As we approach a third pandemic winter, our overall COVID outlook is different from the prior two years, as stronger community immunity and the availability of effective treatments should result in fewer hospitalizations and deaths.

At the same time, with multiple respiratory viruses now circulating widely in San Mateo County, getting the vaccines to protect against COVID and Influenza and taking extra precautions can make a difference. This is especially important for older adults, people with disabilities, and those with underlying medical conditions who remain at higher risk.

Racial and ethnic disparities have decreased over the course of the pandemic, but they persist. This reinforces the importance of continuing to work with an equity lens in our public health roles – such as by collaborating with healthcare providers, schools, and other partners to further the availability of vaccines, tests, and antiviral medications to reach the hardest hit populations.

Vaccinate to protect against COVID and Influenza before the winter.

With “Very High” flu activity in California as defined by the CDC and increasing COVID activity as seen in reported cases, wastewater surveillance, and hospitalization levels, we now recommend both vaccines as soon as possible. This year’s flu shot appears to be a good match for the influenza strains circulating and is available to everyone 6 months and older. The updated bivalent COVID booster, which has been available since September, includes a component of the original virus strain to provide broad protection against COVID-19 and a component for the omicron variant that would be particularly protective during these next winter months.

As of November 30, 25% of all county residents have obtained the updated COVID-19 bivalent booster. For those ages 50 and older, this percentage increases to 35%. We continue to collaborate with health systems and community organizations to inform people about the safety and effectiveness of the vaccine and the many pathways through pharmacies and health care providers, with appointment availability ranging from a few days to a couple of weeks.

In addition, County Health is offering vaccination clinics at rotating locations to reach the communities that have been hardest hit by COVID. This month we have six scheduled clinics in partnership with schools and faith-based organizations in Redwood City, Menlo Park, and East Palo Alto, particularly in communities where pharmacies are not easily accessible. These are listed on our vaccine clinic calendar website and updated regularly. We encourage community partners to continue requesting targeted pop-up vaccine events through the request form found on our Vaccine Clinic Calendar website. We plan to schedule these rotating clinics through the end of January and are prioritizing clinics targeting individuals and families who have been historically underserved and are disproportionately impacted by COVID, such as our Black, Latinx and Native Hawaiian or Pacific Islander residents.

We will continue to partner with schools, particularly those with a higher percentage of children on free and reduced lunch, to offer both COVID and flu vaccines at school sites through the end of March. These clinics will also serve residents from the surrounding community.

Public Health Approach to Preventing Winter’s Respiratory Viruses

Beyond vaccination to protect against the most severe impacts, transmission of the current strains of influenza and COVID can be prevented by limiting exposure to respiratory droplets. Large droplets from the nose and mouth (carrying influenza, RSV) can settle onto surfaces and objects and spread by close contact. Very small droplets (carrying COVID virus) are exhaled into the air farther than six feet.

• Prevent transmission of large droplets by washing hands, avoiding touching your face, covering coughs, and cleaning surfaces.
• Prevent airborne transmission by limiting the number of people indoors, improving ventilation (opening multiple doors & windows) and wearing a mask (N95 respirator) to protect yourself.

If you develop symptoms of a respiratory virus, take 3 steps to care for yourself and protect others.

1. Stay home until symptoms are mild and improving. This includes waiting 24 hours until your fever has resolved. On average people are contagious with COVID for about 8 days after symptoms begin. People with flu are most contagious in the first 3-4 days of illness. People with RSV are usually contagious for 3-8 days.
2. Test for COVID. Rapid antigen self-tests for COVID are conveniently available, including over-the-counter at retail stores, pharmacies, and many schools. For someone with worrisome symptoms or a high risk for severe disease, contact a health care provider who can assess for other illnesses.
3. Wear a mask while you’re contagious. Protect your family, friends, classmates, and community by covering an infectious runny nose or cough with a mask.

Mpox Response

Lessons learned from the COVID pandemic guide our response to ongoing and emerging public health threats. With the first cases of mpox (as it’s now called by the WHO, instead of monkeypox or MPX), we initiated our response including case investigation, contact tracing, vaccinations, and community health education. This collective response has controlled the outbreak, from a peak of 40 cases in August to 1 in November. We’ll continue our enhanced surveillance and disease control activities; and update this Board and communities if the epidemic turns upward again.

We’re grateful for all the healthcare, business, governmental, and non-profit organizations who are preventing disease and promoting overall community health. By collaborating on these collective public health goals, we can enjoy the holidays with health and good tidings.

All together better,

Louise Rogers