Tag Archives: ICU

Dr. Richard Fleming: Letter to Benicia City Council on Benicia’s Mask Mandate

February 11, 2022
By Benicia’s Dr. Richard Fleming
(posted here with permission)

Dear Council members and Mr. Upson – Should Benicia lift its current indoor mask mandate?

My recommendation is: Not yet, but hopefully soon.
Richard Fleming, M.D., Benicia, CA

Our state is lifting the statewide mask mandate February 15. Most Bay Area counties will be lifting their indoor mask mandates the week of February 14, 2022, though the specific approach varies. Some counties will require that unvaccinated people continue to wear masks in indoor public spaces, and that masks are still required by all in some indoor spaces.

There is clearly a strong desire to return to normal life and social interactions after two years of this pandemic. There are objective signs the pandemic may be on the cusp of turning into an endemic situation, given increasing vaccination rates and increasing natural immunity. But it is apparent that different geographic areas are in different stages of moving towards endemicity. And it is also clear from our collective experience over the past two years that it is not unusual to see viral spread increase after public health restrictions are lifted in defined geographic areas.

Given these two realities, I feel our city should proceed in a measured way – relying on objective data which gives the most accurate available picture of the current state of the pandemic in our city – in deciding when to lift the indoor mask mandate. This mandate, it should be noted, has been supported and complied with by the vast majority of city residents and visitors to our city. It would be tempting to yield to feelings of exhaustion with the pandemic, but doing so may lead to policy changes we come to regret.

*    *    *

When our city council put in place the current mask mandate on August 25, 2021, it decided to use an objective metric to decide when this mandate could be lifted. When case rates in Benicia stayed in the CDC-defined moderate transmission level for 30 consecutive days, masking would no longer be required. Subsequent discussions in the council have considered using more than one metric to make a mandate-lifting decision, but no decision was made and goal numbers were not established.

Using several metrics would provide greater assurance about when it would be safe to lift the mask mandate. Any single metric has some intrinsic flaws, so a combination of several would provide a more accurate picture of the state of the pandemic in our city.

Under our current metric – case rate – we have too many cases per week to stop the mask policy. According to Resolution 21-88, we need to reach 27 or fewer cases weekly and maintain that for 30 days. We are currently at 100 new cases per week. Though this number is very high, it is trending downwards. For much of January, we were averaging 200-400 cases per week. Progress is being made, and there is reason to hope that in the weeks ahead, we will achieve a moderate level of transmission. (It is important to keep in mind the caveat that case numbers are increasingly inaccurate and reflect an undercount due to the growing use of home antigen tests. This is why adopting several metrics would provide greater accuracy.)

*    *    *

Other metrics that could be used include the following. I feel that in assessing this data, we look not just at current numbers, but at trend lines, since those can provide dynamic information on the trajectory of the virus.

  • Hospitalizations. We do not have Benicia-specific data, so Solano County data can be used as a proxy. The county is currently seeing 35 covid-19 hospitalizations per 100K residents, which is close to the highest level of the pandemic. More concerning is that our hospitalization rate is trending upwards. It has risen 48% compared to two weeks ago. Our hospitalizations are rising more rapidly than any Bay Area county other than Marin, whose hospitalization rate is only 21 per 100K. So, even though the official case-rate numbers are trending in a good direction, hospitalizations paint a more concerning picture of where our county stands.
  • Vaccination rate. Currently, 78.6% of city residents have gotten 2 shots of Moderna or Pfizer, or 1 shot of J&J. Of this number, 55% are boosted. So the proportion of city residents who are truly fully-vaccinated is 43.2%. (Boosters are proven to be crucial for optimal protection.) 35.4% of city residents received full initial vaccine doses but are not yet boosted. They do have greater immunity than unvaccinated people, or those who did not complete their initial vaccine series. There are many city residents who have some degree of natural immunity, but their level of protection is not clear. A significant proportion of people who report having recovered from covid have no detectable antibodies, and it is not clear how long antibodies persist in those with natural immunity. Bottom line, while our community’s immunity is increasing, a significant proportion of our residents remain highly susceptible to serious covid infection.

Comparing our city’s vaccination rate to nearby counties, 6 of the other 8 Bay Area counties have a higher percentage of their entire county vaccinated than does the city of Benicia. We are still lagging behind in what should be achievable vaccination levels.

  • Test positivity rate. No city data is available. Solano County’s positive test rate is 19%, compared to a statewide rate of 7%.
  • Hospital capacity, ICU bed availability, and ventilator availability. In these metrics, our county is doing fairly well, though it is also true our hospital staff and health care workers are under significant stress and are looking forward to the period when covid-19 becomes truly endemic, rather than aspirationally endemic.

