Coronavirus case rates and test positivity are steadily declining in California and the Bay Area, signaling that the region is finally on the decline from this summer’s record COVID-19 surge, driven by successive waves of subvariants of omicron.
But while the worst may be over, the amount of virus in the community remains far higher than in April before the outbreak, and hospitalizations – a lagging indicator of infection rates – are still high.
Health officials warn of complacency and the possibility of new, evasive immune versions of the virus that could prolong the pandemic well into the fall. They recommend that people stay on guard against infection or re-infection through vaccinations, booster shots and voluntary indoor masking.
“We’re in a good position, of course, but we can’t ignore the virus,” said UCSF infectious disease specialist Peter Chin-Hong. “Things can get unpredictable.”
Although the peak in cases occurred several weeks ago, the continued fluctuations in reported numbers have made it impossible so far to be certain of the downward trend.
The Bay Area reported an average of 34 coronavirus cases per day per 100,000 residents on Friday, according to state data. This is about 35% less than a month ago. But it remains well above the baseline of 6 cases per 100,000 seen in April after the winter omicron surge ended.
The drop in cases is underscored by the recent drop in coronavirus particles found in Bay Area sewage samples. Wastewater monitoring can provide a broader view of virus concentration in the community because it captures everyone’s effluent and is not dependent on who gets tested or whether or not a kit is used. home rapid antigen test.
California follows at 37 cases per 100,000 population, down from around 50 per 100,000 in July. On Friday, the state surpassed 10 million COVID cases recorded since the start of the pandemic.
“This is a longer phase of high transmission than we’ve seen in previous periods,” San Mateo County health officer Louise Rogers said in an update this week. She cited the prevalence of the immune-resistant BA.5 omicron subvariant, which causes new infections and reinfections, even among people who caught the original omicron variant.
Hospitalizations are slowly trending down across the state, but remain steady in the Bay Area. The average number of people hospitalized per day with confirmed COVID-19 infections in California rose from about 3,500 in early July to 4,686 at the end of the month, according to health department data. This represents a 34% increase in one month.
The Bay Area reported 883 people hospitalized with COVID-19 on Friday, up from 748 on July 4. Deaths remain well below previous phases of the pandemic, steady at around 42 a day statewide.
The statewide positive test rate, which tracks the average number of coronavirus tests that come back positive, remains near 15% — a rate that has fallen slightly since the last peak of 16% in mid- July.
Infectious disease experts believe the rate should be below 5% to effectively control the spread of the virus.
Dr. Bob Wachter, chairman of the UCSF Department of Medicine and pandemic expert, said the reported cases likely represent approximately one-fifth of actual cases due to the widespread use of home tests that are not reported to authorities. But the trend line of the official counts nevertheless points downwards.
Despite the overall improvement, only three of California’s 58 counties — Lassen, Plumas and San Luis Obispo — were classified as having “low” community levels of COVID-19 on Friday, according to data released by the Centers for Disease Control and Prevention of the United States. .
Another 27 counties, mostly in the eastern half of the state but including Marin and Santa Cruz, are classified with “moderate” COVID-19 community levels. And nearly all major population centers, including most counties in the Bay Area and beyond, are designated as having “high” community levels.
The CDC strongly recommends universal indoor masking for counties under this classification.
However, many locals are eager to put the pandemic behind them. They have mostly set aside masking and other coronavirus safety measures that have helped the region weather previous waves better than most other places.
Schools are expected to reopen within the next two months without mandatory masks, testing or vaccinations. People are also moving and congregating more freely as local airports report pre-pandemic numbers and major events return to the Bay Area’s cultural calendar.
Golden Gate Park hosts the Outside Lands festival this weekend with 75,000 attendees each day, followed in October by the free Hardly Strictly Bluegrass festival, which draws up to 200,000 attendees each day.
“The reality is, we’re in a COVID world, and it will be like that for the foreseeable future,” said Allen Scott, co-founder of Outside Lands and president of concerts and festivals at Berkeley promotion company Another Planet. Entertainment. “I think people are resigned to living with it.”
Chin-Hong said we are unlikely to see the return of sweeping community-wide restrictions, but more targeted temporary measures are possible if the numbers start to rebound.
“You can imagine temporary mask mandates in schools if teachers and staff start getting sick, like we’ve seen with BART, and in other micro-environments,” he said. “We know they work.”
He attributes the nonchalant attitude to the high number of infections in recent months.
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“The most important thing is that so many people have it now,” he said. “If you’ve lived it, you’re no longer afraid of the unknown. You might think, ‘What if I get it again?’ It’s more tangible now. People are fed up and they are ready to take this risk.
Sonoma County Health Officer Dr. Sundari Mase told supervisors on Tuesday that the most severe COVID-19 outcomes – hospitalizations, intensive care admissions and deaths – are holding up at better levels compared to flare-ups. of 2020 and 2021, but pointed out that we are not out of the woods.
“My message to the community is to stay vigilant,” Mase said. “COVID is with us and we need to take precautions if we don’t want to get sick. Social responsibility is where we are right now.
While Bay Area health systems have weathered the outbreak without undue stress, new challenges lie ahead. In addition to the possibility of new coronavirus variants, the fall could also lead to an influx of flu and monkeypox patients competing for medical resources.
“There will be other threats to hospital beds,” Chin-Hong said. “All of this is straining the healthcare system.”
Chronicle editor Catherine Ho contributed to this report.
Aidin Vaziri (he/him) is a writer for the San Francisco Chronicle. Email: avaziri@sfchronicle.com