Coronavirus cell

Elizabeth Fischer uses an electron microscope to capture images of the coronavirus, which is about 10,000 times smaller than the width of a human hair. (Elizabeth Fischer/KHN/TNS)

The intensive care unit at Adventist Health Sonora was full Monday night as 14 people were being treated at the hospital for COVID-19, Tuolumne County’s interim health officer said Tuesday morning while giving an update to the county Board of Supervisors.

Dr. Eric Sergienko told the board they were already starting to see cases associated with people traveling and gathering over the holidays, and that the hospital was considering repurposing a post-anesthesia room to treat additional patients as modeling predicted hospitalizations to rise in the coming weeks.

“As we see an increase in the number of cases, we see about a one to two week lag before we start seeing hospitalizations and associated deaths with those,” he said.

Sergienko told the board at least two of the 14 hospitalized coronavirus patients Monday night were confirmed to residents of the county, though that number grew to four in the report later that afternoon. He also said two of the 14 were in the hospital’s ICU, which has six licensed beds.

Surge modeling out to Feb. 2 projected the number of daily hospitalized patients in the county to peak at 19, according to a slide from Sergienko’s PowerPoint presentation.

The county reported 18 new cases Tuesday afternoon following Sergienko’s update to the board earlier that morning. None of the new cases were prisoners at Sierra Conservation Center near Jamestown, where an outbreak has infected more than 1,100 inmates since early December.

Michelle Jachetta, the public health director for the county, said they were aware of two SCC inmates who were hospitalized Tuesday afternoon at Adventist Health Sonora. She deferred to the hospital when asked how many COVID-19 patients are from other counties, adding that where they reside is likely private health information.

Sergienko noted during his update to the board that some patients in the 12-county San Joaquin Valley region that includes Tuolumne and Calaveras are being transferred to hospitals in Nevada due to a lack of collective ICU space.

Dr. Alex Heard, chief medical officer at Adventist Health Sonora, did not address questions about whether the hospital was taking COVID-19 patients from other counties and downplayed the impacts on the 152-bed hospital. He said they have used their surge planning to work through “a few temporary challenges” and were functioning under conventional operations as of Tuesday afternoon.

“These are relatively normal procedures, as our capacity is always in flux, whether we are in a pandemic or not,” he said in a statement sent via email. “It is gratifying to know that our local partnerships and surge plans are working well and allowing us to care for our community, including those with COVID-19, and for all of our other patients with urgent, emergency and routine care needs.”

Tuolumne and Calaveras counties both remained under a regional stay-at-home order Tuesday afternoon, with the available ICU capacity in the San Joaquin Valley region currently at 0%. 

Regions are placed under a stay-at-home order when their available ICU capacity dips below 15%, though Sergienko said the state is now using a metric of lifting for them when modeling projects the available capacity to rise above 15% within four weeks.

Sergienko added that current modeling projected the San Joaquin Valley region’s available ICU capacity to still be well below 15% four weeks from now.

The county’s daily case rate of 25.4 per 100,000 people and testing positivity rate of 7.7% as of Tuesday were down from what they were one week earlier, though that still qualified for purple tier — the most restrictive under the state’s tiered ranking system for COVID-19 risk — even without the regional stay-at-home order in place.

Inmate cases do not count against the county’s metric under the tiered system. 

However, the county was expected to get a second shipment of 975 Pfizer vaccines this week as the second dose for those who received the first doses that arrived two weeks ago. The county also received about 600 Moderna vaccine doses last week, some of which went to Mariposa County.

Vaccines are currently being distributed only to people who are part of “Phase 1a,” which includes health care workers and residents at long-term care facilities. 

Eligibility for the vaccine under “Phase 1b” will be expanded to all people 75 or older, people 65 to 74 with underlying health conditions, and frontline essential workers like firefighters, law enforcement, and teachers. Jachetta said there is currently not a specific timeline for when the county will receive enough doses to move into that phase.

Jachetta said the county was working on a graphic or data dashboard that will show the number of vaccines received and how many have been distributed or administered, though she didn’t have any details available on how many people have been offered and declined the vaccine.

The county’s death total from COVID-19 remained at 22 on Tuesday, with the most recent one reported the previous day. Thirteen coronavirus deaths were recorded in the county in December, while the first eight coronavirus deaths occurred between July and November.

There have been 1,945 confirmed cases in the county outside of the prison, which has confirmed 1,118 inmate cases. The county had less than 300 cases total at the end of October and 16 total inmate cases at the end of November.

Calaveras County, which reports cases twice a week, confirmed an additional 45 cases on Tuesday. That brought the county’s total since the start of the pandemic to 898 cases, with 748 individual cases described as recovered, and 128 active cases. 

The county has also confirmed a total of 22 deaths from coronavirus since the start of the pandemic, though 16 were reportedly part of an outbreak at the Adventist Health Care nursing home in San Andreas that occurred in late July and early August.

Tuolumne County had 132 active cases as of Tuesday, while Calaveras County had 128.

Contact Alex MacLean at amaclean@uniondemocrat.net or (209) 768-5175.

Recommended for you