Covid update: Hospitalization rates double, wastewater samples show alarming East Bay spike

We took off masks, started going to bars and seeing friends and family. It felt like pandemic days were largely behind us. It was bliss, until it wasn’t. 

Case totals alone no longer paint a full picture due to the prevalence of home testing and failure of many to report results. Still, case rates are steadily ticking up across the country, with numbers all too similar to the August surge caused by the delta variant. 

Omicron subvariants are taking off like wildfire in the uncontrolled environment, and we know this in part because wastewater is telling us what unreported tests are not. According to California Department of Health reporting of wastewater sample analysis, moderate to extreme spikes of Covid-19 have been detected across the Bay Area in May, with an alarming concentration in Central Contra Costa County.

Hospitalization rates provide the most accurate and trackable indication of how well we’re weathering the latest surge – the state is reporting a 57 percent increase in hospitalized Covid-19 patients compared to the same time last month. The increase is far more steep in at least two Bay Area counties.   

In another sobering reminder that spreading the virus has consequences, the U.S. Covid-19 death toll surged past 1 million this past week, according to Johns Hopkins University Coronavirus Resource Center.

So, exhausted by it all or not, we’re going to talk about Covid, yet again.  

U.S. 

• Confirmed cases: 83,089,370
• Cases over past 28 days: 2,204,178
• Deaths: 1,001,692
• Deaths over past 28 days: 11,106
• Hospitalizations over 7-day average (5/11-5/17): 3,250 (+24.2% over prior week) 
• Fully vaccinated ≥5: 70.7%
• At least one dose ≥5: 82.6%
• Unvaccinated ≥5: 17.4% 
• First boosters ≥12: 48.2% 

Source: John Hopkins University Coronavirus Resource Center COVID-19 global tracking tool and the U.S. Centers for Disease Control and Prevention as of 9:20 a.m. Friday, May 20, 2022.

North Carolina reported more than 68,000 confirmed cases over the last 28 days. While that number isn’t remarkable on its own, the state’s 28-day death toll of 1,264 certainly is. North Carolina has lost more people to Covid in the last month than any other state, including California, which had more than three times the confirmed cases in that same period.  

California 

• Total confirmed cases: 9,407,983
• Cases over past 28 days: 220,219 
• Current hospitalizations/ICU: 1,708/208 (hospitalizations up 57% from month prior)
• Total deaths: 90,918
• Deaths over past 28 days: 1,182 
• Fully vaccinated ≥5: 75.2%
• At least one dose ≥5: 84.1% 
• Unvaccinated ≥5: 15.9%
• First boosters ≥12: 58.6%
• Seven-day average test positivity rate: 6%

Source: John Hopkins University Coronavirus Resource Center as of 9:20 a.m. Friday, May 20, 2022 and California Department of Public Health. 

The state’s most dismal Covid data is coming out of San Bernardino County where the 28-day death toll reached 478 people as of Friday. That’s an incredibly high case fatality rate given there were 7,192 confirmed cases over the past 28 days. Compare those numbers to Los Angeles County, where a staggering 69,076 cases were confirmed in the 28-day period with 151 reported deaths. 

The CDPH reviews hospitalizations and deaths among people with different levels of vaccination. They recently found unvaccinated people are 7.4 times more likely to be hospitalized and 9.1 times more likely to die from a Covid-19 infection than people who received a booster dose.

State-run testing sites are offering treatment for those who test positive. Treatment may be antiviral pills or other treatments such as monoclonal antibodies and anti-inflammatories and they are offered at no cost, though facilities may charge for administering the drugs. All costs are covered for people receiving Medicare or Medi-Cal benefits. The treatments are recommended for anyone who tests positive, but strongly suggested for people over the age of 65 or with medical conditions that include, but are not limited to, diabetes, obesity, cancer and depression. 

