As Santa Clara County gears up its infrastructure to deliver more COVID-19 vaccinations, county leaders on Tuesday expressed concern over the state's planned takeover of vaccine distribution and its rollback of the regional stay-at-home order.
The distribution and availability of vaccines continues to be an issue throughout the state, with counties and health care providers unsure of when they will receive the vaccines or how much, making it difficult to plan, they said during the Board of Supervisors meeting. The state doesn't receive that information from the federal agencies, which oversee distribution, Dr. Mark Ghaly, the state's health and human services secretary, explained on Tuesday during a state press conference.
The slow rollout has frustrated many officials and the public, who are hoping that President Joe Biden's administration will straighten out the bottleneck. Biden administration officials plan to hold a press conference regarding their strategy on Wednesday morning.
Ghaly said the state plans to revise its prioritization and distribution of the vaccines to help speed up the process as more doses become available, but the details aren't yet known. The state will shift from its current tier system based on occupations and age to eligibility by age groups, most likely beginning in mid-February, across all 58 counties.
State officials also have set up a website, MyTurn.ca.gov, which will establish a statewide eligibility system and provide residents a way to learn when they can sign up for their vaccines. The system, which is currently in the pilot phase in San Diego and Los Angeles counties, could expand throughout the state sometime in February.
The biggest unknown, however, is the impact of the state's plan to shift from a counties-based vaccine allocation system to a third-party administrator. The administrator, who has yet to be named, would be responsible for providing and distributing the vaccine doses to the various entities: counties, hospitals and others, Ghaly said.
County officials expressed concern during Tuesday's Board of Supervisors meeting.
"It will be important and critical to be sure, to make sure they provide (the vaccines) to the county system," County Counsel James Williams told the supervisors. "Obviously, it's a significant concern how to get the vaccines to the providers. It raises a lot of questions. It is extremely concerning."
The county health care system provides more vaccines than any other entity in the county's health care sector. The population it serves, largely low-income residents and people of color, is also among the most vulnerable to the coronavirus, he noted.
Dr. Marty Fenstersheib, the county's COVID-19 testing and vaccine officer, said the county system has vaccinated more than 127,000 people with the first dose and has provided 31,900 second doses, making up about half of the shots administered to date throughout the county from all providers, but it is only receiving about 30,000 to 40,000 doses a week, which includes the first and second doses.
Reaching the goal of vaccinating 85% of the population by Aug. 1, "takes 100,000 doses a week or 13,000 per day," he said.
County officials are also cautious about the state's Jan. 25 rollback of the regional stay-at-home order and the curfew, which limited nonessential travel and gatherings between 10 p.m. and 5 a.m. Ghaly said during a Tuesday state press conference that the lowering number of infections, hospitalizations and deaths since Thanksgiving indicated that those measures were effective. Individual behavior does make a difference, and the fact that people took the stay-at-home order more seriously around the Christmas and Hanukkah holidays resulted in the downward trend that the state is now seeing, he said.
In Santa Clara County, the number of hospital beds in use for both intensive care unit patients and non-ICU patients is also decreasing. At its peak in early January, the county had 173 ICU beds in use. That number has now dropped to 146. Non-ICU beds peaked at 559 and are now at 292, said Dr. Ahmad Kamal, the county's COVID-19 director of health care preparedness.
Although the record-setting case counts this month are declining, the number of cases still remains high in the state and the county, officials noted.
The number of hospitalizations is still five times higher than in October, prior to the surge caused by the holidays. Hospitals continue to defer nonemergency surgeries and outpatient operations to manage the COVID-19 caseload, Kamal noted.
"Being on the other side of the spike is faint reassurance," County Executive Jeff Smith said.
He noted that a well-known projection by the University of Washington found death rates could continue to rise even if the state maintained the regional stay-at home order.
"Right now we're at about 37,000 deaths so far in the state. But using this projection, if we were to continue with the current protections … we would still almost double and go up to 70,000 deaths at the beginning of May. Since the restrictions have been eased, (the projection) shows (an additional) 10,000 deaths … at the beginning of May. So basically, by easing, we're risking losing 10,000 more Californians.
"This just points out that although we in Santa Clara County have some positive feeling that we might be getting a downturn after the holiday peak, we're still connected to the rest of the state and to the rest of the country, and COVID is still out of control and we still have much to worry about," Smith said.
One bright spot in controlling the pandemic is testing, which has shown a marked improvement. Up to 25,000 people a day are now being tested, he said. The county now has a vast network of testing sites from mass testing to pop-up and local community testing events and a mobile testing van. Volunteers also have engaged in door-to-door outreach among immigrant communities that are traditionally wary of the government.
Through its isolation and quarantine program, the county has helped nearly 1,400 residents, including unhoused people, to isolate or quarantine in hotels since the beginning of the pandemic through Jan. 21. It has also assisted more than 2,640 households with groceries and help with other necessities. The county also has distributed more than $4.4 million in direct rental and financial assistance to nearly 2,100 households as part of the program.
Watch the county's COVID-19 report here:
Find comprehensive coverage on the Midpeninsula's response to the new coronavirus by Palo Alto Online, the Mountain View Voice and the Almanac here.