COVID-19 positivity soars in California: New areas at ‘high’ spread while testing plummets

California’s COVID-19 positivity rates continue to climb to their highest levels since the winter, as new counties enter the U.S. Centers for Disease Control and Prevention’s “high” community spread level.

The statewide positivity rate grew to 14.8%, the California Department of Public Health reported on Friday, up from 13% the previous week. That is the highest reported since Jan. 25, during the original omicron surge.

Case rates have remained steadier, with the state reporting 36.8 cases per 100,000 in the most recent week, up slightly from 34.5 last week. But as testing rates plummet and more people opt to use at-home rapid tests, which are not included in the state’s total, case rate has become a less reliable indicator of the virus’s spread. Officials say that other metrics, like wastewater, paint a more accurate picture — and they show that the current surge may rival California’s record spike in January.

Thirty-eight of California’s 58 counties received the CDC’s “high” designation for community spread this week, up from 25 last week.

Those 38 counties were: Sacramento, Alameda, Amador, Calaveras, Contra Costa, El Dorado, Fresno, Kern, Kings, Lake, Lassen, Madera, Marin, Mariposa, Mendocino, Merced, Monterey, Napa, Nevada, Placer, Plumas, San Benito, San Francisco, San Joaquin, San Mateo, Santa Clara, Shasta, Siskiyou, Solano, Sonoma, Stanislaus, Sutter, Trinity, Tulare, Tuolumne, Ventura, Yuba and Yolo.

The CDC recommends an indoor mask mandate for counties with high community spread. In June, only Alameda County instituted a mask mandate when it received the CDC designation — and scrapped it last week, citing a consistently low hospitalization rate.

Positivity rates in the Sacramento region are on the rise. Sacramento County’s positivity rate hovers slightly under the state’s, at 14.6%, compared to 13.8% a week earlier.

Placer County’s rate swelled to 15% from 12.1% a week ago. El Dorado County’s positivity rate rose to 18.4% from 15.7%, and Yolo’s to 8.3% from 7.7%.

But with hospitalizations and deaths in the Sacramento area and much of the state remaining at a steadily low rate, this surge feels less devastating — in some places — than the ones that came before.

A return to ‘business as usual’?

While COVID-19 hasn’t reached endemic levels yet, the region is in an “ambiguous area” right now when it comes to managing the virus, said Dr. Dean Blumberg, chief of pediatric infectious disease at UC Davis Children’s Hospital

“I think we are shifting from the area where COVID was really consuming all our time and resources, and we’re getting back to business as usual with COVID kind of in the background at this point,” Blumberg said.

The return to normalcy can be partly attributed to a “decoupling” of cases and hospitalization, in which hospitalizations remain steadily low even as case numbers fluctuate. This comes from an increase in vaccinations coupled with people previously being infected, both of which result in a higher immunity against severe disease, the doctor said,

While mild breakthrough disease may result in a range of symptoms, including coughing and fever, hospitalization is less likely.

“Then it’s more of an annoyance, missing a few days of school or work rather than a health crisis,” Blumberg said.

Yolo County health officer Dr. Aimee Sisson also attributed the low hospitalization rate to the availability of Paxlovid, a medication that can help ease COVID-19 symptoms. Paxlovid, she said, has proved effective at keeping high-risk patients out of the hospital.

Sisson directly attributed Yolo County’s decision to hold off on an indoor mask mandate to the decoupling of cases from hospitalizations. Although she suspects cases in the county might be at an all-time high, so long as hospitalizations remain low, the threat to daily life is minimized.

“We’re in a different phase of the pandemic,” Sisson said earlier this week. “Yes, we have a lot of infections, but they are not wreaking havoc on our healthcare system. They are not causing deaths like they were earlier.”

Sacramento-area testing program ends

Healthy Davis Together, a free community testing program that has served Yolo county since September 2020, ended on Thursday.

The program was originally meant to shut down in 2021, but ran through June after receiving more county funding during the original omicron surge. The program will continue wastewater analysis through the fall, but its testing programs and virus sequencing — which provided the most localized breakdown of COVID-19 variants in the Sacramento region — have halted.

“COVID-19 will be in our lives for the foreseeable future, including new variants, but we now have the accumulated knowledge and many more tools to protect ourselves and our community,” the city of Davis said in a news release. “The city and UC Davis rallied together through Healthy Davis Together and we did what we set out to do — to reduce the spread of COVID-19 in Davis and contribute to a safe, gradual return to city and campus life. We are so proud to be part of such a remarkable and resilient community.”

Sisson said Wednesday that the end of Healthy Davis together will likely cause COVID-19 data coming out of the county to be “really screwy” in the coming week.

The program’s closure coinciding with Fourth of July weekend means that cases will be on the rise as testing volume is cut significantly, Sisson said. The resulting data will likely appear a week later.

“My prediction is that our case rate is going to take a nosedive but our testing positivity is going to go through the roof,” Sisson said. “And people are going to be confused as to what that means. But mostly it means that our biggest testing program ended and there is still a lot of virus in the community, which we will see in our wastewater level.”

Case rates, hospitalizations fluctuate in Sacramento region

Sacramento County’s latest case rate — reflecting the week ending June 23 — is 36.8 per 100,000 residents, state health officials said in Friday’s update. This marks a 6.1% increase from the case rate one week ago, and a 6.7% increase from the most recent metric released Tuesday.

Hospitals in Sacramento County were treating 187 COVID-19 patients on Thursday, state data shows, down from 192 one week earlier. The intensive care unit total was 23, up four from last week.

Placer County’s latest case rate is 23.2 per 100,000 residents, a 4.1% decrease from one week earlier.

Hospitals in Placer County were treating 82 virus patients Thursday, down from 86 one week earlier. The ICU total held at seven.

Yolo County’s latest case rate is 45.8 per 100,000 residents, a 2.5% increase from one week earlier. It has the sixth-largest case rate of any California county.

Hospitals in Yolo County were treating five virus patients Monday, up from three a week earlier. The ICU total remained at zero.

El Dorado County’s latest case rate is 28.3 per 100,000 residents, a 29% increase from one week earlier.

Hospitals in El Dorado County were treating 11 virus patients Thursday, up from six a week earlier. The ICU total dropped to one from two.

Sutter County’s latest case rate is 25.1 per 100,000 residents, down 9.3% from last week, and Yuba County’s is 25.9 per 100,000, down 7.8%, state health officials reported Friday.

The single hospital serving both Yuba and Sutter counties was treating 9 virus patients Thursday, down from ten a week earlier. The ICU total dropped to two from three.

The Bee’s Michael McGough contributed to this story.