Medical experts warn against complacency as new COVID variant appears Counties like Butte most at risk for a surge

by Natalie Hanson
posted April 16

Public health experts are urging people to stay vigilant and get vaccination boosters as the new COVID-19 variant BA.2 becomes the dominant strain of coronavirus.

Experts worry that as the new variant spreads, in counties like Butte where vaccination rates and community masking are low, communities will be particularly vulnerable.

Butte County Public Health data reports that as of April 11, the population is 55.8% fully vaccinated, 5.76% partially vaccinated and 38.35% unvaccinated. Yet, statewide, 75% of people 5 and older are fully vaccinated and 9% are partially vaccinated.

According to the Centers for Disease Control, by April 2, BA.2 had become the dominant strain in the United States. However, in Butte County, omicron still appeared in 84.6% of the county’s cases while BA.2 was responsible for 15.4% of cases in March.

Experts convened by Ethnic Media Services at a recent news briefing said that compared to the omicron and delta variants, the BA.2 variant is equally virulent. They agreed that due to multiple factors like employment in high-risk jobs with less access to quality healthcare, Latinos are most at risk for infection, hospitalization and death.

The doctors all agreed that a second booster is highly recommended for everyone over 50.

“My concern is that if the vaccination remains low and the caseload surges, those counties that have the lowest vaccination rates will be hit the hardest,” said Dr. Dali Fan, health science clinical professor at UC Davis.

“This is a window of opportunity for us to campaign and get people vaccinated and boosted to prevent the next big hit if it comes. If the caseload in the community is higher, everybody’s vulnerability is higher.”

Another expert warned that vaccinations and boosters don’t have a permanent effect.

“The immunity that we build to exposures or vaccines is temporary,” said Dr. Ben Neuman, professor of biology and chief virologist at the Global Health Research Complex at Texas A&M University. “It has a window and it’s like a little egg timer and it ticks down one tick at a time until you’re no longer protected.”

He said the current COVID-19 variants are able to infect people with some immunity at six to eight times the normal rate. “Think of them like they’re armored. These are the viruses that can spread to people who have some immunity already.”

Neuman added that the word “immunity” can give people false hope when used to denote “complete invulnerability” – rather than the medical definition, which “means you have a fighting chance, and nothing better than that.”

Risks for children
A Stanford pediatrics expert said that even though the new variant hasn’t yet caused more child hospitalizations, vaccination is important.

During the omicron wave, children who were unvaccinated were more vulnerable to getting infected than the vaccinated, said Dr. Manisha Newaskar, pediatric pulmonologist for Stanford Children’s Health. Children with conditions like obesity, asthma or cancer remain the most vulnerable.

Asked if mask mandates should return to K-12 schools, Newaskar said she thinks everyone should follow the judgment of their local public health authorities.

“Kids these days are very cautious,” she said. “They have learned what we all have learned through this pandemic, that we need to be flexible.”

Newaskar said she is hopeful for Pfizer and Moderna achieving emergency use authorization for all age groups. The parents of children who are not vaccinated need, in her opinion, “guidance from the doctors or people who they trust most.”

“As the younger children get vaccinated, it will bring a big sense of relief — at least to the pediatric community,” she said. “It is our duty to sit down and have discussions with the parents and help them understand these vaccines are very safe, they will protect their children and it’s very important.”

Neuman said, “The idea that children or anyone would have an immune system that’s strong enough to deal with COVID, but somehow so fragile that it’ll break under a vaccine has to be one of the weirdest things I have ever heard from a scientific perspective.”

A higher risk for Latinos
According to the California Department of Public Health, Latinos make up 40% of California’s population, and have had 47.6% of total confirmed cases and 43.8% of all COVID-related deaths. This is high compared to non-Latino whites, who make up 36% of the state population, but represent 24.5% of confirmed cases and 34% of confirmed COVID-related deaths.

