Why are COVID hospitalizations so low in SLO County even though daily cases remain high?
Despite averaging about 20 new COVID-19 cases each day and gatherings leading to hundreds of infections, hospitalizations in San Luis Obispo County remain low, which SLO County’s health officer attributes to a variety of factors.
Since March, the county has tallied more than 4,000 COVID-19 cases and 32 deaths.
As of Thursday, two people in the county were hospitalized with COVID-19, with neither in intensive care. That’s in contrast to past months when hospitalizations often reached double-digits. Only a few weeks ago, on Sept. 17, 15 people were hospitalized, including five in the ICU.
Dr. Penny Borenstein said county health officials can’t pinpoint all the reasons for the recent low hospital numbers.
But she said SLO County tends to be a healthier county to begin with; the local cases tend to be people in younger age groups (indicating vulnerable populations are mostly adhering to guidelines); and health care has improved with more knowledge about how to treat the disease compared to early stages of the virus.
“The severity of disease in our county is not consistent with what we’re seeing across the state and the nation, and the world,” Borenstein said.
Borenstein said that she hopes the level of hospitalizations would be considered as a metric for SLO County’s ability to allow further business openings.
“I do realize it’s difficult for the state to have a one-size-fits-all approach for all counties,” Borenstein said.
Large gatherings are causing new cases
Large gatherings are often the source of COVID-19 transmission, including get-togethers of family and friends that have been associated with 500 cases since July.
More than 100 cases have been linked to other types of gatherings, including restaurants, work, day care, funerals and sporting events, Borenstein said.
More than 60 cases have been associated with religious services or groups, and 20 are from protests or rallies.
“You can see that it is coming together across families and mixed crowds, particularly large crowds, particularly indoors but not exclusively indoors, and for lengths of time that put people at risk,” Borenstein said.
Borenstein said that the county’s messaging will encourage people to be mindful of holiday gatherings, with Halloween, Thanksgiving and Christmas on the horizon.
“We’re used to, as a society, coming together,” Borenstein said.
But she pointed to Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, who said he is skipping a larger family Thanksgiving gathering this year.
“I would urge the public to consider that, as well to avoid contributing to an upsurge during the winter months,” Borenstein said.
SLO County’s lack of COVID-19 progress
Overall, Borenstein said, the county is not showing signs of progressing by reducing the number of daily coronavirus cases.
“We’re coming into fall and the heart of our fall season,” Borenstein said. “... Unfortunately we continue to average above the threshold for the (state guideline) tier that we’re in.”
Borenstein did note that 95% of the local cases to date have fully recovered.
SLO County’s current status in the red tier of state guidelines — allowing restaurants to operate with at 25% indoor capacity and fitness centers at 10%, for example — is thanks to adjusted metrics from other criteria, the county health officer said.
“We do continue at this time in the red tier,” Borenstein said. “This has us several weeks without any movement within the tiers. We’re retaining our status and the amount of business openings. But we’re not progressing, which is we want to do. And we are at risk of going back.”
At roughly 20 new cases per day, is close to slipping back into the purple tier, Borenstein said, which would lead to further business restrictions.
So far, the county’s high rate of testing has resulted in adjustments that kept it in the red tier.
The county is now at 7.5 cases per 100,000 residents per day, but its adjusted rate is only 5.1.
“The only way we’ve been able to retain our (red tier) status is because of the adjustment factor, which is a product of the high volume of testing we continue to do in this county,” Borenstein said. “So, our adjustment is significant and our adjusted rate is 5.1. We need to keep an eye on what our actual case count is should testing fall off.”
How does the county improve?
“I know I’ve been saying the same things week after week, but they remain true,” Borenstein said. “Keep distance from others. Stay home when you’re sick. Wear a face mask routinely. And very much, particularly, avoid gatherings amongst mixed households.”
On Tuesday, the state announced that all personal care services may be open in all tiers, regardless of case count as long they follow distancing guidelines, Borenstein said.
Those include skin care, body art, tattoo and piercing operations.
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