Delta variant leads to rapid rise of hospitalizations in Sonoma County

Just two months ago, Sonoma County seemed on the verge of defeating the coronavirus pandemic.

There were a mere 10 new infections a day, and the average daily number of people being treated for the virus at local hospitals was eight.

Today, the highly infectious and more transmissible delta mutation — the most dominant COVID-19 strain in the United States — is spreading rapidly countywide, mostly among unvaccinated residents.

There are more than 45 new daily infections and the average number of COVID-19 hospital patients countywide has increased to 42 since the July 4 holiday weekend. On Friday, the county topped 1,000 active cases for the first time since March, when only about a quarter of residents 16 and older were fully vaccinated, according to its COVID-19 data portal.

Coronavirus-related deaths, which lag hospitalization spikes by about a week, already have started a steady climb. In July alone, nine more county residents so far have died from complications of the dreaded respiratory disease. Only one fatality in May was attributed to the pandemic disease. Area medical experts fear additional deaths are inevitable, the fallout of a recent surge they say was totally preventable.

“This is a vaccine-preventable disease, and I think it’s really tragic that people are getting ill because of the choice they’re making to not get vaccinated,” said Dr. Gary Green, an infectious disease specialist at Sutter Santa Rosa Regional Hospital.

“There are other countries where people would give their right arm for a vaccine and they’re desperate for vaccine,” Green said. “And in the United States, a country of such resources, we’re just making bad choices.”

‘Not out of the woods’

This week, federal health officials warned the nation was “not out of the woods yet” and is once again at “another pivotal point in this pandemic.” Officials said the dangerous delta mutation is ravaging communities with low rates of inoculation.

Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, pleaded with unvaccinated people to take “the delta variant seriously.”

“This virus has no incentive to let up, and it remains in search of the next vulnerable person to infect,” Walensky said.

Green said 99% of his COVID-19 patients have not had their shots against the virus. He said he often encounters feelings of remorse among many of them.

Some vaccine-resistant residents, he said, are preferring to risk the possibility of getting the coronavirus as a means of protection, rather than getting vaccinated. But Green said “protection from natural immunity for COVID-19 is not as good as vaccination, and that is an unsafe and less effective strategy.”

At Santa Rosa Memorial Hospital, the county’s largest hospital and the region’s highest-level trauma center, virus-related hospitalizations have sharply increased since April and May, said Dr. Chad Krilich, chief medical officer of Providence St. Joseph Health, which operates Memorial, Petaluma Valley and Healdsburg hospitals.

Krilich said during the peak of the winter pandemic surge in January and February, Memorial Hospital treated on average more than 40 COVID-19 patients a day. That number dropped to four to five virus patients in April and May.

The average number of COVID-19 patients at Memorial jumped to 14 in July, he said. Petaluma Valley, which had an average of one virus patient daily in April and May, now has roughly seven. Similar increases are occurring at Healdsburg District Hospital, he said.

As of Friday, there were 44 confirmed COVID-19 patients at the county’s acute care hospitals, according to state public health data. During the peak of the winter pandemic surge, 110 virus patients were being treated at local hospitals.

A good sign, Krilich said, is that the total number of local Providence St. Joseph Health patients dying of COVID-19 is 20% of what it was during the winter surge. With pandemic deaths trailing hospitalizations, he acknowledged more deaths could be reported in the coming weeks.

The California Department of Public Health’s COVID-19 computer forecast modeling predicts that by Aug. 21 there will be 52 coronavirus patients at Sonoma County hospitals, and an additional 14 deaths.

If the forecast comes to pass, the county’s pandemic death toll from July 1 through that date would be 23, a marked jump from the four coronavirus patients who died in June and the single pandemic death in May.

“We are not where we were in January, and we’d like to avoid returning to that, hence the reason why we’re all really encouraging that the remaining 25% of people within the county ... which is 125,000 people, to please get vaccinated,” Krilich said.

Taylor Davison, a Memorial Hospital worker who registers patients in the emergency department, said the recent surge of COVID-19 patients has exacerbated what she said were chronic staffing shortages. Davison, a local leader with the National Union of Healthcare Workers, said wait times at the hospital emergency room are now two to three hours.

One nurse at Memorial said the hospital has to dedicate more rooms for treating coronavirus patients than it did just a few weeks ago. The nurse, who asked that his name not be used because he’s not authorized to speak to media, said the summer surge and its effect on the hospital is less severe than previous pandemic surges.

“I don’t see a huge spike like we did after Thanksgiving,” he said.

Vaccinations slow hospitalizations

Dr. John Swartzberg, an infectious disease expert at UC Berkeley School of Public Health, said the rate at which virus-related hospitalizations have been increasing is not as large as the rate increase of new infections. He credits high vaccination rates in the Bay Area for that.

“There’s so many people vaccinated, and a significant percentage of people immune from surviving COVID, that the number of people getting hospitalized has decreased from what we’ve seen in the past,” Swartzberg said.

“That's also reflected by the fact that essentially everybody being hospitalized and dying are people who are not vaccinated.”

Swartzberg said that while there have been a significant number of “breakthrough” cases — when a fully vaccinated person becomes infected by COVID-19 — they are almost always asymptomatic or experience mild symptoms and do not require hospital care.

Is herd immunity still possible?

The delta variant, a highly transmissible coronavirus strain that now accounts for 83% of genomic tested COVID-19 cases in the United States, creates an even greater imperative for people to get vaccinated, Swartzberg said.

Public health data shows that otherwise healthy seniors who are vaccinated are not likely to wind up in the hospital, much less die, if they contract the virus.

“But if I was 76 and not vaccinated, right now with the delta (variant) I’d have a high chance of getting infected and a good chance of getting hospitalized and dying,” he said.

Swartzberg said prevalence of the delta strain among coronavirus mutations is likely higher than the new report from the CDC because the data being disclosed by the federal agency already is one to two weeks old when it’s released. He said likely 90% of all detected variants at this point are delta.

The delta strain, which was first detected in India in December 2020, is believed to be 50% more transmissible than the U.K. variant. That strain was reported to be 50% more transmissible than the original coronavirus.

Swartzberg and Green, the infectious disease physician at Sutter hospital, said the delta variant invariably raises the bar for so-called herd immunity. Herd immunity occurs when a large share of a population becomes immune to a disease, halting its spread.

Swartzberg said earlier strains of the virus triggered vaccination rate estimates of 75% and 85% before herd, or community immunity, could be reached.

“I’d probably boost those numbers by at least 5%. So, you're talking about 80% to 90% range is likely,” he said.

Dr. Lee Riley, another UC Berkeley infectious disease expert, said he thinks the dominance of the delta variant eventually could be replaced by another, even more transmissible, variant.

Riley said coronavirus mutations are occurring all the time in different communities. But he said, “mutations are accelerated in populations where people are not vaccinated,” as was the case last year until December in the county and around the country when no one was immune and a host of variants emerged.

Green said that although the weekly level of vaccinations has significantly declined, he still thinks Sonoma County can reach herd immunity. He said it’s going to require a persistent and patient message about the benefits of vaccination.

The rise of local hospitalizations, though, is a reminder that the pandemic is not over, he said. And he doesn’t think we’ve hit a wall in terms of getting more people vaccinated.

“There are two populations: There are people who are reluctant, and people who are resistant,” Green said.

“The reluctant population will probably turn the corner and, with good information, get vaccinated. The resistant population who just kind of dig in deep — I think they’re at tremendous risk of getting infected and not surviving.”

You can reach Staff Writer Martin Espinoza at 707-521-5213 or martin.espinoza@pressdemocrat.com. On Twitter @pressreno.