Sonoma County hopes to keep COVID-19 at bay to make full June 15 reopening

With the coronavirus waning, Sonoma County anticipated the state’s go-ahead Tuesday to further relax restrictions on businesses and public life.

Gov. Gavin Newsom added a surprise for the county and state’s 40 million residents: California intends on June 15 to fully reopen all 58 counties, although a mandate to wear masks will remain in place.

Although Newsom slightly hedged that state officials could reapply restrictions if cases of dangerous coronavirus variants spiked, he acknowledged by setting a statewide full reopening date that he was pitting the state’s vaccine campaign against the potential for virus mutations to spread.

The governor called it “really a race, these vaccines against the variants.”

Now, the key question is will Sonoma County be safely ready to take this big step forward to regaining a sense of pre-pandemic normalcy in nine weeks? If not, then what could occur?

Whether the county will be prepared for a mid-June entire reopening will largely depend on the continued ability to keep virus spread in check, even as variant strains wreck havoc in other parts of the country and world, area public health officials and medical experts said.

“I’m really optimistic. I’ve never been this optimistic in the pandemic so far, and I’m not even cautiously optimistic,” said Dr. Gary Green, an infectious disease specialist at Sutter Santa Rosa Regional Hospital.

It’s hard not to be optimistic. The rates of new COVID-19 cases, hospitalizations and deaths are steadily dropping. The county’s latest adjusted new daily case rate was 4.2 cases per 100,000 residents. And the test positivity rate, meaning the overall share of positive virus tests, stands at 1.7%. On Friday night, the county announced zero new confirmed cases of coronavirus for the past 24 hours.

What’s more, the pandemic disease has all but disappeared from local skilled nursing homes and assisted living properties, where the vaccination of the county’s most vulnerable residents is almost universal. Last summer, these senior care homes were the deadly epicenter of the infectious disease.

The all-important inoculation campaign broadened April 1 to residents as young as age 50. Starting April 15, people as young as 16 will be eligible for shots, although the number of weekly doses shipped here is expected to remain unpredictable and far short of the consumer demand for them.

Herd immunity when?

Dr. Urmila Shende, the county’s COVID-19 vaccine chief, said the coming weeks are going to be critical as the vaccination effort begins to target younger people to ultimately reach the goal of so-called herd immunity. That’s the point when at least 75% of local residents are fully immunized, the county’s key weapon to eventually defeat the coronavirus.

“At this point, we do see that the vaccine is extremely effective. (But) we do know there are variants among us,” Shende said. “The question is how quickly those variants are going to spread in the community and how quickly we can get the vaccine out.”

On Friday, a third of county residents older than 16 were fully vaccinated, and nearly 21% had gotten one shot of the two required Moderna or Pfizer vaccinations, according to county public health data. At the current pace of shots going into arms after three full months, all county health providers administering inoculations will be challenged to push the fully vaccinated rate from the current 33% of the adult population to that 75% herd immunity mark in two-plus months when the state intends to reopen.

County Health Officer Dr. Sundari Mase had said multiple times she expected the community to reach COVID-19 immunity by the end of summer. Last week, she expressed optimism that would occur but acknowledged the tight vaccine supply and some hesitancy locally to get the shots make it difficult to predict when herd immunity will be achieved.

Similarly, Mase said it’s too early to predict whether the county will be ready for a full reopening by June 15, but she noted coronavirus transmission, related hospitalizations and test positivity are each trending in the right direction.

During a meeting with The Press Democrat editorial board and two of the newspaper’s reporters, Mase said the county remains aligned with state-mandated public health restrictions and intends to fully reopen on the state’s timeline. But if the pandemic worsens locally by summer, she said, the county could decide to keep tighter rules in force than the state’s.

“At this particular time, there’s no plan for us to deviate from the state plan,” Mase said of the June 15 target date for the state to do away with its four-part reopening regimen that has been in place since late August.

State officials have certain benchmarks to meet before officially approving a full reopening, she said, including having enough vaccine doses for anyone 16 or older who wants to be inoculated and keeping virus-related hospitalizations low.

