'Dramatically Changed' 

By any mark or measure, it was a grim week in Humboldt County, and not just due to the smoky, orange haze that overtook the sky as four wildfires raged with minimal containment to its east.

In the seven-day period before the Journal went to press Aug. 10, the county saw 539 new cases of COVID-19, 15 hospitalizations and three deaths, as well as a new public health recommendation against gatherings, a mandatory masking order and the ensuing cancellation of scores of highly anticipated local events, from Hops in Humboldt to Arts Alive. Plus, Humboldt County First District Supervisor Rex Bohn — recently voted the county's "best" politician in the Journal's annual Best of Humboldt contest, the party for which was also canceled — announced he'd tested positive for the virus despite being fully vaccinated. (Bohn was feeling "fine" and isolating at home while still participating in the supervisors' meeting virtually as the Journal went to press.)

"The arrival of the Delta variant has dramatically changed the situation in our county," Health Officer Ian Hoffman told the Humboldt County Board of Supervisors on Aug. 10. "The rise in cases seen in many counties has now hit here, with 400 percent increases in cases in a matter of a few weeks."

And the surge showed no signs of slowing but instead seemed to be sharpening its trajectory, having nearly doubled from 280 cases confirmed the seven-day period running through Aug. 3 to the 539 cases confirmed over the ensuing seven days. The county's test-positivity rate, which some health officials feel is the best measure of the virus' spread in a community, leapt from 10.1 percent in July — already the highest for any month since the pandemic began — to 16.3 percent through the first 10 days of August, dwarfing the state (6.2 percent) and national (10.2 percent) rates.

The surging case numbers have already strained local hospital capacity — Hoffman and St. Joseph Health CEO Roberta Luskin-Hawk said hospitalization rates are higher than they've been at any point in the pandemic — and hospitalization increases generally lag at least four days behind case increases. The threat on hospital capacity is ultimately what spurred Hoffman to reinstitute the county's masking mandate, which had been lifted in June when the state re-opened its economy and removed most COVID restrictions.

During an Aug. 4 press conference, Luskin-Hawk said the surge in COVID-19 cases is wearing an already "exhausted" staff and could ultimately compromise the hospital's ability to care for non-COVID patients, noting the hospital has already begun canceling some elective procedures "to preserve staffing for COVID."

And Luskin-Hawk said the prospect of bringing in nurses and doctors from outside the area to buttress local forces simply isn't practical, noting that about 100,000 nurses have retired nationwide during the pandemic and she was recently told by a staffing agency that demand is far outpacing supply.

To the north, meanwhile, Del Norte County is seeing the highest hospitalization rates in the state and its only hospital, Sutter Coast, announced Aug. 10 that it is setting up two "surge tents" to care for the dramatic increase in COVID-19 patients.

"Current case levels are driving some of the highest surge levels to date, requiring emergency response efforts," hospital CEO Mitch Hanna wrote in a statement. "It's going to take all of us working together to reduce the spread of illness and slow the rate of infection. We must be vigilant — wear a mask, practice good hand hygiene, avoid large gatherings and get vaccinated. Vaccination against COVID-19 is still the most effective way to prevent serious illness and death from the virus."

Humboldt County Public Health, meanwhile, released data Aug. 9 on the prevalence of so-called breakthrough infections of fully vaccinated individuals. The data shows that cases among both demographics have surged sharply since the state's reopening in June, though the unvaccinated tested positive for the virus at much higher rates — an average of 43 per 100,000 residents — than the vaccinated — an average of 17 per 100,000 residents — last month. (Hoffman had previously estimated about a quarter of July's cases were confirmed in fully vaccinated individuals.)

But while the Delta variant seems to be more effective at infecting fully vaccinated individuals and being transmitted by them, data still shows the vaccinated are much more protected against severe illness, hospitalization and death. In Humboldt County, Hoffman has said none of the county's deaths and only a "very small number" of its 263 hospitalizations were fully vaccinated, telling the board on Aug. 10 that the breakthrough hospitalizations were all considered at elevated risk due to age or underlying conditions.

While data indicating the prevalence of breakthrough hospitalizations since the rise of the Delta variant remains limited, Hoffman pointed to Marin County as a possible example. Marin County has a fully vaccinated rate of nearly 75 percent compared to Humboldt's 51 percent.

"They're having case rates as high as Humboldt County but their hospitalization rates are very low right now, some of the lowest in the state," Hoffman said. "A big indicator of how well this vaccine works is not that it's preventing the spread among the vaccinated but reducing hospitalizations."

And that's the current goal. At the Aug. 4 press conference, Hoffman said the aim of his new mask order is just bending the curve of infections to prevent local hospital capacity from being overrun. He said modeling indicates that if all local residents follow the mandate meticulously, it could reduce case rates by more than 50 percent. Realistically, Hoffman said he hopes to see it reduce cases by 15 to 25 percent, adding that every little bit counts.

"By reducing 20 or 15 percent, we're talking about several extra beds in the hospital, which is going to alleviate strain," he said "... We have to protect the critical infrastructure of our fragile hospital system in Humboldt County. And we want to see businesses stay open, we don't want to return to any lockdown situations. And we have to have kids in school this fall. It is with all of that in mind that we're doing this."

Thadeus Greenson (he/him) is the Journal's news editor and can be reached at 442-1400, extension 321, or [email protected]. Follow him on Twitter @thadeusgreenson.