Amid Rollout, S.F. Health Director Warns 'Vaccine Will Not Crush This Curve'

The coronavirus vaccine rollout has begun in California. But in San Francisco, at least, health officials downplayed what might typically be a headline-ready, made-for-TV moment: trucks delivering a life-saving vaccine to beleaguered hospital workers who have been the front-line troops in the fight against a global pandemic.

The first doses of Pfizer’s coronavirus vaccine arrived in California Sunday night at Los Angeles International Airport. Within hours, the Bay Area received its first delivery of 2,000 doses at San Francisco General Hospital.

But you wouldn’t have known it from listening to Monday's coronavirus briefing by one of the city’s top health officials.

Grant Colfax, San Francisco’s director of health, instead delivered a sober analysis of the city’s latest surge — COVID-19 cases are up 50% since Thanksgiving — and asked people to take a “step back and realize how dire our situation is at this point.”

He briefly acknowledged the city was one of four in the state to receive the first shipment of doses while taking questions from reporters. But he was less than celebratory.

“The hope of this vaccine will not crush this curve and with limited supply the vaccine will not save us from this current increase and surge in hospitalizations,” he said.

The Bay Area’s ICU capacity is hovering just above the 15% threshold set by the state to trigger its latest stay-at-home order.

There was a little more theatricality involved in an event attended by Gov. Gavin Newsom, who offered a qualified comment about how Californians should celebrate the vaccine’s arrival but also be “mindful about the challenge we face.”

Newsom sat with five health care workers as they received the state’s first vaccine doses at a Kaiser Permanente facility in Los Angeles. Kim Taylor, an emergency department nurse, was one of the workers who received a shot.

“We front-line workers have been working around the clock, sacrificing so much of what we do and love to take care of our patients, we've been doing this while trying to take care of our own families and keep them safe, what I want you guys to know is — help is on the way, today's just the first step,” she said.

Marty Fenstersheib, Santa Clara County’s vaccine and testing officer, said an initial round of more than 17,000 doses for county use will arrive this week.

“We are following the priorities that were determined by the CDC and the state,” he said. “We will be vaccinating health care workers as well as residents of skilled nursing facilities.”

In Marin County, the vaccine, which was supposed to arrive Monday, has been delayed and is now due on Wednesday. Vaccinations could begin there on Thursday.

A few hours after his press conference, Newsom announced in a tweet that Pfizer was sending an additional round of its coronavirus vaccine to California next week.

—Kevin Stark

Cases of COVID-19 and New Syndrome on the Rise Among California Children, Especially Latinos

At least seven California children have died from COVID-19 since the pandemic began, more than 350,000 have tested positive for the virus and the number of kids diagnosed with a new, rare inflammatory syndrome continues to grow.

All of these stats are on the rise just as a new highly contagious strain of the virus is worrying parents and experts alike, and as the state tries to move toward reopening schools next month.

“We are at a critical time because the overall number of cases of COVID are increasing so much,” said Dr. Jackie Szmuszkovicz, pediatric cardiologist at Children’s Hospital Los Angeles. “We are seeing more children with MIS-C the last few weeks following that big increase (of cases) in the community.”

MIS-C, or Multi-system Inflammatory Syndrome in Children, is the name of a new inflammatory syndrome that afflicts a small number of kids three to six weeks after they experienced coronavirus, even if they had mild or no symptoms at all.

While children have been spared some of the worst effects of the coronavirus and the high death toll seen among adults, the youngest Californians are still at-risk, especially given the current surge. Kids usually experience mild to no symptoms of the infection but it’s what happens to a small number of them a few weeks afterward that has doctors worried. Pediatric doctors are preparing for a wave of inflammatory syndrome cases three to six weeks after the current surge especially with the new more transmissible variant, said Szmuszkovicz.

Read the full story.

Elizabeth Aguilera, CalMatters

California COVID Numbers May Signal Surge Is on the Wane

New COVID-19 cases and hospitalizations continue to inch downward across California, according to the latest state data.

Slightly more ICU beds have also become available, as hospitalizations dipped below 20,000 for the first time since Dec. 27.

The 11.3% average rate for people testing positive for the virus is the lowest the state’s seen in over a month.

The recent improvements may show that the state's wave of winter coronavirus cases and deaths have crested, Health and Human Services Secretary Dr. Mark Ghaly said on Tuesday.

