Infections may rise after holiday travel

The number of hospitalized COVID patients has spiked during the holiday season, and with year-end travel and new Omicron subs landing in San Diego County, experts worry the trend could continue .

As of Dec. 28, nearly 480 confirmed and suspected COVID patients were hospitalized — more than double the count on Thanksgiving. Since October, the average daily rate of confirmed cases in San Diego County has tripled, reaching 19.7 per 100,000 people on December 24, and the county reported 15 new deaths this week. Currently, the CDC places San Diego at an “average” level of community COVID.

Why is this important

The new coronavirus continues to develop and spread across the country, causing severe disease and numerous deaths in San Diego County, especially among vulnerable populations such as people with compromised immune systems.

The flu has also been on the rise this fall — months earlier than in years past — leading to more than 19,000 infections and 29 deaths so far in San Diego County. In the previous five years, San Diego County averaged about 11,000 cases per year.

“Usually, our peak is late January … or later in February,” said Wilma Wooten, public health officer for San Diego County. “The only thing predictable about the flu is that it’s unpredictable.”

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While the seven-day average number of newly reported COVID cases dipped slightly in December, those numbers could rise again as post-holiday data comes in.

The coronavirus mutates as it spreads, giving rise to variants and sub-variants that alter its transmission, severity and immune evasion. The Omicron variant that appeared last year led to a huge spike in cases last winter, and the sub-variants still account for the majority of infections.

In San Diego County, the Omicron BQ.1.1 subvariant has been the predominant form of the virus since it first appeared in wastewater sampling data in October. Another variant, XBB, has become the most common in the northeastern United States. Wastewater sampling shows XBB in San Diego County in late November.

“It seems to be more immunogenic so we may see more hospitalizations, more illnesses,” said Corinne McDaniels-Davidson, epidemiologist and director of San Diego State University’s Public Health Institute.

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“I think there’s still two weeks maybe three weeks of pain to come — cases of COVID and cases of flu,” said Dr. Davey Smith, head of infectious diseases at the University of California San Diego. “We’re only a few days after Christmas, so it’s hard to say.”

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Smith added that previously authorized monoclonal antibodies do not work against the most common subtypes now being spread in San Diego, limiting effective treatment options for people at risk of serious disease, such as the elderly, people who are immunocompromised or people with chronic health conditions.

Although the virus has changed, the methods to prevent COVID remain the same: cover, spread, hygiene, ventilation and vaccines.

Although 81% of eligible people in San Diego County have been vaccinated, only 21% have received the newer bivalent booster that is intended to combat Omicron. The newer sub-variants are more likely to cause breakthrough infection, although doctors still recommend the vaccines to prevent infection, hospitalization and death.

“Many people don’t even know that there is a bivalent booster available that is different from the previous booster,” McDaniels-Davidson said. “I think there was a milquetoast kind of pressure behind it.”

Although community outreach has increased in recent weeks, county officials are not currently weighing any new coverage requirements.

“We’re in another phase of COVID-19,” Wooten said. “Our recommendations follow the science and align with CDC, as well [the California Department of Public Health] in those recommendations.”

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Given the backlash against measures that were deemed too restrictive — or not restrictive enough, depending on your perspective — McDaniels-Davidson said it makes sense for local officials to follow the CDC’s lead.

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“A lot of people are very nervous to say, ‘You know what? We should all be wearing masks,’” she said.

Therefore, she said, the federal government should issue stronger guidance on how local officials should act as cases and hospitals rise and new strains spread. With San Diego County currently at the “medium” community level, the CDC currently recommends masks for people at high risk of infection or testing who have contact with high-risk individuals.

Holidays, when friends and family often travel to spend time together, could help spread COVID, Smith said.

“A lot of young people will have this infection, without symptoms, and then they’ll bring it to these holiday parties and it’s a disaster,” he said. “I just see too many families mourning their loved ones and realizing that they had a part in that walk. And that’s just heartbreaking.”

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News: Based on facts, directly observed and verified by the reporter, or reported and verified by informed sources.

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