‘It Gives Me Tremendous Anxiety’: California's Delta Surge Sparks Flashbacks for Many Health Care Workers

Remember that moment just about a month ago when there was a palpable sense everything might be OK?

The economy was reopening. People were packing back into restaurants. Sweaty bodies filled clubs.

Even exhausted health care workers breathed their first deep sigh of relief as communities across California experienced the first real lull in the COVID-19 pandemic.

“It was like COVID updates — none,” said Dr. Nicole Braxley, an emergency medicine physician at Mercy San Juan Medical Center in Carmichael. “And everyone’s like, ‘Yeah! Let’s talk about something else.’ ”

‘Not Out of The Woods Yet’

Then the delta variant hit California, and rapidly took hold, particularly in unvaccinated pockets of the state. It now appears to be spreading two to three times faster than the original strain of the virus. Early research from China shows that people who catch the delta variant have, on average, about 1,000 times more copies of the virus in their respiratory tracts than those who contracted the original bug.

Case tallies are rising across the state. In Sacramento County, where Carmichael is located, hundreds of people a day are now testing positive. Less than a month ago, Braxley was seeing one or two COVID-19 patients a week. Now, she's treating about a dozen people a day.

Most of them are unvaccinated, and many express regrets.

“I had a gentleman that I had to admit for COVID,” said Braxley, the Mercy San Juan Medical Center physician. “And he said, ‘Can you give [the vaccine] to me today? I've been meaning to get it.’ It's too late. The decision has already been made and the damage is done. And so now we just have to admit the patient and hope for the best.”

The delta variant is even taking hold in places like San Francisco, where 77% of eligible residents are fully vaccinated. The vast majority of hospitalized cases are among unvaccinated people, but there is also the occasional severe breakthrough case — when a fully vaccinated person contracts the virus — mostly in older people.

Liz McCusker, a nurse in the emergency room at Saint Francis Memorial Hospital in San Francisco, remembers an 81-year-old man who arrived with a violent cough.

“He was such a lovely gentleman,” she said. “He’d gone down the path of having the vaccine and taking care of himself, but developed these symptoms and was really very sick. It’s just sad to see that again.”

His condition never improved, and he eventually died.

“Sort of a reminder that we are not out of the woods yet,” McCusker said.

Flashbacks to Last Winter

Along with spreading faster, the delta variant might also be more potent than the original strain.

“We're seeing patients becoming sicker and their conditions are worsening much more quickly,” Dr. Mira Irons, the American Medical Association’s chief health and science officer, said in a recent “AMA COVID-19 Update” video.

This week, the U.S. Centers for Disease Control and Prevention changed its masking guidance. The agency is now urging anyone living in areas with "substantial" and "high" transmission of COVID-19 to mask up indoors. The recommendation applies to nearly two-thirds of all US counties, including more than 90% of California. State health officials are also following suit and encouraging all residents to mask up in indoor public spaces.

"In recent days, I have seen new scientific data from recent outbreak investigations showing that the delta variant behaves uniquely differently from past strains of the virus that cause COVID-19," CDC Director Dr. Rochelle Walensky said during a media briefing on Tuesday.

The U.S. vaccine supply is ample, but only about half of all Americans, and half of Californians, are fully vaccinated.

And vaccination rates have slowed substantially. In the early days of the rollout, demand for shots far outweighed supply. Now, public health officials are grappling with the opposite problem.

Mass vaccine sites have shut down in urban areas because long lines shrunk to nothing. The same is true in many rural counties. In Lassen County, for instance, fewer than 20% of residents are fully vaccinated. And across the Central Valley, many counties have plateaued at a full vaccination rate of around 35%.

“There are places in the world and people in countries that would give their right arm to get a vaccine,” said Braxley, with tears in her eyes. She apologized for getting emotional. It’s not usually her style, she says, but it’s been a long year.

The state’s hot spot is, again, Los Angeles County, where thousands of people are now testing positive every day.

“I'm running around like a chicken without a head,” said Dr. Dinora Chinchilla, a pulmonologist specializing in critical care in Los Angeles County.

She says she’s drowning under her current load of patients, all of whom are battling the virus. The situation is sparking flashbacks for her to last winter’s peak.

“It gives me tremendous anxiety to think that we're going the other direction again,” she said.

The night after her interview, Chinchilla sent a text reporting that two more of her patients had died.

A Daunting Task Ahead

Gov. Gavin Newson says he’s not only exhausted, but floored that people are still hesitant about getting the vaccine.

“With the deadliness and efficiency of the delta virus, you're putting other innocent people's lives at risk, you're putting businesses at risk, you're putting at risk the ability to educate our kids by getting them back in person full time for in-person instruction,” he said during a media briefing on Monday. “You don't have a choice to go out and drink and drive and put everybody else's lives at risk, that's the equivalent.”

Many local public health officials across the state are desperately scrambling to get more people vaccinated. In Alameda County, crews are going door to door with the goal of 90,000 home visits in census tracts with the lowest vaccine rates. The hope is that in-person conversations will motivate on-the-fence residents to sign up for an appointment. Similar efforts are also unfolding in more than a dozen other counties across the state.

‘Race Against Time’

Some counties are also throwing vaccine parties.

At a recent July rally in Alameda, on an urban community farm adjacent to a low-income housing complex, balloons line fences, hamburger smoke billows from grills, and an emcee jumps on the stage to announce $100 and $500 raffle prizes to the growing crowd. Even Alameda Mayor Marilyn Ezzy Ashcraft stops by.

“We want to meet people where we are,” she said. “But I do feel that it’s a race against time.”

A group of teens clap enthusiastically for Z’haria Anderson, 15, after a nurse administers a shot of the Pfizer vaccine in her left arm. Anderson, who works on the farm, says her schedule has been packed, and so is delighted the vaccination event came to her today.

“It just feels really nice knowing that I'm contributing to helping the world get a little bit safer,” Anderson said.

Other attendees at the event blamed their belated decision to get vaccinated on being squeamish about the side effects. Some also worried the science wasn’t there yet.

“I just think I wanted to watch to see more studies to see how women was reacting to the dosage,” said Roxanne Akins, an Alameda resident. She says she finally showed up because friends and family around her stepped up.

“They were a great inspiration to go ahead and get this done,” she said.

The event offered residents a lively afternoon, but the tally at the end of the day fell far short of the 75 shots the mayor had expected to see administered: All of the bells and whistles inspired just 13 people to get vaccinated.

That’s the battle public health officials continue to face. The process of protecting people is slow and it’s arduous — but it’s the best hope of preventing the delta variant from claiming more lives.

Unvaccinated Californians can go to myturn.ca.gov or call (833) 422-4255 to schedule their appointment or go to myturn.ca.gov/clinic to find a walk-in clinic in their county.