Hopeful economic prospects

Kevin Buchholz, owner of Echelon Cycle & Multisport in Santa Rosa’s Railroad Square neighborhood, said he hopes an eventual reopening this summer will spur more economic activity. He’s particularly looking forward to the return of large athletic events like the Ironman foot race and Levi’s GranFondo cycling extravaganza.

Buchholz, 44, echoed concerns raised by health care experts as the county incrementally eases pandemic restrictions that will culminate with the full reopening.

“I just don’t want us to get ahead of ourselves and get too cocky,” he said, adding that he’s scheduled to get his first virus shot.

Jeff Ingram, 55, of Roseville strolled Thursday through Railroad Square, wearing a face mask. Ingram, who works for a heating, ventilation and air conditioning company that’s doing work in the county, said he’s confident the state can accomplish its June 15 reopening goal.

“We’ve developed the knowledge and behavior as a community to better manage the pandemic,” Ingram said, noting state residents have had a year to learn lessons from it.

The variant threats

Although California’s COVID-19 transmission rate has dropped to the third-lowest in the country at 45 new daily cases per 100,000 people, keeping the virus and its threatening variants at bay will require the aggressive vaccination push to continue.

The governor projected over 30 million shots will be administered statewide by June 15. Currently, 21.5 million inoculations have been given, yet only 8.1 million state residents are fully vaccinated, according to state health department data.

A big national vaccination setback was confirmed Friday that will cut distribution in California by thousands of doses, in at least the next couple weeks when vaccination eligibility will dramatically expand statewide. Until regulators resolve quality control problems at a key production site for Johnson & Johnson’s one-dose inoculation, federal officials said supplies will be extremely tight.

As a result, California will receive only 67,600 doses the week of April 11, down sharply from the expected 572,700 J&J dose shipment. And although California expects slight dose increases next week from Moderna and Pfizer, state officials said they anticipate 400,000 fewer vaccine doses overall, or 15% less, than the previous week, followed by a 5% drop the week of April 18.

Meanwhile, coronavirus strains are raging in an alarming fourth surge in northeastern states New York, Pennsylvania, New Jersey and Delaware, as well as Michigan in the Midwest. Outside our nation’s borders, Europe, India, Brazil and parts of Canada are contending with widespread transmission.

“What’s happening now (in those states and abroad) is going to hit California, there’s no question,” said Dr. Michael Vollmer, a regional infectious disease specialist and epidemiologist at Kaiser Permanente.

“The question is what type of severity; what are we going to see in terms of a fourth wave of community disease.”

Vollmer said that mainly depends on how well the public adheres to public health rules.

“People really need to continue to wear a mask (and) they need to pay attention to what type of gatherings they’re attending,” he said. “Are they getting together with friends who are also vaccinated, who are taking precautions, or are they getting together with folks where they don’t know what type of precautions they’re taking.”

Coronavirus variants have been detected here, and county health officials and infectious disease experts say they could stymie progress made thwarting the highly contagious virus that emerged in the community in March 2020.

The county’s most recent tally of variant cases discovered locally is at least seven, including two cases of the U.K. variant, two cases of one West Coast variant strain and three cases of another West Coast mutation.

The vaccines have not only been shown to prevent COVID-19, but there is increasing evidence they also reduce the chance of transmission. In order for a virus to mutate into something more virulent or transmissible, it needs to spread.

Vaccine equity push

Jesús Guzmán, a director on the board of Alliance Medical Center in Healdsburg, said local and state leaders must be “hyper-vigilant” in tracking and monitoring further business and community reopening, and the effects on communities of color to “ensure that we don't repeat the sames mistakes that happened during prior reopenings.”

Guzmán said local health clinics, partnering with the county and other community-based organizations, are playing a key role trying to reach the level of vaccine equity along racial lines that will reduce transmission in disadvantaged communities.

According to the latest county public health data, there’s still a racial disparity among local inoculated recipients. So far, 62% of residents fully vaccinated are white and 18% are Latino, even though Latinos comprise 27% of the population.

