vaccination rate than previously reported. The number of residents who are Asian or multiracial is higher, translating to a lower vaccination rate than previously reported. The inclusion of the population under the age of five also changes the vaccination rates for each race/ethnicity group. These improved data will continue to guide the focused work with under-vaccinated groups.

Our key public message on vaccination is the importance of staying up to date. For those aged 50 and up, it is especially important to obtain a second booster to minimize the risk of severe impacts from COVID.

The FDA, CDC and the state of California have now approved Pfizer and Moderna COVID vaccines for children ages 6 months and older, providing flexibility for health care providers. In addition, the FDA is recommending the addition of an omicron component to COVID booster vaccines, likely to be available in the fall.

With many vaccination pathways through health care providers and pharmacies for most residents, our County Health focus is on under-reached groups. For the population under the age of 5, this involves tailored support for some pediatric practices serving children covered by Medi-Cal and vaccination clinics at Early Head Start sites in East Palo Alto and South San Francisco.

All together better, 

Louise F. Rogers