*    *    *

Bottom line, I encourage you to maintain your commitment to using objective data to decide on when to lift the mask mandate. I recommend you adopt 3 metrics – cases, hospitalizations, and vaccination rates – as the data to look to. Choosing a goal for each metric, and requiring 2 of the 3 goals to be met over some period of time, would help maintain a safe environment for our city. I feel making the decision based on such measures would be widely-supported in our city. And, at whatever point you decide to lift the mandate, I recommend you also clearly advise our residents that indoor mask-wearing in public spaces is still appropriate and encouraged until the metrics improve even more, and that you also allow individual businesses to continue requiring masks of their own customers.

Sources for above data available upon request.

Thank you.

Richard Fleming, M.D.
Benicia

Solano County discloses previously unreported COVID deaths – 13 in two days


By Roger Straw, Tuesday, May 18, 2021

Solano reports 15 new cases today, and 6 new deaths!  Stay safe, and remember: People with mild COVID can have long-term health problems

Solano County COVID report on Tuesday, May 18.
[Source: see far below.  See also my ARCHIVE spreadsheet of daily Solano COVID updates.]
Solano County COVID-19 Dashboard – SUMMARY:

Solano County reported 15 new COVID cases today.  Reports are that our red-tier Solano County will not be joining all other Bay Area counties opening in less restrictive tiers anytime soon.  We saw 1,288 new cases in April, an average of 43 per day.  In the first 18 days of May, Solano reported 549 new cases, an average of 30 per day.  

The County reported 6 NEW DEATHS today, one young adult age 18-49 and 5 persons over 65 years of age.  According to the Fairfield Daily Republic, yesterday’s 7 newly reported deaths occurred in January and February, with more such reports to come this week.  No doubt this includes most if not all of today’s 6 new deaths.  Solano County Public Health Officer Dr. Bela Matyas has in the past performed “occasional updates” on previously unreported hospitalizations.  Now we can add deaths to that practice.  Our hearts go out to all of these, and their families and friends. 

We learned of no new hospitalizations today.  Our percent positivity rate remained steady today at 5.8%.

>> The virus is still active here.  Stay safe, get vaccinated, wear a mask and social distance!  We will get through this together.

Cases by City on Tuesday, May 18:

  • Benicia remained steady today, total of 984 cases since the outbreak began.
  • Dixon added 4 new cases today, total of 1,908 cases.
  • Fairfield added only 4 new cases today, total of 8,985 cases.
  • Rio Vista remained steady today, total of 370 cases.
  • Suisun City remained steady today, total of 2,264 cases.
  • Vacaville added only 2 new cases today, total of 8,617 cases.
  • Vallejo added only 5 new cases today, total of 9,795 cases.
  • Unincorporated areas remained steady today, total of 103 cases.

COMPARE: Screenshots from Solano County COVID Dashboard on Monday, May 17:


The data on this page is from today’s and the previous Solano County COVID-19 Dashboard.  The Dashboard is full of much more information and updated weekdays around 4 or 5pm.  On the County’s dashboard, you can hover a mouse or click on an item for more information.  Note the tabs at top for SummaryDemographics and Vaccines.  Click here to go to today’s Solano County Dashboard.


Sources

Solano weekend toll: COVID kills 7 elders, County reports 37 new infections


By Roger Straw, Monday, May 17, 2021

Solano reports 37 new cases over the weekend, and 7 new deaths!  Stay safe, and remember: People with mild COVID can have long-term health problems

Solano County COVID report on Monday, May 17.
[Source: see far below.  See also my ARCHIVE spreadsheet of daily Solano COVID updates.]
Solano County COVID-19 Dashboard – SUMMARY:

On May 17, Solano County reported 37 new COVID cases.  The County also reported 7 NEW DEATHS, all persons over 65 years of age.  (It is not clear if these deaths represent an outbreak over the weekend or one of Solano County’s “occasional updates” representing previous deaths only now being reported.)  Our hearts go out to all of these, and their families and friends.  RECENTLY: We saw 1,288 new cases in April, an average of 43 per day.  In the first 17 days of May, Solano reported 534 new cases, an average of 31 per day.  Reports are that our red-tier Solano County will not be joining all other Bay Area counties in opening to less restrictive tiers anytime soon.

We learned of 1 new hospitalization today, someone over 65 years of age.  Solano’s Active cases fell dramatically today from 276 to 143, our lowest since June 17 of last year.  Our percent positivity rate also fell today from 6.9% to 5.8%, our first day under 6% since April 30, but still much higher than in recent months.

>> The virus is still on the move here.  Stay safe, get vaccinated, wear a mask and social distance!  We will get through this together.

Cases by City on Monday, May 17:

  • Benicia added 1 new case today, total of 984 cases since the outbreak began.
  • Dixon added 5 new cases today, total of 1,904 cases.
  • Fairfield added 15 new cases today, total of 8,981 cases.
  • Rio Vista remained steady today, total of 370 cases.
  • Suisun City added 2 new cases today, total of 2,264 cases.
  • Vacaville added 5 new cases today, total of 8,615 cases.
  • Vallejo added 9 new cases today, total of 9,790 cases.
  • Unincorporated areas remained steady today, total of 103 cases.

