April 13, 2021 -This morning, the CDC announced new guidelines to temporarily halt the use of the single-dose Johnson & Johnson vaccine “out of an abundance of caution” because six women developed blood clots in the days and weeks following vaccination. San Diego County announced it will follow this guidance and stop issuing the vaccine until additional information is available.
About 7 million people in the United States have gotten the Johnson & Johnson vaccine so far. Six cases out of 7 million would make this occurrence “extremely rare” according to a joint statement from the CDC and FDA, and that is if a causal relationship can be established.
The CDC’s Advisory Committee on Immunization Practices will meet Wednesday to further review these cases and assess their potential significance. One reason for the pause, which is expected to be as short as a couple of days, is to ensure health care providers are aware of this potential side effect so they can plan for how to recognize and treat it.
If you or someone you know has received the Johnson & Johnson vaccine in recent weeks, the joint statement recommends paying attention to symptoms of blood clots, such as severe headaches, leg pain or shortness of breath. The six patients who experienced blood clots developed symptoms from six to 13 days following their vaccination.
Vaccination progress It’s too early to know what effect this pause will have on availability of vaccine appointments, especially with eligibility opening Thursday for everyone 16 and older. But the county continues to make solid progress in administering vaccines:
- Almost 2.23 million COVID-19 vaccine doses have been delivered to the region, and about 2.1 million have been administered.
- Of those vaccinated to date, nearly 720,000 county residents, or 26.8% of San Diegans 16 and older, are fully immunized.
- Overall, nearly 1.2 million county residents have received at least one shot of the two-dose vaccine. That’s 44% of those eligible.
In looking at the county’s vaccine dashboard, I thought it was interesting that coastal North County has a lower vaccination rate than communities in the northeast and central north. I don’t have any insight as to why, but thought it was worth noting. Remember, one of the best ways to ensure we continue on a good path to resuming normal activities is to get vaccinated when it’s your turn.
Updated metrics Last Tuesday San Diego County squeaked by on our case count, 5.8, barely qualifying us to move to the orange tier. Today’s report from the state shows we’ve ticked up to 6 cases per 100,000. This is back in the red tier range, but according to the state, decisions about moving counties back to more restrictive tiers will now be made based on more than just the case rate and testing positivity.
Here are some excerpts from the state’s website that explain the process:
Unless there are extenuating circumstances, such as low rate of vaccine take up, a county will only move to a more restrictive tier if hospitalizations are increasing significantly among vulnerable individuals, especially among vaccinated individuals, and both test positivity and adjusted case rates show a concerning increase in transmission.
- During the weekly assessment, if a county’s adjusted case rate and test positivity has fallen within a more restrictive tier for two consecutive weekly periods, the state will review the most recent 10 days of data, including hospitalization data, and if CDPH determines there are objective signs of stability or improvement the county may remain in the tier. If the county’s most recent 10 days data does not show objective signs of stability or improvement the county must revert to the more restrictive tier. For subsequent weekly assessments, the above rules apply.
- At any time, state and county public health officials may work together to determine targeted interventions or county wide modifications necessary to address impacted hospital capacity and drivers of disease transmission, as needed, including movement across more than one tier. Key considerations will also include the rate of increase in new cases and/or test positivity, more recent data as noted above, public health capacity, and other epidemiological factors.
I expect the County of San Diego will address this at its weekly news conference, which I’ll report out on Thursday. In the meantime, this just goes to show that we do need to continue to follow health precautions and not get lulled into a false sense of security.
Additional stats are linked below:
Keeping an eye out for signs of a surge
Elsewhere in the United States, case numbers are starting to increase once again. In Canada, Ontario’s school system is switching back to online learning.
California meanwhile has maintained one of the lowest daily cases of COVID-19 over the past week. Michigan has the highest in the nation for that same time period – 12 times higher than California’s.
Increasing cases in the Midwest are being attributed to the more contagious B.1.1.7 variant, first called the British variant. Again, here in California, we are not seeing that strain become as prevalent as in other areas (or as once predicted here).
This story in The San Diego Union-Tribune points to the “West Coast variant” as one explanation. Even though it’s more contagious than the original, it’s less contagious than the B.1.1.7 variant. Nonetheless, more people in California are getting the West Coast variant than the B.1.1.7 one.
Another factor that could explain why California’s numbers aren’t increasing like those in other states is that we have had a large number of people who have already had COVID-19 and therefore having built up natural immunity. If you add those getting vaccinated to those who have natural antibodies, California could reach herd immunity by mid-June, according to the article.