Bay Area

The latest omicron subvariant surge is most drastically impacting the East Bay, specifically Contra Costa County, and San Francisco. Twelve Bay Area and neighboring health officers on May 13 issued a statement strongly urging residents to again wear masks indoors and limiting large gatherings to outdoor, well ventilated spaces. They stopped short of implementing mandates.

Since the statement was issued, there’s been little change in masking and behavior in public settings. Below is a breakdown of the most recent data from each county.

Alameda County

• Total confirmed cases: 287,619
• Cases over past 28 days: 13,446
• Current hospitalizations/ICU: 76/3 (hospitalizations up 60% from month prior)
• Total deaths: 1,865
• Deaths over past 28 days: 27 (JHU data – county data reflects 16) 
• Fully vaccinated ≥5: 84.1%
• At least one dose ≥5: 90.4% 
• Unvaccinated ≥5: 9.6%
• First boosters ≥12: 63.7%
• Seven-day average test positivity rate: 7.3%

Source: John Hopkins University Coronavirus Resource Center as of 9:20 a.m. Friday, May 20, 2022, Alameda County Public Health Department and California Department of Public Health. 

The county’s rolling seven-day test positivity rate more than doubled between April 19 and May 18, leading to a 60 percent jump in hospitalizations.  

Contra Costa County

• Total confirmed Cases: 212,240
• Cases over past 28 days: 8,040
• Current hospitalizations/ICU: 63/7 (hospitalizations up 59% from month prior)
• Total deaths: 1,304
• Deaths over past 28 days: 4 
• Fully vaccinated ≥5: 82.5%
• At least one dose ≥5: 87.1% 
• Unvaccinated ≥5: 12.9%
• First boosters ≥12: 58.8%
• Seven-day average test positivity rate: 11%

Source: John Hopkins University Coronavirus Resource Center as of 9:20 a.m. Friday, May 20, 2022, Contra Costa Health Services and California Department of Public Health.

Contra Costa Health Services reports that of the county’s 1,304 Covid-19 deaths, about 83 percent of them have been among unvaccinated residents. 

The county is currently leading with the highest test positivity rate among the nine Bay Area counties, which aligns with the astronomical wastewater sample detection discussed above. San Francisco is just behind with a 10.4 percent positivity rate.

Marin County*

• Total confirmed cases: 39,323
• Cases over past 28 days: 2,372
• Current hospitalizations/ICU: 15/1 (hospitalizations up 60% from month prior)
• Total deaths: 293
• Deaths over past 28 days: 5 
• Fully vaccinated ≥5: 92.8%
• At least one dose ≥5: 98% 
• Unvaccinated ≥5: 2%
• First boosters ≥5: 64%
• Seven-day average test positivity rate: 10% (up more than 5% from previous month)

Source: John Hopkins University Coronavirus Resource Center as of 9:20 a.m. Friday, May 20, 2022, Marin Health and Human Services and California Department of Public Health. 

*San Quentin State Prison, the site of a major Covid-19 outbreak in July 2020, reported cases and deaths separately from Marin County. The facility confirmed a total of 3,012 cases, 98 of which are active, and a resulting 28 deaths among the prison population, which have been included in the above county totals. Another 947 prison staff members have also tested positive since the pandemic began, with 21 in the past two weeks — staff cases and deaths were recorded within their county of residence. Source: CDCR data as of Friday, May 20, 2022.

The county health department tracks health outcomes by vaccination status, finding that unvaccinated residents are 4.4 times more likely to be infected, 14 times more likely to be hospitalized and 5 times more likely to die from Covid-19.

Napa County

• Total confirmed cases: 27,978
• Cases over past 28 days: 854
• Current hospitalizations: 1 
• Total deaths: 143
• Deaths over past 28 days: 0
• Fully vaccinated ≥5: 82%
• At least one dose ≥5: 91.1% 
• Unvaccinated ≥5: 8.9%
• First boosters ≥12: 64%
• Seven-day average test positivity rate: 8% (*7-day lag. Rate doubled from previous month)

Source: John Hopkins University Coronavirus Resource Center as of 9:20 a.m. Friday, May 20, 2022, Department of Health and Human Services and California Department of Public Health.  

