SANTA CRUZ — Rates of COVID-19 have been steadily rising across Santa Cruz County and the nation for weeks.
But as has been the case since the early days of the pandemic, the impact on elderly residents is being disproportionately felt and local health officials are concerned.
Santa Cruz County Deputy Health Officer Dr. David Ghilarducci told the Sentinel that four of the county’s seven nursing homes were experiencing COVID outbreaks as of Tuesday, meaning each had three or more infections at once. He added that, tentatively, five deaths had been reported across the seven facilities in the past two weeks, though county officials are still waiting for death certificates to come through that confirm the official cause.
“This is really alarming to us,” said Ghilarducci. “We think it could get a lot worse.”
Lack of vaccinations
Though county officials have consistently emphasized that elderly and immunocompromised individuals are high risk for adverse outcomes from a COVID infection, Ghilarducci said he believes a lack of consistent vaccinations may explain the troubling jump in cases and deaths at these facilities in recent weeks.
According to Ghilarducci, about 75% of all nursing home residents in the county are up to date on their COVID-19 vaccinations, but that figure for individual facilities ranges from as low as 54% to as high as 89%.
An even larger disparity exists among nursing home staff, where 66% of all employees are up to date with vaccinations, with a low of 14% in one facility and a high of 100% in another.
“I’m going to be urging them to update their vaccination rates to the extent that they can,” said Ghilarducci, who plans to meet with nursing home managers this week, though county staff has already visited the various facilities to provide assistance.
Ghilarducci acknowledged the state’s recent requirement that the county implement a broader definition for a COVID-related death, but added “There’s clearly a rise in illness from COVID in this particular setting right now, regardless of how you define the death.”
Ghilarducci explained that when the COVID vaccine was released in late 2020, there was a nationwide requirement that staff in health facilities that bill Medicare or Medi-Cal had to be vaccinated. But that ended with the close of the state of emergency earlier this year and booster shot totals have lagged behind.
Representatives from Dominican and Watsonville hospitals along with Sutter Health told the Sentinel in March that they would be relaxing masking and vaccination requirements when the emergency ended, though these measures were still recommended.
“Dignity Health Dominican Hospital is committed to providing safe care for patients and a safe work environment for clinicians and staff,” said Dignity Health, the owner of Dominican Hospital, in a statement to the Sentinel when asked about the status of their masking and vaccination policy. “Dominican Hospital is closely monitoring the prevalence of COVID-19 in the community and follows the guidance of the CDC and the California Public Health Department for all COVID-19 related issues, including masking and vaccinations.”
Ghilarducci said the county is currently considering the possibility of implementing an order requiring workers, regardless of vaccination status, to temporarily mask until the current spike in cases dissipates. He said officials have not decided if this potential order would apply to all health care workers or just nursing home staff in the county.
Ghilarducci declined to share the names of the nursing homes experiencing outbreaks because “it’s not necessarily that they’re doing anything wrong.” He said leadership in several facilities have expressed frustration at the lagging vaccination numbers, but feel powerless to do much about it for fear that they might drive away staff that are already working for mediocre pay in the most unaffordable rental market in the nation.
“They’re trying to balance between how much to push versus keeping the place running,” said Ghilarducci. He expects at least a couple of the facilities will come out of “outbreak” status in the coming days.
Still out there
Meanwhile, local wastewater data continues to keep the door open for a late-summer surge, as trends across the county have continued to ascend. Local and national experts believe the new subvariant EG.5 – unofficially referred to as “Eris” – could be driving the increase, but also noted that the warm-weather rise is following the trend in recent years where spikes occur in late summer and winter seasons.
Tammy Green, the nurse manager of Dominican Hospital’s Emergency Department, said her team is experiencing a recent uptick in COVID patients, but most cases are mild. Some do end up getting hospitalized, but the majority have been elderly individuals with other conditions that have weakened their immune systems.
“We are not being overwhelmed how we were at one point (in previous years),” said Green. “We know exactly what to do, we’re familiar with the process and the things we need to do to take care of ourselves and prevent spread to staff and other patients.”
When numbers began to rise recently, Green said Dominican’s staff was notified by management and advised to wear masks at work, a call which most have followed.
Ghilarducci said that for the general public, numbers are climbing but “nothing alarming” at this point as spread is still relatively low. Still, he stressed that vaccination has to become a part of the community’s regular health routine, similar to the way the flu vaccine is used now. Vaccines can reduce disease severity, spread and can also buffer against the possibility of long COVID – a debilitating persistence of symptoms that can last weeks, months or years – which occurs in about 5%-10% of cases, according to Ghilarducci.
An updated vaccine that targets COVID omicron subvariants similar to EG.5 is expected to be made available in mid to late September.
“We have every reason to expect this will continue to go on probably the rest of our lives; that different variants will pop up,” said Ghilarducci. “It’s really important we maintain a state of readiness to reduce the amplitude of these waves.”
COVID by the numbers
Wastewater data: Numbers are trending upward across all regions of the county.
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