COVID cases hit all-time highs in rural California hospitals as delta variant rages
Seven small California counties have recently broken their all-time records for COVID-19 patients in hospital beds, as cases of the delta variant are growing explosively in rural parts of the state.
Del Norte, Humboldt, Tuolumne, Nevada, Mendocino, Lake and Amador counties each since the start of this month have recorded their highest daily total for hospitalized COVID-19 patients, state health data show.
Six of those counties ranked among the state’s seven worst by new cases per 100,000 residents over the past week — all but Mendocino, which ranked 13th worst out of 58.
Per-capita rates among the seven ranged from 39 daily new infections per 100,000 in Mendocino County to 91 per 100,000 in Del Norte County. The statewide rate was 26 per 100,000, according to California Department of Public Health data updated Monday.
Transmission levels that severe in the seven rural counties mean the number of patients who will need hospital care, already at a record high, is likely to keep climbing at least the rest of August and likely into September, since hospitalizations tend to lag lab-confirmed cases by roughly two weeks.
And as facilities in those counties fill up, more patients will likely have to seek care out-of-county, adding to the burdens of neighboring counties already facing their own surges.
The counties are sparsely populated, ranging from Del Norte at about 28,000 residents to Mendocino at 135,000.
Some have just one hospital and no options nearby.
Del Norte County has a lone general acute care facility: Sutter Coast Hospital, in Crescent City. From the start of the pandemic through mid-July 2021, Sutter Coast had never reported having more than four coronavirus patients simultaneously, and for many days this May and June had none at all, CDPH data show.
On Monday, state health data showed 23 hospitalized with the virus at Sutter Coast, taking up nearly half of the facility’s 49 licensed beds. Seven were in the intensive care unit, leaving no ICU beds available.
Del Norte County is nestled on California’s northwest corner along the Oregon border. The nearest alternative for residents of Crescent City, which has a population of about 7,000, is 90 minutes south along Highway 101, in also-surging Humboldt County.
Health experts have been saying since before the delta variant grew dominant in the U.S. that lackluster vaccination rates in rural areas would leave the door open for intense, localized surges.
“Disparities in COVID-19 vaccination between urban and rural communities can hinder progress toward ending the pandemic,” Centers for Disease Control and Prevention officials wrote in a May report.
Highly infectious delta, which CDPH now says made up more than 90% of sampled cases from July, has supercharged the health crisis and concerns for health care resources in poorly vaccinated areas.
In the CDC report, the “rural” distinction applies to 21 of California’s 58 counties, including all seven facing their harshest period of the pandemic in terms of hospitalizations.
Each of the seven have vaccination rates below the state average of 55% fully vaccinated, some of them far below.
Humboldt and Mendocino are relatively close at 52%, as is Nevada County at 51%, according to CDPH numbers updated Monday. But the other four have dismal immunization figures: Tuolumne at 43%, Lake at 42%, Amador at 41% and Del Norte at 35%.
“Please get vaccinated. We ask this from the bottom of our hearts,” Del Norte County health leaders wrote in a letter to the community Monday.
“As your physicians, and as the people with whom you have worked, played, laughed, and cried, we must admit we are tired. We will keep working, of course. But we are tired. We are tired of the suffering, pain and death that can be avoided by getting vaccinated.“
The letter was signed by more than 100 doctors — physicians, surgeons, pediatricians, family doctors, anesthesiologists, psychiatrists and more.
How are counties responding to ‘game-changing’ delta?
Del Norte (91 daily cases per 100,000)
Prior to the letter, Del Norte County’s health department on Aug. 3 recommended that residents “forgo large gatherings at this time” due to high transmission levels and low vaccination rates in the area.
Del Norte also in August began a “Vax to Win” lottery, with weekly drawings for $500, $250 and $100 for newly vaccinated county residents.
New vaccinations are improving considerably in the county. State health data show about 330 Del Norte residents received a first dose for the week of Aug. 8-14, more than quadruple the total from July 8-14 and the county’s best pace since late April.
Nevada (61 per 100,000)
Nevada County officials urged those attending last week’s county fair to wear masks, both indoors and outdoors, according to a joint statement from county health officials, hospital leaders and the CEO of the fair.
The county also called upon those ages 65 and older, the immunocompromised or those with other underlying health conditions to “consider not attending the Fair,” which ran last Wednesday through Sunday.
“I would think long and hard about attending large gatherings,” Nevada County deputy health officer Dr. Glennah Trochet said in a statement.
It will take several days before local health officials can start to determine whether the county fair produced a spike in cases.
Lake (60 per 100,000)
Lake County health officials in a late July report to the Board of Supervisors noted a concerning trend in younger adults: residents ages 20 to 44 made up about half of cases last month, despite making up only one-quarter of the county population.
“Many had a sense the pandemic was ‘over,’ and relaxed their commitment to the precautions that had brought Lake County’s COVID-19 cases to low levels,” the county’s public health division wrote in an Aug. 6 news release.
“Then, in late June, Lake County documented our first cases of the Delta Variant, a hyper-transmissible strain that has truly been game-changing.”
Amador (57 per 100,000)
Amador County’s health office in a weekly update Aug. 10 said the “sharp” surge in local COVID-19 cases, hospitalizations and ICU admissions had required “the activation of surge plans to accommodate these patients.”
The county does not have an indoor mask mandate, but health officer Diana Evensen urged residents to wear masks indoors in line with CDPH recommendations.
“Eleven Amador residents are currently hospitalized locally with COVID-19, in addition to 3 residents of other counties,” Evensen wrote. “One Amador teenager with an underlying condition is currently hospitalized out-of-county with COVID pneumonia.
“Of those hospitalized, all but one are unvaccinated.”
Tuolumne (56 per 100,000)
Tuolumne County public health officials in a Friday update wrote that the area continues to “experience an extremely high rate of new cases daily” and that, due to high demand, those seeking a diagnostic COVID-19 test through state-run sites should make an appointment in advance rather than show up on a walk-in basis.
Humboldt (45 per 100,000)
Humboldt County returned to a universal mask mandate Aug. 7. Humboldt officials wrote in an update last Friday that 33 county residents hospitalized marked a new all-time high.
One of the day’s new admissions was between the ages of 10 and 20, the county wrote.
Mendocino (39 per 100,000)
Mendocino County last week re-imposed a mask mandate for indoor public settings, regardless of vaccination status.
In the order, county health officials noted that daily case rates and average hospitalizations had each increased about eightfold since April and May.
This story was originally published August 17, 2021 at 5:00 AM with the headline "COVID cases hit all-time highs in rural California hospitals as delta variant rages."
