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August 31, 2021 – Message from the Chief
Louise Rogers, chief, San Mateo County Health

Health Officer Updates Messages from the Chief

As September arrives, we are glad to see each week bringing continued progress in reaching San Mateo County residents with first and second doses, while we and other health care and pharmacy partners are also planning to offer third booster doses for those who become eligible by the third week of September. 

The Latest

We expect the coming weeks will bring more certainty to those plans and timing as federal and state authorities issue guidance that will be needed to launch the boosters. The guidance will likely prioritize those populations that received their second doses at least 8 months ago, including health care workers, first responders and older adults. We are proud of the collective effort that has brought our countywide vaccination rate of eligible residents to 91.6% and have confidence that our collective infrastructure for vaccinations among all health care systems and pharmacies is strong to carry out this new phase of work. 

We also remain committed to our priority to lift every population that has been lagging to reach an 80% vaccination rate by December 31st. This includes staying the course in reaching all of our patient/client populations who comprise a significant portion of the county’s remaining unvaccinated. San Mateo Medical Center has reached approximately 66% of its patients with one dose and has estimated there are about 19,000 remaining. Behavioral Health and Recovery Services has reached 65% and has estimated there are about 4,000 remaining. Aging and Adult Services has reached at least 78% and has estimated there are about 1600 clients and 2,000 In Home Supportive Services (IHSS) workers remaining. We are so pleased to see patient, sustained efforts leading to both East Palo Alto and North Fair Oaks recently reaching the 80% mark! We see incremental progress in every population/geographic community each week and continue to welcome your ideas about how to improve. We plan to continue an array of strategies to reach everyone, including our local community-based and pop-up clinics as well as re-mobilized mass vaccination clinics at the SMC Event Center.

I am thrilled to welcome a new Public Health, Policy and Planning Director, Marc Meulman, who joins our County Health executive team today, bringing a wealth of experience from Orange County, where he was Chief of Operations for Public Health. We feel very fortunate to have attracted a seasoned public health leader to join us during this important phase of the pandemic.  

Our most recent experience of the virus in San Mateo County

Our 7-day lagged average reported August 30th was 14.7 new cases per 100K in the population, slightly lower than the 14.8 figure I shared last week. This is an average of 115 new COVID-19 cases per day, the same as last week’s figure. The plateauing I noted in my last week’s update remains, though transmission remains high. Hospitalizations due to COVID-19 continue to hover around a patient census of 50 most days. We continue to monitor test positivity both countywide (3.3%) and in the Healthy Places Index lowest quartile census tracts (4.8%). Our testing was reported by the state at 716 tests per day per 100K in the population. We continue to provide groceries and rental assistance through the Public Health Support Program operated by the Mental Health Association to between 2 and 23 households a day who need this support to isolate. 

We are excited to see students returning to school for in-person learning, and we also understand the caution that parents and others feel. Our website data dashboard for August 30th shows that San Mateo County had 3,397 cases of all ages over the last 30 days; of these 400 (12% of cases) were <9 years old and 417 (12% of cases) were between the ages of 10-19. One month prior, on July 30th, we saw that San Mateo County had 1,929 cases of all ages over the previous 30 days; of these, 175 (9%) were <9 years old and 210 (11%) were between the ages of 10-19. To put this into a longer perspective, we can also look back on the entire pandemic and see that of 48,545 cases, 3,565 (7%) were <9 years old and 5,433 (11%) were between the ages of 10-19. We know that when the rates of COVID are high in the community, cases will appear at schools, just as they do in other settings. When a case is identified in a school, there are structured guidelines for implementing isolation, quarantine and modified quarantine, including increased testing and temporary exclusion from extra-curricular activities during the quarantine period. Transmission can happen in any setting, including in schools, but children are often exposed to COVID-19 at home or in social settings where safety practices may vary. However, with effective prevention protocols in place — including universal indoor masking, vaccinations of eligible persons, testing, good hand hygiene, staying home when sick and proper ventilation — the data show that these multiple layers of defense can stop the spread of COVID in school settings. The lack of in-person learning during the COVID-19 pandemic not only disrupted education but also weakened social supports and harmed the mental health of students. The risks and benefits of returning to in-person learning are clearer now than any other time during this pandemic – we must all continue to do everything possible to keep kids safely attending their schools.

