Sonoma Valley health officials voice ‘twindemic’ concerns

The flu season is just beginning and the COVID case and positivity rates are low in Sonoma County, but health officials are concerned that both could hit the area hard in the coming months.

“Everyone is concerned about the potential for a ‘twindemic’ or worsened disease due to both COVID and influenza,” said Dr. Sundari Mase, health officer for the Sonoma County Department of Health Services.

In Sonoma County, as of Oct. 14, the COVID case rate, which is the percentage of new COVID cases that turn up each day per every 100,000 people, has fluctuated from a high of 254 on Jan. 10 to none in mid-March, to 46.9 on June 6, to 6.7 on Oct. 14. The positivity rate, which reflects a seven-day average, has gone from a high of 22.5% on Jan. 17 to a low of 2.4% on March 16, to 16.6% on June 25, to 4.7% on Oct. 14.

The recent levels are the lowest they have been in several months, Mase said, adding that wastewater surveillance also suggests decreased transmission.

“Both testing and positivity rates are low at the moment, but the holidays are right around the corner,” said Cheryl Johnson, CEO of Sonoma Valley Community Health Center (SVCHC).

The number of hospitalized COVID patients also has been declining over the past several months in Sonoma County. There was a high of 116 hospitalizations on Jan. 21, followed by a low of two on April 8, 57 on July 11 and 19 on Oct. 12.

Dr. Anthony Fauci, chief medical adviser for the pandemic, said that it is likely that another variant will emerge in the fall or winter in the United States during a recent virtual talk at the Center for Strategic and International Studies.

“I agree, and we will need to continue close surveillance,” Mase said. “It is hard to predict what may happen over the next few months. There are new variants of omicron that are emerging, and this may impact a surge. We will follow trends and variants closely.”

Health professionals are keeping a close eye on one particular variant, BA.2.75.2. Dr. Eric Topol, director of the Scripps Research Translational Institute in La Jolla, told the Los Angeles Times that this variant and the BQ.1.1 variant already have been established as the “most extreme immune escape” variants seen to date, and that “is not a good thing,” considering the impact of the potent omicron variant, in particular.

“There is concern that new variants such as BA.2.75.2 are able to evade immunity from our current vaccines and from primary infection with previous variants,” Mase said. “We are monitoring the emergence of new variants through genotyping and wastewater surveillance.”

Johnson adds, “A virus’ philosophy is to survive, via mutation, and replicate. The COVID virus — and the flu virus, for that matter — honor that philosophy well.”

She also says that New York is already starting to see an increase in flu cases compared to the same time last year.

“Officials are attributing this to people assuming old, pre-COVID habits and an unwillingness to receive the flu shot or get the COVID booster,” Johnson said. “The precautions for COVID are the same for the flu, so it is conceivable there will also be a rise in COVID cases.

“For the last two years, New York has been ‘the canary in the coal mine,’ so I would expect to see similar patterns here about 30 to 60 days later than what happens there.”

SVCHC administers COVID vaccines and booster shots — including the new bivalent vaccine, recommended for those 12 years old and above — on Wednesdays from 5 to 8 p.m. at the center, 19270 Sonoma Highway in Sonoma. Appointments can be made by accessing this webpage. People wanting booster shots should bring a vaccination card.

“Like the flu, the COVID virus continues to mutate and has to be boosted,” Johnson said. “Also like the flu, the COVID virus continues to mutate. The new bivalent vaccines contain both the original strain and the current, dominant strain. Prior boosters only had the original strain.”

She says that requests for the bivalent booster have been lower than expected. According to data from the California Immunization Registry (CAIR), in Sonoma Valley, 172 doses of the bivalent booster were administered by SVCHC and 25 were administered at Sonoma Valley Hospital.

“Given that the age floor is so low, we are not experiencing the demand we thought we would see,” she said. “Based on last year, it’s conceivable that demand will increase a week before Thanksgiving and continue to New Year’s.”

By comparison, Mase says that countywide, the demand for booster has been strong. CAIR records show that as of Oct. 13, 39,101 doses had been administered in Sonoma County.

“There definitely seems to be demand for the bivalent booster and many vaccinations are being given at our fixed and mobile sites,” she said.

Mase urges more Sonoma County residents to receive the booster.

“It provides immunity against the omicron variants of COVID, and therefore, it will offer great protection from potential negative outcomes such as severe illness, hospitalizations and death,” she said. “The booster is important for everyone who is eligible, but especially for those over 65 and those with underlying medical conditions.”

Mase also encourages people to get vaccinated for the upcoming flu season, which generally runs from October to May, with the peak typically from December through March.

“Everyone 6 months and older is advised to get the vaccine,” she said. “The upcoming flu season is predicted to be more serve due to the fact that fewer people got influenza during COVID, due to the mitigation measure in place the last two years.”

She and Johnson urge everyone to be proactive about taking care of their health during the fall and winter months.

“Social distancing and masking kept flu levels low the last two years,” Johnson said. “If they are not prevalent during flu season, we expect an uptick in flu, COVID or both — people have been known to get them simultaneously.”

Mase added, “Although many of our mitigation measures are now recommended rather than mandated, the best way to protect yourself, your family and the community is to get vaccinated and boosted, continue to mask in indoor settings and take precautions if you or someone that you live with are at risk.”

Health officials generally feel that Californians are well-positioned heading into the colder months due to ready supplies of vaccines, supplies, therapeutics and the rollout of updated booster shots, but Johnson urges more public vigilance.

“It feels as if we are better positioned, but we would be better off if vaccines were being administered in arms,” Johnson said.

Reach the reporter, Dan Johnson, at daniel.johnson@sonomanews.com.