San Francisco

• Total confirmed cases: 146,381
• Cases over past 28 days: 9,433
• Current hospitalizations/ICU: 80/10 (hospitalizations up 72% from month prior)
• Total deaths: 872 
• Deaths over past 28 days: 15
• Fully vaccinated ≥5: 88%
• At least one dose ≥5: 90% 
• Unvaccinated ≥5: 10%
• First boosters ≥12: 75%
• Seven-day average test positivity rate: 10.4% (up 5.6% from previous month)

Source: John Hopkins University Coronavirus Resource Center as of 9:20 a.m. Friday, May 20, 2022, San Francisco Department of Public Health and California Department of Public Health. 

San Francisco’s test positivity rate on May 12, the most recent data available, is exactly where it was on the first day of such reporting on April 1, 2020 when basically all gatherings were prohibited. In contrast, Bay to Breakers was allowed to make its big return this last weekend, drawing upwards of 15,000 people, while case rates were known to be soaring. 

San Mateo County

• Total confirmed cases: 139,088
• Cases over past 28 days: 7,648
• Current hospitalizations/ICU: 39/1 (hospitalization 3-day average up 38% from May 7)
• Total deaths: 756
• Deaths over past 28 days: 5 
• Fully vaccinated ≥5: 88%
• At least one dose ≥5: >95% (county caps vaccination rates at 95% to address over-estimates) 
• Unvaccinated ≥5: (not calculable due to rate cap)
• First boosters ≥12: 65%
• Thirty-day average test positivity rate: 6.5% 

Source: John Hopkins University Coronavirus Resource Center as of 9:20 a.m. Friday, May 20, 2022, San Mateo County Health Department and California Department of Public Health. 

Santa Clara County

• Total confirmed cases: 346,636
• Cases over past 28 days: 16,363
• Current hospitalizations: 115 (hospitalizations up 32% from month prior)
• Total deaths: 2,300
• Deaths over past 28 days: 26 
• At least one dose ≥5: 91.4%
• Unvaccinated ≥5: 8.6%
• First boosters ≥12: 70.3%
• Seven-day average test positivity rate through May 12: 6.6% (up 2.8% from April 19)

Source: John Hopkins University Coronavirus Resource Center as of 9:20 a.m. Friday, May 20, 2022, Santa Clara County Public Health Department and California Department of Public Health. Santa Clara County does not break down percentages by partial and fully vaccinated status for eligible populations.    

Solano County

• Total confirmed cases: 90,221
• Cases over past 28 days: 2,648
• Current hospitalizations: 19 (hospitalizations up 84% from month prior)
• Total deaths: 451
• Deaths over past 28 days: 4
• Fully vaccinated ≥5: 74%
• At least one dose ≥5: 83% 
• Unvaccinated ≥5: 17%
• Seven-day average test positivity rate: 5% (up 1% from previous seven-day period)

Source: John Hopkins University Coronavirus Resource Center as of 9:20 a.m. Friday, May 20, 2022, Solano Public Health and California Department of Public Health. 

Sonoma County

• Total confirmed cases: 91,316
• Cases over past 28 days: 3,905
• Current hospitalizations/ICU: 28/4 (hospitalizations up 28% from month prior)
• Total deaths: 491
• Deaths over past 28 days: 2
• Fully vaccinated ≥5: 82%
• At least one dose ≥5: 89% 
• Unvaccinated ≥5: 11%
• First boosters ≥12: 66.1%
• Seven-day average test positivity rate: 5% (up 1% from previous seven-day period)

Source: John Hopkins University Coronavirus Resource Center as of 9:20 a.m. Friday, May 20, 2022, County of Sonoma and California Department of Public Health.