Vaccination update

We continue to stress that COVID-19 vaccination is the most important action to protect oneself, one’s loved ones and the community, and we continue to see progress each week. The state immunization registry report of August 29th showed that 91.6% of our total eligible county population aged 12 and older have received a COVID vaccine. This is 615,908 total eligible individuals vaccinated, which is an increase of almost 5,000 eligible residents since my last report. Of those who have received any COVID vaccine, a large percentage, 89.5%, have completed their vaccination series. Our updated estimate of the number of unvaccinated eligible San Mateo County residents is now 56,000. 

The new refined/improved demographic estimates provided by the State Department of Finance have now been integrated into the data dashboards on our website and in this report, resulting in changes to some vaccination reach percentages countywide and within several age, geographic and race/ethnicity categories. The updated estimates allow us to hone our understanding of which communities are lagging compared to the progress countywide. Our strategies remain unchanged to increase the reach of the vaccine, close gaps in vaccination rates, and prioritize the communities and populations that still need to attain at least 80% vaccination rates. 

We see that we have reached 79.9% of those ages 10 and over in our lowest quartile Healthy Places Index census tracts overall, and we continue to focus on raising the lowest of these. Last week we continued to make significant progress in both East Palo Alto and North Fair Oaks and are proud to report that both communities have reached the goal of at least an 80% vaccination rate. East Palo Alto is now at 80.0% and North Fair Oaks is now at 80.3%. Within the last week our City of EPA partners shared a common goal of getting to “80 in August,” and we are thrilled to celebrate the achievement of this goal! However, the work does not stop, and we will continue these efforts to reach the remaining unvaccinated. We are so appreciative of the persistent efforts of many partners to support this progress, reinforcing the potential for every other community in San Mateo County! While the following communities still show vaccination rates below 80%, we aim to better understand the data and our actual reach, particularly where population estimates are less precise. 

Communities under our goal of at least 80% vaccinated

Geographic Community as of 8/29/2021 # of 1st and single dose vax given by any entity in past 7 days % vax with 1st or single dose Estimate # eligible unvax
Broadmoor 16 69.6% 1,440
El Granada 16 65.6% 1,916
Loma Mar* 0 68.6% 54
Moss Beach 10 52.4% 1,478

*Vaccinations by city are calculated by geocoding and aggregating self-reported addresses by city or town. Population estimates are less precise for areas with small population.

Pop-up clinics remain a strong strategy to move us closer to achieving our vaccination goals, and we have 65 clinics either completed or moving forward (an increase of 4 since my last report). 

Of the total county residents who have been vaccinated, 58.4% are people of color, 36.3% are white, and 5.3% are of unknown race/ethnicity. We continue to focus our efforts on increasing vaccination rates among Black, Hispanic and Pacific Islander communities in which rates are still below 80%. With our updated Department of Finance numbers, our improved denominator (population) estimates now show increased reach with our Hispanic and multiracial groups, but we a see a slight decrease in our reach for Black and Native Hawaiian/Pacific Islander groups. We will continue to monitor progress towards 80% vaccination using these updated population estimates.  

Race/Ethnicity Groups under our goal of 80% vaccinated

Note: Due to data collection and reporting limitations these estimates are imprecise and likely reflect under-reporting of reach in each racial/ethnic group given the number of residents who self-identify as “other,” “multi-race” or for whom race/ethnicity data was not collected by the vaccinating entity. 

Race / Ethnicity % age 12+ vax as of 8/22/21 % age 12+ vax as of 8/29/21 % increase since 8/15/21

Estimate # eligible unvax 

Black / African American 62.8% 60.3% -2.5percentage points 7,121
Hispanic 56.5% 58.0% +1.5 percentage points 72,819*
Multiracial 45.9% 53.4% +7.5 percentage points 9,850
Native Hawaiian / Pacific Islander 62.1% 61.7% -0.4 percentage points 3,743

*This is an over-estimate of the number of Hispanic residents to be reached as it exceeds the total number of residents to be reached; however, we see this is as our largest community under-reached by COVID-19 vaccination among the groups that are still below 80% vaccination rates.

We are pleased to share that the new data from the Department of Finance confirms we have reached 82% of the 85+ population (3,552 remaining unvaccinated). Since the 12-15-year-old group became eligible, 78.9% have already been vaccinated with their first dose. We look forward to the eventual approval of vaccines for younger children and until then we will continue to partner with County Office of Education and schools to provide convenient vaccine opportunities for eligible youth ages 12+ and their families. 

All Together Better,
Louise F. Rogers