On Friday, at the Roseland Library in southwest Santa Rosa, Gustavo Mondragon, 42, received his first COVID-19 shot at a new vaccination clinic set up in one of the neighborhoods in Sonoma County hit hardest by the pandemic. The clinic is a partnership between the county, Santa Rosa Community Health, Latino Service Providers and the CURA (COVID-19 Urgent Response and Aid) project.

Mondragon, a construction worker who lives in west Santa Rosa, said he just heard about the inoculation clinic from his mother-in-law earlier that day. He called from work during a break and got a same-day appointment.

“I’m really happy to do my part to get everything back to normal, or as close to normal as possible,” he said, speaking in Spanish.

Dr. Marie Mulligan, chief medical officer of Santa Rosa Community Health, said the Roseland clinic is one example of “aggressive immunization efforts across the county” involving her organization.

”We’re not letting up on our immunization efforts and the federal government has been forthcoming with overall increased vaccine supply,“ Mulligan said. ”So this is a reason to be cautiously optimistic, especially if we continue rigor around masking and social distancing when that (June 15) opening does happen.“

‘A path forward’

Vollmer, the Kaiser epidemiologist, acknowledged the need to set a statewide reopening date, contingent on meeting certain pandemic benchmarks. The battle against the virus can’t simply be framed as an endless campaign, he said.

“The key is you’ve got to give people a light at the end of the tunnel,” Vollmer said. “You can’t just say this is a forever thing, there has to be some attempt at a path forward.”

In Sonoma County, and elsewhere in the Bay Area, that light has become a lot brighter since the darkest days of the pandemic last summer and over the winter.

On Wednesday, for the second time in less than a month, Sonoma County officially advanced to a less restrictive tier on the state’s color-coded reopening road map. Unveiled last summer, counties make progress across four tiers — purple, red, orange and yellow — based on the ability of locales to control the virus.

For more than seven months, the county was stuck in the most restrictive purple tier, precluding many businesses from reopening or expanding operations as the county struggled with widespread viral transmission.

By mid-March, the county’s pandemic metrics had dropped precipitously since the winter, just as they had across the Bay Area and in many parts of the state. The local rate of transmission — currently an average of fewer than 25 new COVID-19 cases a day — has not been this low since before the summer surge in 2020.

Nursing home progress

County health officials point to successful efforts controlling the virus in nursing homes and assisted living facilities as an example of how vaccinations ultimately can end the pandemic. Senior care home residents, along with front-line workers and those 75 and older, were among the first to be inoculated when the first vaccine doses were delivered to Sonoma County in late December.

There hasn’t been a death attributed to complications of the coronavirus among senior care home residents since Feb. 16. No residents have tested positive for the virus in the past two weeks, and no senior care home workers have become infected the past week, county epidemiologist Jenny Mercado said.

County health officials said test postivity, the share of COVID-19 tests that turn up positive, among county residents 75 and older is nearly zero.

“If we remember that 66%, or two-thirds of the deaths experienced in the population, were in that elderly population,” said Ken Tasseff, the county’s vaccine site coordinator.

“So that strategy, I believe, has saved lives,” he said, of giving the oldest and most vulnerable residents early priority for vaccinations.

Now, officials are trying to replicate that success among the county’s most disadvantaged residents, many of them Latino, who have shouldered a disproportionate share of coronavirus infections.

It remains a work in progress with the county teaming with local clinics and community organizations. That intensifying effort, which is vital to the county’s vaccine equity goals and includes pop-up inoculation events and fairs, will be key to controlling further the spread of the virus and its variants.

Complacency could be deadly

Sutter hospital infectious disease specialist Green, speaking at a press briefing last week to update the county’s pandemic response, said the county has reached a point in which local health care workers have been able to “get a breath of fresh air” after a demanding year.

“We’ve seen a lot of death and dying, and we don’t want to see any more,” he said.

Green warned that public complacency could have deadly consequences.

“This is a race of vaccine against variants, and I think if we stop wearing masks, if we stop social distancing, if we start crowding into places and we go beyond our small bubbles, I think another surge will end up costing us lives,” he said.

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