1/ "Resurgence of SARS-CoV-2 Infection in a Highly Vaccinated Health System Workforce" published today in @NEJM details β 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3/ Unpublished analysis of cases through 8/26 shows continued β in vaccine effectiveness, with Pfizer at just 49% - one of the reasons that @UCSanDiego has an indoor masking mandate π·
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
I had hoped to be done with these when I wrote the last one ~100 days ago, but the rate of positive #COVID19 tests @UCSDHealth is back to almost 4%, near the winter surge peak. So here we go again...π§΅
2/ Fortunately, the number of patients hospitalized with #COVID19@UCSDHealth is still relatively low at 22, but the uptick is worrisome, particularly with @SanDiegoCounty hospitalizations >200 again for the first time since March
3/ Of course the most important reason we are not seeing more inpatients with #COVID19 is that some of these new cases are so-called breakthrough infections that are far less likely to be severe or require hospitalization
Read on for some thoughts about hospitalization numbers, vaccine timing, and the predicted baby bust πΌ
And two small rewards at the end... π
2/ @UCSDHealth has hit a temporary equilibrium with census relatively stable ~7 days. Today we have 127 inpatients hospitalized for #COVID19 including 40 in the ICU, 31 on mechanical ventilators, and 7 on ECMO circuits
3/ @SanDiegoCounty hospitalization data shows a similar plateau with 1,591 inpatients across multiple hospitals today and a 7-day rolling average of 1,573 according to @HASDIC data
Let's talk about #COVID19 contact tracing...almost 27k #COVID19 cases in @SanDiegoCounty, and county staff can NOT keep up. Despite hiring >200 contact tracers, just 10% of cases are now investigated within 24 hours!
2/ Contact tracing works great for sexually transmitted infections, but does not scale well for a pandemic caused by a respiratory disease spread by airborne droplets. So what should we do? Hire more contact tracers?
3/ Recent models show that "minimizing contact tracing delays, for instance with app-based technology, further enhanced effectiveness, with the potential to prevent up to 80% of all transmissions."
@UCSDHealth is now caring for 51 inpatients with #COVID19 including 21 on vents and 5 on ECMO. These individuals come from all over southern California, particularly @SanDiegoCounty and @ImperialCntyCA
2/ In a bit of bright news, with just 16 positive PCR results in the last 24 hours, the 7 day rolling average @UCSDHealth decreased to ~21 positive tests/day. This rate of ~2.3% is now the lowest across @UofCAHealth
3/ Unfortunately, @SanDiegoCounty hit two grim milestones yesterday with over 25k #COVID19 cases (+587) and over 500 deaths. San Diegans over 70 yo represent only 17% of the cases but 87% of the deaths, and nearly all had underlying medical conditions.
As we end this holiday weekend @UCSDHealth is caring for 47 inpatients with #COVID19. Overall @SanDiegoCounty bed capacity is fine with 382 total inpatients, though will be watching closely for an β in based on recent data.
2/ The amazing @UCSDHealth#SARSCoV2 results team is monitoring >100 patients at home or in public health temporary housing. This is the highest # of people monitored in home isolation in a single day. It is also 10x higher than baseline monitoring responsibilities 6 weeks ago.
3/ #SARSCoV2 test results from July 4th, 2020 shows another record setting day with 562 new cases identified in @SanDiegoCounty and 5,410 new cases in California.