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San Diego County reaches key benchmark: herd immunity

Workers from Cal-Mat dismantle one of beds on the 10th floor of Palomar Medical Center.
Workers from Cal-Mat dismantle one of beds on the 10th floor of Palomar Medical Center. The floor was used as a federal aid station for the coronavirus.
(Charlie Neuman / For The San Diego Union-Tribune)

Crews begin removing emergency overflow hospital from Palomar Medical Center Escondido

State workers arrived at Palomar Medical Center Escondido Monday, June 14, to begin removing the beds, ventilators and other equipment that have filled two floors of the hospital since April 2020, when it looked like California might see the same deadly surge as New York.

Coming, as it did, on the eve of June 15, the day that most pandemic restrictions will fall, dismantling the federal medical station at Palomar is the ultimate signal of confidence. Pulling that gear out and trucking it back to warehouses in Sacramento is a clear sign of confidence from the California Office of Emergency Services that it is not likely to be needed any time soon.

This spring, noted Mel Russell, Palomar’s chief nursing officer, the plan was to keep the equipment in place through the end of the year.

“It’s nice to know that they want to get the stuff out of there a little early,” Russell said. “We’re getting back to normalcy, and this is just another sign of that, I think.”

One doesn’t cut down one’s safety net if they think there is a real chance of falling.

It is the growing success of California’s vaccination campaign that provides confidence that the state is no longer tiptoeing along an endless COVID-19 tightrope.

According to the state’s vaccine dashboard, about 66 percent of residents age 12 and older have received at least one dose, and Gov. Gavin Newsom said the state has crossed the 70 percent of all adults threshold set by President Joe Biden.

San Diego County is doing better still.

On Saturday, the region’s vaccine tracker ticked past 2.1 million, a figure said to represent 75 percent of the 2.8 million San Diego County residents age 12 and older.

This is the local “herd immunity” threshold said to represent a point at which the virus will have a hard time spreading very far or very quickly.

Getting to that mark before the Fourth of July has been a core goal of the massive vaccination campaign that has captivated the community for nearly six months.

Dr. Robert “Chip” Schooley, an infectious disease expert at UC San Diego Health, said that the public should both celebrate the moment and remember that herd immunity thresholds are approximate and don’t really say much about the risk of remaining unvaccinated.

Especially with new variants, including the “delta” type that was first spotted in India, there is still considerable risk to those who have not yet received their shots.

“Nothing magically happens at 75 percent that weren’t already well underway at 73 percent or 65 percent,” Schooley said. “We’re seeing a continuous improvement in the control of the virus as more and more people are vaccinated.

“But one of the dangers we have in saying ‘we’re at 75 percent’ is that we will stop pushing forward. We are still going to continue to see cases at a relatively brisk clip in people who aren’t vaccinated.”

Scripps Research immunologist and molecular biologist Kristian Andersen, a leading global voice on the potential danger of coronavirus variants, could be expected to have one of the most conservative outlooks on the Tuesday, June 15, reopening plans.

His lab is intimately involved in the genetic sequencing work that is necessary to identify the presence of variants, providing a front-row seat as vaccination raced mutations through the winter and spring. For a while there, it was not clear that the pace of inoculation could increase faster than the new, more-transmissible viral types could spread.

But Andersen said in an email Monday, June 14, that he supports the reopening plans. Continued monitoring of the delta variant will continue to be critical, but vaccination percentages are now great enough, he said, to make reopening plans reasonable.

“I don’t believe the delta variant will be too problematic — at least not in the short term,” Andersen said. “We’ll very likely see it rise to near-dominance in San Diego over the next few months, but I don’t expect it will lead to a steep increase in the number of cases and hospitalizations, all thanks to our tremendous vaccination efforts.”

It was not so long ago that many worried that variants would outrace the pace of vaccination, extending the holiday surge that forced hospitals across Southern Californian to frantically expand their intensive care units.

At Palomar, though, the benefits of vaccination seem to have arrived in time. Though the hospital’s previously-vacant 10th and 11th floors stood ready to receive hordes of COVID-19 patients, only 188 were treated on the 10th from Dec. 24, 2020 through Mar. 2, 2021. The number of patients cared for on any given day never exceeded 22.

But the experience of working with the state to get the facility up and running will help if coronavirus is not done with us yet, said Ryan Fearn-Gomez, Palomar’s manager of clinical operations and improvement.

“If there was to be another spike, we’d be ready to do it again in a heartbeat,” he said.

— Paul Sisson is a reporter for The San Diego Union-Tribune


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