The importance of accurate COVID-19 numbers in Solano and Benicia

Having accurate numbers on COVID-19 cases, hospitalizations, mortality rates, and long-covid rates is very important.

I’m glad Solano County has decided to include positive antigen tests in their case numbers. False positive antigen tests are uncommon, so a positive antigen test almost always means a true infection.

The antigen test is the rapid test done with the at-home kits. Many of these positive antigen test results are not being reported to the county or state, so total covid-19 cases are increasingly being under-counted. Nonetheless, it is appropriate for Solano County to do what other counties have been doing, which is to count positive antigen tests as covid-19 infections.

It is a little surprising the county has decided to start excluding positive serological test results. A positive serological (or antibody) test for COVID-19 is almost always due to a prior COVID-19 infection. I am not sure what the rationale is for deciding to take these cases off the count of covid-19 infections.

One of the biggest data gaps is how many people are facing long-covid problems. In assessing the impact of the virus, this is an important aspect to understand. Sadly, there are currently no county-level, statewide, or even national numbers on how many people are dealing with this condition.

Looking at the big picture, Solano County will, in all likelihood, continue to see better numbers, in parallel with the improvement in the state’s and the country’s numbers.

As we celebrate our progress locally, it is important to look at the fact that neither Benicia nor Solano County is an island, and much of what happens with the pandemic here is impacted by the situation in surrounding areas. There is little doubt that we in Benicia and Solano County have benefitted, and continue to benefit, from the actions of other Bay Area counties, which have much better numbers than we do. These better numbers are no doubt due to the fact these other counties have much higher vaccination rates and have had more stringent public health safeguards in place than has been the case in Solano County and in Benicia.

And, because we are not an island, there is also little doubt that Solano County has made things slightly worse for the other Bay Area counties.

The question which will be hard to answer is whether we (Benicia and Solano County) could have seen fewer hospitalizations, fewer deaths, and fewer cases of long covid had we followed the same public health measures as the rest of the Bay Area, including more masking requirements, more vaccine mandates, and more vaccinations. Actually, the question is not whether we would have had fewer, but how many fewer, in each category.

This is not just an historical question. It is a question which should concern all of us today. How many of the 80 Benicians who acquired covid-19 this past week may have avoided this infection if our city had waited a couple of weeks longer to lift its mask mandate? How about those who will become infected next week? It would be nice if there was some way to quantify that, but it may never be known.

Richard Fleming, M.D.
Benicia, CA