COMPARE: Screenshots from Solano County COVID Dashboard on Friday, May 14:


The data on this page is from today’s and the previous Solano County COVID-19 Dashboard.  The Dashboard is full of much more information and updated weekdays around 4 or 5pm.  On the County’s dashboard, you can hover a mouse or click on an item for more information.  Note the tabs at top for SummaryDemographics and Vaccines.  Click here to go to today’s Solano County Dashboard.


Sources

COVID-19 in Solano County: 4 new hospitalizations today, 21 new cases


By Roger Straw, Friday, May 14, 2021

Solano reports 21 new cases today, 4 hospitalized, no new deaths.  Stay safe, and remember: People with mild COVID can have long-term health problems

Solano County COVID report on Friday, May 14.
[Source: see far below.  See also my ARCHIVE spreadsheet of daily Solano COVID updates.]
Solano County COVID-19 Dashboard – SUMMARY:

On May 14, Solano County reported 21 new COVID cases.  Our hearts go out to those 21 and their families and friends.  RECENTLY: We saw 1,288 new cases in April, an average of 43 per day.  In the first 14 days of May, Solano reported 497 new cases, an average of 36 per day.  Reports are that our red-tier Solano County will not be joining all other Bay Area counties in opening to less restrictive tiers anytime soon.

We learned of 4 new hospitalizations today, all persons over 65 years of age.  Solano’s Active cases fell today from 296 to 276.  Our percent positivity rate also fell today from 7.4% to 6.9%, our first day under 7% since May 3rd, but still much higher than recent months.  We have not seen rates this high since Feb. 22.

Cases among children and youth have increased alarmingly
Percent of today’s new cases, age groups, May 14, 2021
Date New Cases
0-17 years
New Cases
18-49 years
New Cases
50-64 years
New Cases
65+ years
TOTAL
14-May 7 10 2 2 21
14-May 33% 48% 10% 10% 100%

Compare TODAY (above) with percentages since LAST SUMMER (below).  Note especially children and youth 0-17 years:

Percent of  ALL CASES SINCE JUNE 2020, age groups as of May 14, 2021
Date Cases
% 0-17
Cases
% 18-49
Cases
% 50-64
Cases
% 65+
6/5/20 5.8% 45.2% 25.6% 23.3%
7/1/20 9.0% 57.5% 20.1% 13.4%
8/31/20 11.0% 60.6% 19.2% 9.2%
5/14/21 12.2% 55.4% 20.5% 11.8%
Hospitalizations – new information today…

The Solano County COVID dashboard Summary tab only shows active hospitalizations for the current day (16 today – 3 more than yesterday).  This number represents the total currently hospitalized after yesterday’s admissions and discharges.  Little can be learned from this about the accumulated total of hospitalizations since the outbreak began.

Solano County Hospitalizations by Age Group.  See Solano Dashboard DEMOGRAPHICS TAB for details.

But on the Demographics tab of the County dashboard, the County “occasionally” updates the accumulated total of hospitalizations by age group.  These numbers were updated earlier this week and again today.  Today the County reported 4 new hospitalizations, all persons age 65+.   On Monday this week, the County reported 3 new hospitalizations since early April, and added another 6 on Tuesday.  The 5-day increase of 13 hospitalizations includes 1 person age 18-49, 1 person 50-64 and 11 persons age 65+.   We’ll keep an eye on this for more “occasional” updates.

Solano County Total COVID Hospitalizations by AGE GROUPS as of May 14
Hospitalizations
Age 0-17
Hospitalizations
Age 18-49
Hospitalizations
Age 50-64
Hospitalizations
Age 65+
    26     324     332     602

>> The virus is still on the move here.  Stay safe, get vaccinated, wear a mask and social distance!  We will get through this together.

Cases by City on Friday, May 14:

  • Benicia remained steady today, total of 983 cases since the outbreak began.  Benicia averaged 2 cases/day in April.
  • Dixon added 1 new case today, total of 1,899 cases.
  • Fairfield added 6 new cases today, total of 8,966 cases.
  • Rio Vista remained steady today, total of 370 cases.
  • Suisun City remained steady today, total of 2,262 cases.
  • Vacaville added 4 new cases today, total of 8,610 cases.
  • Vallejo added 10 new cases today, total of 9,781 cases.
  • Unincorporated areas remained steady today, total of 103 cases.

COMPARE: Screenshots from Solano County COVID Dashboard on Thursday, May 13:


The data on this page is from today’s and the previous Solano County COVID-19 Dashboard.  The Dashboard is full of much more information and updated weekdays around 4 or 5pm.  On the County’s dashboard, you can hover a mouse or click on an item for more information.  Note the tabs at top for SummaryDemographics and Vaccines.  Click here to go to today’s Solano County Dashboard.


Sources