1/ "Resurgence of SARS-CoV-2 Infection in a Highly Vaccinated Health System Workforce" published today in @NEJM details ↓ in vaccine effectiveness against INFECTION among @UCSDHealth employees - from 95%+ in the spring to 65% in July
2/ Our contact tracing team (led by @DrLucyEHorton) found virutally all known exposures were in the household or community. Few @UCSDHealth employees (mediage age 39) required hospitalization, but each is out 10+ days, creating staffing challenges, as well as additional exposures
3/ Unpublished analysis of cases through 8/26 shows continued ↓ in vaccine effectiveness, with Pfizer at just 49% - one of the reasons that @UCSanDiego has an indoor masking mandate 😷
4/ Analysis by month of vaccination also shows lower effectiveness for those who were fully vaccinated earlier compared to those vaccinated more recently (51% vs. 67%) suggesting waning of immunity and potential benefit of boosters
5/ Based on this data, our team believes that healthcare workers should be offered boosters as soon as possible, particularly as we experience continued record high patient volumes
Dr. Joseph Simone first published a set of maxims for understanding academic medical centers in 1999. They are so fundamental we often don’t know when we are stealing Joe’s lines.
Learn more about these famous aphorisms 🧵 (1/16)
Joe first published "Understanding Academic Medical Centers: Simone’s Maxims" as a Clinical Cancer Research editorial in September 1999 🧵 (2/16)
A possible sign of good news this morning? Our 7-day rolling average @UCSDHealth dropped for the first time to 14.1%. Patient, employee, and student rates are all down, tracking with @NMartinUCSD models
2/ Staffing continues to be a huge challenge with 730 @UCSDHealth health employees newly diagnosed with COVID in the last 7 days; we are managing day-to-day thanks to heroic team members stepping up to help
3/ With 1,414 @UCSanDiego students and 473 campus employees testing positive in the last 7 days, university leadership made the decision to extend virtual learning until late January 👏 sandiegouniontribune.com/news/education…
As we exceed 800 patients hospitalized with COVID across @SanDiegoCounty and 8000+ new cases just yesterday (!) how high will we go, and what's next?
A 🧵...
2/ According to @NMartinUCSD, who gave me permission to share her latest model, we will hit peak cases soon, but could see 1500-2500 hospitalizations across San Diego. My guess is that we will not exceed the 1800 of last winter, but time will tell 🏥🔮
3/ Yesterday @UCSDHealth set records for both the highest absolute total tests (almost 8k) and positive results (1,012) of the entire pandemic. On the bright side, the 12% positivity rate will actually drop the 7-day rolling average...
@SanDiegoCounty has over 600 individuals hospitalized with COVID - 2nd highest in the state (see fox5sandiego.com/news/coronavir…). We are on a steep trajectory and will soon surpass the peak of last summer's hospitalizations. Why?🧵
2/ First, South Africa and the UK saw fewer hospitalizations with their omicron surge, but ~25% of local cases are still delta according to data from @K_G_Andersen, so we are experiencing a twindemic of sorts.
👉searchcovid.info/dashboards/omi…
3/ Second, most inpatients have not had 2 doses of vaccine, and almost none have received 3 doses. We will be changing the logic of the @UCSDHealth dashboard this week to show booster doses since this is more effective for severe disease
2/ Based on the steep rise and fall of the omicron surge in South Africa, many are predicting the same here. I am less optimistic because the @SanDiegoCounty surge is still ~25% delta, which will drive a longer duration with more hospitalizations 🏥
3/ The San Diego COVID surge is still ↑ with @UCSDHealth positivity rates at unprecedented levels, and @SDCountyHHSA reporting almost 6,000 (!) new cases yesterday. And we know this undercounts home testing...
👉 sandiegocounty.gov/content/sdc/hh…