Similar disparities exist in vaccinations. In the state as a whole, only 64% of Latinos have received at least one COVID vaccine, compared to 74% in the non-Latino white population. However, those numbers are much closer together in Butte County; Public Health Communications Director Lisa Almaguer said as of April 11, 51.3% of white residents have had two doses of the vaccine, compared to 49% of Latinos.

These disparities persist because of over-representation of Latinos in frontline occupations with a high risk of exposure, said Daniel Turner-Lloveras, a volunteer physician for the Covid-19 Vaccine Education & Empowerment in Detention Program. They are also more likely to live in overcrowded housing that is unsuitable for proper quarantine and lack access to quality healthcare.

He said although Latinos are 18 percentage points lower than whites for vaccination rates statewide, Latinos are “actually at one of the highest rates for wanting to get a vaccine.”

“With federal funding of testing, treatment and vaccinations being cut, Latinos will probably see
an already unjust situation get worse than in the past,” Turner-Lloveras said. “Legal status should not be used ever to exclude immigrants from assistance, particularly when you consider all the undocumented essential workers who support day-to-day activities during the last two years of the pandemic.

“We need to improve access to health insurance coverage for all, including those who are undocumented,” he said.

“… we’ve become unusually comfortable with the number of people dying every day …” — Turner-Lloveras

“While we’ve become unusually comfortable with the number of people dying every day, if you look at the people around you, a neighbor, a friend … these are the people dying every day.”

Butte County has had more than 400 COVID-related deaths, according to public health data.

Asked about counties with poor vaccination rates, Neuman said, “Our gains have been impressive, but they are temporary, and can be undone easily if we fail to knock the virus out completely. The one variable we can control is what we do.”

“I see us more or less going back to normal and waiting for the virus to make the next move, and I don’t think that is a good idea.”

Local representatives weigh in
While masks are no longer required in any public settings in Butte County, Almaguer said people are advised to get vaccinated and boosted, to wear masks indoors at schools and at large gatherings; and to get tested if exposed, experiencing symptoms, attending a high risk event, or traveling.

Butte County does not currently have a permanent public health officer running Butte County Public Health. Enloe Medical Center’s Dr. Marcia Nelson has often been relied upon to deliver the latest expert guidance, and said residents should “use good judgment about wearing masks based on our own health and the health of those around us.”

Nelson said BA.2 has been in Butte County since February, and emphasized that COVID vaccines are approved and safe for people at least 5 years old and a booster shot is recommended by Enloe for everyone 12 years old and older.

For now, weekly cases have dropped to about 4 on average, as of last week. Hospitalizations are also at a low point at nine per week, the lowest since July 20 of last year. But Nelson encouraged vigilance.

“We still have new cases of COVID and also see breakthrough COVID in those who have had vaccines and a booster. In both of these situations, COVID can be spread to others,” she said.

Reyna Nolta, president of the Hispanic Resource Council of Northern California, praised Public Health and Enloe for what she called “progress” in performing outreach to Latino residents.

Connecting people with up-to-date medical information about the virus and vaccines and getting trusted community sources to post on social media continues to be critical, Nolta said. She said there are many conspiracy theories about the vaccines circulating, “that it’s bad for them … there’s such crazy stories.”

Nolta said that many social media comments on Public Health posts and at public meetings discourage masking and spread “disrespect of public health recommendations” – behaviors that “put the community at risk.”

“I think the people are getting tired,” she said. “They just want to go on like it’s normal. I think unless we see the same little wave of people dying, they’re not going to take it seriously. That’s my opinion.”

While Nolta said she is concerned about a lack of effort from other counties in the area, in Butte County, Public Health has hired bilingual staff and “really stepped it up.”

“I really feel they’re doing everything they can to have staff who are approachable,” Nolta said.

To connect more people to resources, including immigrants, the Council is organizing Día del Campesino to be held Oct. 2 in downtown Chico with five food vendors, a raffle and booths to connect with local Spanish-speaking providers.

“Everyone from all communities are welcome to come,” Nolta said.

Natalie Hanson is a journalist working for a Marin newspaper and produced this story for ChicoSol with support from an Ethnic Media Services fellowship.