Even with the declines, the numbers are still extremely high. California on Wednesday reported its second-highest number of COVID-19 deaths, 694. The 14-day average for daily coronavirus-related deaths in the state is 492.

California this week surpassed 3 million COVID-19 cases since the outbreak began early last year. Nearly 35,000 people have died.

Laura Klivans and Associated Press

California's OK of Moderna Vaccine Batch Frees Up 300,000 Doses

California said it's safe to immediately begin using a batch of Moderna coronavirus vaccine doses after health officials urged a halt to injections and held a review because several people had reactions.

Wednesday's decision frees up more than 300,000 doses to counties, cities and hospitals struggling to obtain supplies. With the largest U.S. population at 40 million people, California has the second-highest COVID-19 death toll in the country behind New York.

The state Department of Public Health on Sunday urged a pause in the use of a specific lot of the Moderna virus after fewer than 10 people who received shots at a San Diego vaccination site needed medical care, possibly due to rare but severe allergic reactions.

But after a safety review and consultation with Moderna and health agencies, the state “found no scientific basis to continue the pause” and said vaccinations can “immediately resume,” state epidemiologist Dr. Erica Pan said in a statement.

“These findings should continue to give Californians confidence that vaccines are safe and effective, and that the systems put in place to ensure vaccine safety are rigorous and science-based,” Pan said, adding that some of her family members had received it.

With the all-clear for Moderna’s vaccine, San Francisco will be able to use 8,000 doses it had put on hold and no longer expects to run out of vaccine on Thursday as previously feared, the San Francisco Chronicle reported. Health officials had received fewer than 2,000 additional doses this week for city hospitals and community clinics.

Associated Press

Biden to Require Masks on Planes and Other Transportation

Deep in the deadliest coronavirus wave and facing worrisome new mutations, President Joe Biden will kick off his national COVID-19 strategy to ramp up vaccinations and testing, reopen schools and businesses and increase the use of masks — including a requirement that Americans mask up for travel.

Biden also will address inequities in hard-hit minority communities as he signs 10 pandemic-related executive orders on Thursday. Those orders are a first step, and specific details of many administration actions are still being spelled out.

The new president has vowed to take far more aggressive measures to contain the virus than his predecessor, starting with stringent adherence to public health guidance. He faces steep obstacles, with the virus actively spreading in most states, slow progress on the vaccine rollout and political uncertainty over whether congressional Republicans will help him pass a $1.9 trillion economic relief and COVID response package.

The U.S. mask order for travel being implemented by Biden will apply to airports and planes, ships, intercity buses, trains and public transportation. Travelers from abroad must furnish a negative COVID-19 test before departing for the U.S. and quarantine upon arrival. Biden has already mandated masks on federal property.

Although airlines, Amtrak and other transport providers now require masks, Biden's order makes it a federal mandate, leaving little wiggle room for passengers tempted to argue about their rights. It marks a sharp break with the culture of President Donald Trump's administration, under which masks were optional, and Trump made a point of going maskless and hosting big gatherings of like-minded supporters. Science has shown that masks, properly worn, cut down on coronavirus transmission.

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—Ricardo Alonso-Zaldivar, Associated Press

10 More COVID-19 Deaths in California Prisons in Last Week

Ten inmates in California state prisons have died from complications from COVID-19 in the last week, bringing the total number of prisoner deaths related to the coronavirus to 184. Nineteen staff members for the California Department of Corrections and Rehabilitations have also died from the virus.

The number of active cases in custody has been dropping since a high of nearly 11,000 on Dec. 20.

Still, as of Jan. 18, infections in state prisons were about six times those of California as a whole when adjusted for population.

Just over 3,000 incarcerated people have gotten their first dose of the vaccine, which takes a few weeks to offer protection. But even inoculation won't prevent the virus from spreading in pentitentaries, says Dr. Peter Chin-Hong, an infectious disease specialist at UCSF.

“It doesn’t matter if you vaccinate a zillion people, if they are crowded together they are going to spread COVID very efficiently,” he said.

While the vaccine is a helpful tool, it needs to be coupled with other safety measures like physical distancing of inmates, masks and proper ventilation, says Chin-Hong.

Prison facilities “are ancient for the mass majority of locations," he said. "They are overcrowded ... It seems really surprising, disappointing and heartbreaking that we haven’t cared for inmates as we have for the general population.”