That doesn’t mean we can let our guards down. If cases can surge elsewhere they can surge here too. So, please stay the course by following recommended health precautions:
- Avoid crowds
- Wear a mask
- If you gather with others, do it outdoors
- Get vaccinated when it’s your turn
Reopening and recovery In the emergency preparedness world, a common refrain is that you start planning for recovery on the very first day of emergency response. This is because recovering from an emergency can be far more complex and lengthier than the incident itself.
I thought of this when I saw that the court system has gotten another extension on deadlines for holding arraignment hearings. According to this article, there have been 19 criminal jury trials in the nine weeks since jury trials resumed Feb. 8. To put this in perspective, during the last full year before the pandemic, the court held 435 criminal jury trials.
So, while everyone is very happy to see business slowly returning to normal, we should keep in mind that it will take quite some time to make up for lost time and for things to actually be back to normal.
Update on city services We are entering week three of the city’s gradual shift to more in person services. Starting today, you can make an appointment on Tuesdays and Thursdays to have an in-person meeting with our building and planning permits staff at our Faraday Center. You can also come to the Faraday lobby to pay your water bill, a parking ticket or other city bills in person.
Our facilities staff have put up Plexiglass barriers, marked off the floor, put up signs and retrofitted the heating and air conditioning systems with advanced filtration. All reopened city facilities have completed and posted a safe reopening plan and trained staff on new protocols and procedures.
We have already expanded in person services at the library, reopened the Cannon Art Gallery for limited days and hours, and reopened our large community centers on a limited basis. A full list of in person services is on the city’s website, including hours of operation and how to make an appointment, if that is required.
I expect we will further expand in person services as we approach the state’s June 15 date for fully reopening all businesses, assuming case numbers and other metrics remain within targeted ranges. Our goal is to remain thoughtful about our reopening plans, with the health of our community and city employees the top priority.
I also have a feeling many people have gotten used to accessing city services remotely and might even prefer it. We want to be as flexible as we can in meeting everyone’s needs, which will likely include some of the newer online options remaining available.
Time to grieve At this stage of the pandemic, I am starting to see more and more articles trying to make sense of what we have all experienced over the past year. Two had to do with grief. One described the long-term effects of losing a loved one. Researchers at Penn State created something called the COVID-19 Bereavement Multiplier, which found that, on average, every person who has died from COVID-19 has left behind nine loved ones who will experience significant grief for years to come. Symptoms of grief, such as trouble sleeping, depression and anxiety, can interfere with daily activities, causing a wave of physical and emotional aftereffects, lasting far beyond the pandemic.
Another study, this one published in the Journal of the American Medical Association Pediatrics, calculated that nearly 40,000 children in the United states have lost a parent to COVID. This study also points to long-lasting consequences. In this case, losing a parent is correlated with lower grades and increased use of drugs and alcohol.
Finally, there is the grief of missing out on life’s moments and milestones. Missed vacations, time with grandparents, weddings, holiday celebrations, sports championships – they are also losses, but ones that many people feel guilty acknowledging. When some are losing loved ones, it doesn’t feel right to grieve something so much smaller by comparison. According to psychologists, however, it’s important to acknowledge these losses too and allow ourselves time to grieve.
Kids helping kids I know that last part was a bit heavy. So, I’ll end today with two stories, both uplifting examples of Carlsbad at its best.
This Coast News article highlights the Carlsbad Unified School District’s “Champions” program, which creates opportunities for high school seniors to serve as role models for younger members of our community.
These “senior ambassadors” visit elementary schools to share how they’ve found their paths, stayed true to themselves, lived with integrity and made positive choices. Since they couldn’t do in person visits this school year, they created inspirational videos and interactive activities elementary school students could do during the stay-at-home order. The seniors even have trading cards with their photos and lists of accomplishments that the younger students collect, confirming that to the younger students, seniors really are like celebrities.
Volunteers needed Proving you’re never too young to get involved in your community, the Carlsbad Unified School District is looking for help with its Community Friends Preschool Program.
Community friends – also known as “reverse mainstreamers” – are children 3 to 4 years old who display developmentally appropriate skills, including self-help, social skills, and speech and language skills. These kids are paired with students with special needs so they can help model these skills.
Requirements for Community Friends:
- 3-4 years old
- Age-appropriate speech language skills (i.e., makes verbal greetings, participants in conversation by asking questions or making comments with adults and peers, speech is clear and understandable by an unfamiliar person)
- Age-appropriate play skills (i.e., initiates play, demonstrates pretend play, demonstrates partner play and follows directions)
- Age-appropriate cognitive skills (i.e., independent self-help skills, follows a classroom routine with minimal prompting, able to help peers, follows through with a plan)
Volunteers are being recruited now for the school year that starts this fall. Here is more information, including a link for the application.
I’ll be back Thursday with more updates.
Scott Chadwick, City Manager
City of Carlsbad | 1200 Carlsbad Village Drive, Carlsbad, CA 92008