More and more people are getting sick with COVID-19 in large swaths of California where vaccination rates remain far below the state average.
In Northern California and the Central Valley, hospitals are once again overwhelmed and understaffed. Some schools have temporarily closed because of staffing shortages.
“What we're seeing is increased rates of transmission because of the Delta variant being so incredibly, highly transmissible, and much more infectious than the previous strains,” said Dean Blumberg, chief of pediatric infectious diseases at the UC Davis Children’s Hospital.
Last week, Shasta County broke its record for the most COVID-19 hospitalizations at any point during the pandemic. In that county, 46% of eligible people are fully vaccinated.
“Our extremely high transmission is being driven by the Delta variant,” said Robin Schurig, the director of public health in Shasta County.
Most people who require hospitalization or ICU care are unvaccinated, Schurig said, reflecting state and national trends.
More Young People Getting Sick
In many counties where case numbers are once again climbing, young people are driving the surge.
Vaccination rates are lower among younger people, and this, combined with reopening the economy in June and the arrival of the Delta variant, has contributed to the spread, according to Blumberg.
“With less lockdowns, less social distancing, then what we're seeing is a skewing of the age of infection to younger ages of infection,” he said.
In Fresno County, where 63% of the eligible population is vaccinated, people between ages 20 and 50 make up the majority of infections.
“Our unvaccinated [population] unfortunately is our younger population, and they're driving this pandemic right now,” said Joe Prado, interim assistant director of the Department of Public Health in Fresno.
The county created a separate dashboard to understand how the virus is moving through groups of children and teenagers — an effort in part to help school districts make informed decisions, Prado said.
The same pattern holds true in Tulare County, where the test positivity rate is over 10%, and 47% of eligible people have been vaccinated.
“It's a steep incline at the moment,” said Dr. Karen Haught, the public health officer in Tulare County.
Hospitals Under Stress
Across counties where vaccination rates remain low, hospitals are being pushed to the brink.
“We have folks working extra hours, extra shifts, extra days,” said Robert Folden, the executive director of Mercy Medical Center in Redding. “That's distinctly different with this current variant are, unfortunately, the number of deaths that we're seeing.”
Other medical facilities in the area are extremely understaffed. Shasta Community Health Center, which is a clinic, has 60 open positions currently, according to chief operations officer Brandon Thornock.
“Please be patient at the other health care organizations and other organizations that are experiencing similar shortages, it's only going to get worse,” he said.
Thornock says he expects the staffing situation will grow more severe after the statewide vaccination requirement for health care workers takes effect at the end of September.
Hospitals in Tulare and Fresno counties have exceeded their hospital bed capacity and have had to transfer people to other facilities. The situation is so acute in Tulare County that over the past few weeks, its hospitals have canceled elective surgeries to focus resources on caring for COVID-19 patients.
“We're at a point in Fresno County that we didn't experience during the last surge in December and January,” Prado said.
The county has asked for support from the Department of Defense in managing the current surge. Fresno County expects the National Guard will help at its most stressed hospitals — like one in Clovis that is at 140% capacity — but the details have not been finalized.
As the virus spreads rapidly through communities with low vaccination rates, frontline workers are getting sick or having to quarantine after exposure, further stressing institutions and small businesses.
On a recent day, the hospital system in Fresno County had about 300 employees out for COVID-related reasons, either because they were sick, or they were in quarantine, according to Prado.
“That hurts a hospital system when you have that many employees out,” he said.
Both Tulare and Fresno have made requests to the state for additional support, and are hoping more traveling nurses will arrive soon to care for sick people.
Schools are feeling the pressure, as well. As the Delta variant spreads, schools and businesses have faced closures as their staff members get sick or have to quarantine after exposure to the virus.
In Shasta County, at least two schools closed temporarily because they didn’t have enough health staff to operate. A shortage of substitute teachers has exacerbated the already tenuous situation, according to Judy Flores, the superintendent at the Shasta County Office of Education.
“We can have a large number of student issues and it [does] not impact our ability to stay open. But you get certain staff positions not being able to be filled, and it does inhibit a school to stay open,” she said at a press conference last week.
Getting People to Get the Shot
Shasta, Tulare, and Fresno health officials say they have seen slight increases in vaccination rates as more and more people are getting sick. None of these counties has implemented vaccine requirements beyond the state mandates.
“It would be difficult for that to be enforced here,” Haught said.
At a press briefing this week, Shasta County’s health officer Dr. Karen Ramstrom appealed to businesses and employers to implement policies that would encourage people to get vaccinated, wear masks, and socially distance.
“We need to stop fighting the prevention recommendations. They’re tools to support our livelihoods in our community,” she said. “No one is coming to save us.”
Absent widespread vaccination, Blumberg from UC Davis says the future is clear.
“At this point in the pandemic, with the Delta variant circulating that is so transmissible, if you haven't been vaccinated, you're going to get COVID,” he said. “So then, we just have to get through that.”