He warns that the arrival of new, more infectious variants of the virus may already be circulating in California prisons. A more transmissible virus, combined with an aging prison population, can spell disaster, he says

“The risk of these individuals after contracting COVID in terms of doing poorly and dying is higher than your general population.”
In a statement, a spokesperson for the California Department of Corrections and Rehabilitation said approximately 18,640 people have had their release date sped up due to the pandemic.. CDCR has released 24,000 inmates overall since March, it said.

Marco Siler-Gonzales

Kaiser Limits Vaccinations for Seniors to Members Over 74

Kaiser Permanente says it is not yet able to give COVID-19 vaccinations to all seniors under the age of 75, due to a lack of supply.

On the heels of the federal government and then the state expanding vaccine eligibility to people 65 and over, the health care giant opened up its phone lines last week for seniors to make vaccination appointments. But slots for those under 75 were only briefly available, according to the company, as the limited supply has forced it to prioritize older seniors, along with continuing to vaccinate health care workers.

Vaccine supply permitting, the company expects to honor existing appointments made by those under 75 when they were available.

Members should no longer attempt to proactively make vaccine appointments, the company says.

"There is no need for members to contact us by email, phone, or on the website until they first hear from us," Kaiser said.

With more than 1.5 million members age 65 and older, Kaiser received a first-dose vaccine supply last week of just 20,000 doses, it said.

"At the current rate, we are looking at vaccine distribution that is much slower than any of us find acceptable," a company statement said. "We are doing all we can to get additional vaccine supply as soon as possible."

Kaiser says that as of Jan. 16, it had administered more than 170,000 doses in California, including the second shots that people must receive to complete their inoculation.

Polly Stryker and Jon Brooks

Don't Worry So Much About the California Variant, Says Infectious Disease Specialist

During a press conference on Sunday, Bay Area health officials said they are “concerned” about the rising number of coronavirus cases identified with a California variant of COVID-19. This variant is different from others identified in the U.K., South Africa and Brazil.

The California variant was first discovered in May and simmered in the population over the summer and fall, when the number of cases was much lower than it is now.

Known by virologists as L452R, the variant grew from 4% of the samples scientists sequenced in the first half of December to roughly a quarter in the second half of the month.

Virologists are still trying to determine if the variant is more infectious than the original coronavirus strain.

Dr. Sarah Cody, Santa Clara County’s health officer, says it’s too early to draw conclusions about the variant, which has been identified in a number of outbreaks.

“We need to lean in and do more investigation,” she said. “And that’s what we’re doing.”

Dr. Monica Gandhi, an infectious disease specialist at UCSF, talked about the variant with KQED’s Tara Siler on Tuesday. Gandhi says she is not worried about the effectiveness of the vaccines on the variants. Here is an excerpt from that interview, edited for length and clarity:

How concerning are these variants in terms of California's current surge?

Dr. Monica Gandhi: We only know, so far, that the so-called U.K. variant B117 is more infectious, and we don't know if the L452R, the California strain, is more infectious. It just happened to be the strain that is being sequenced and coming out in our latest Bay Area surge. But it may have just gotten lucky; it doesn't mean it's more infectious. It may have just been the one that was spreading as things were opening up.

How effective will the vaccines be in protecting us from these new virus variants?

Gandhi: I think it's really important to feel hopeful about the vaccines and not start getting really concerned that [the variants] are going to evade them. The reason I say that is because the two authorized vaccines we have, from Pfizer and Moderna, have the entire spike protein that you code for when the vaccine is put in your system, and you make a very complex antibody response to that spike protein.

These variants have little point mutations along the spike protein, but that doesn't mean the spike protein is totally changed. In fact, there are three mutations on the L452R variant along the spike protein, but that doesn't mean the vaccine won't work. I think that is total speculation, and we'll worry a lot of people if we stress that too much.

On that front, do you think we're underselling the vaccines?

Gandhi: I am really concerned about that. These vaccines could not be better. We thought that if we got a 50% efficacy rate, we would probably still approve it in this country, and these vaccines are 95% effective at preventing COVID-19 infection that's symptomatic, and almost 100% effective in preventing severe outcomes. These vaccines are amazing. Instead of worrying that these variants are going to evade the vaccine response, I'm not worried about that at all. In fact, Pfizer's done some studies with B117, and it looks like the U.K. variant is just fine in terms of the vaccine working. So I wouldn't speculate. I think when we keep focusing too much on the negatives, it actually could prevent people from getting the vaccine. We are lucky to have these vaccines, and we've got to get them out.

More on coronavirus variants:

Polly Stryker, Kevin Stark and Jon Brooks