Timothy Lutz, director of Tulare County Health and Human Services, needed just one word to frame his reaction to the area’s current COVID situation: “Wow.”
‘Extremely High’ Death Rate
He offered that assessment early on the morning of January 21, a day after Tulare County saw 319 new cases and nine deaths.
In the brief time since – just 24 hours later – 14 more COVID patients have died, and the number of infected rose by another 355 new cases to more than 42,000.
That’s a nearly 10-fold increase in infections since the onset of cold weather.
“In the late summer months, we were averaging around 500 cases,” Lutz said. “Now, we’re at more than 4,500. That shows we’re battling COVID in the community.”
COVID has killed 529 Tulare County residents. About 37,000 patients have recovered.
“Our death rate has been extremely high,” Lutz said. “It is an astonishingly high number when you think about that.”
The county’s death rate is about 1.2% of infections.
“It’s far more deadly than any flu virus,” Lutz said.
Vaccine Rollout Progresses Haltingly
The good news, of course, is that a vaccine against the coronavirus causing COVID-19 is available, and the TCHHS has been rolling it out as quickly as it can.
“We’ve been going pretty aggressively,” Lutz said.
By January 19, the county had distributed more than 5,000 coronavirus inoculations. One day later, that number had climbed to more than 9,000. But it hasn’t been easy.
“I feel at times that managing this vaccine rollout is like trying to thread a needle in a windtunnel,” Lutz said.
Besides frustrating problems with state-supplied vaccine tracking software–which doesn’t allow the county to prioritize patients based on age and occupation–there have been issues with supply consistency leading to delays and confusion.
“We could get 8,000 or 9,000 doses this week, and the following week we get 3,000,” Lutz said. “It’s very frustrating.”
No-Shows and Extra Vaccine
Also causing problems are a large number of people who sign up for the county’s inoculation clinics then fail to arrive. The vaccine must be kept at extremely low temperature, essentially frozen, and is prepped for use based on the number of people who register for the two-shot series.
“Once we thaw these vaccines, they have a very, very short shelf life,” Lutz said. “We want to make sure we don’t waste a dose. At the end of a clinic, if there’s extra, they do a push.”
Attempts to avoid wastage have led to calls through unusual channels, such as chain emails and telephone calls from hospitals, alerting those who are currently eligible for the vaccine they’ve moved up the list. Lutz says changes in the state’s vaccine priorities has also hampered the vaccine rollout.
“This is the area we have struggled with the most. We were engaged with stakeholders starting last week, we’re going to be looking at this 1B group, which is teachers and police officers and other first-responding individuals and also includes farmworkers,” Lutz said. “Now, the state is announcing a push on not industry-based tiers, by age-based tiers, so now we have to change our strategy.”
How to Get Inoculated
While a hotline is in place for appointments – accessible by dialing 211 – county health officials have stated that the number has been “overwhelmed with calls.”
The best bet is to use the county’s online interest form at covid19.tularecounty.ca.gov/covid-19-vaccine. Currently, all county vaccine clinics are completely booked.
“We have nearly 30,000 people sign up through that. We can send direct messages to them right away,” Lutz said. “We’re looking at sending those groups announcements before the appointments are available on the website.”
TCHHS is also planning a vaccination clinic for seniors at the Ag Expo in Tulare. Sign-ups will be available through 211 and online.
“If they can’t get hold of 211, seniors should call the Kings/Tulare Area Agency on Aging 800 number,” Lutz said.
That number is (800) 321-2462.
Getting the COVID shot, according to Lutz, is the best measure against coronavirus infection.
Fighting Fear and the Virus
Due in large part to misinformation spread online, many people are reluctant to receive the coronavirus vaccine. That fear was exacerbated last week when reports of allergic reactions to a batch of shots began to appear.
Lutz said the side-effect can be easily treated and should not keep people from getting the vaccine.
“I think the first message is, one, we encourage people to get the vaccine,” he said. “I know there’s still a lot of vaccine hesitancy out there. There will always be people who have an anaphylactic response. That’s why we have a waiting period. We in the scientific community believe it is effective.”
Tulare County, in one aspect, is faring better than other places in the states, where more than half of medical personnel are refusing the vaccine. Our county saw a must lower refusal rate.
“That’s the piece that worries me. It was about a 60 percent acceptance rate,” Lutz said. “It varies, depending on the population, but we’re seeing between 60 and 65.”
Public’s Reaction Varies
Part of the skyrocketing infection rate is due to a premature relaxing of precautions against the virus.
“It has been a definite pendulum. Early on, people took it more seriously,” Lutz said. “As it went on, they took it less and less.”
While “quarantine fatigue” is affecting almost everyone at this point, many are having their attitude changed by personal experience.
“Some of the people who were skeptical are taking it more seriously,” said Lutz. “What I’m hearing is they have relatives who have contracted it or even worse, died from it. It’s been their teacher.”
Caution should be a watchword throughout the county at this point, as there have consistently been no available ICU beds for weeks. In the early days of the pandemic, just 18% of the ICU beds at Kaweah Delta Medical Center, Adventist Hospital in Tulare and Porterville’s Sierra View Hospital were given over to acute COVID patients. That number is now above 50%, with ICUs still contending with non-COVID patients.
“We typically are hovering on one to three ICU beds available every day,” said Lutz. “That’s a lot of juggling our hospitals are doing to get patients out, but not too quickly.”
No Help on the Way
The county, Lutz said, is essentially on its own as the entire country deals with the second wave peak. All the county’s hospitals have applied to the state for additional resources, and some have “trickled in,” but calls for additional medical personnel from the National Guard or the Department of Defense, which supplied a medical team to Kaweah Delta last year, will go unheeded.
“The answer from the state is there really isn’t additional help,” Lutz said. “The National Guard and Department of Defense teams are deployed elsewhere. Those resources were just not available. They were deployed across the country.”
The good news is that the peak of the second wave appears to have been January 6 – ironically, the same date protestors stormed the US Capitol Building in Washington, DC.
Lutz believes that may also be true for Tulare County, as holiday gatherings are now behind us. The astronomical infection rate at present is due mostly to those gatherings.
“Fifty-percent to 60% of our cases are coming from gatherings,” he said. “The week before Christmas was when we saw the end of the Thanksgiving peak. Now, we’re seeing the result of the Christmas gatherings.”
The deaths from those Christmas and New Year’s Eve parties will be many.
“I can see the collective toll is going to be huge,” Lutz said.
Other Disease Vectors
Sending children back to school has also been responsible for at least two known outbreaks in Visalia. Classrooms were shuttered at Hurley Elementary School and the Global Learning Charter School following the discovery of active COVID cases.
Many restaurants, especially in downtown Visalia, have reopened in defiance of state mandates. Lutz’s description of going down Main Street as he was returning from a recent vaccination clinic typified the attitude of many locals.
“Driving through downtown Visalia, it looked like a pre-pandemic night,” he said. “That’s quite disheartening because a lot of those people are going to become cases.”
Lutz appreciates that many want the pandemic to just go away.
“Following the guidelines is frustrating for us, despite our ICU at capacity and our medical workers at exhaustion,” he said. “You have broad swaths of the community that just don’t want to follow the guidelines.”
For everyone’s benefit, however, we have to try harder. We must wear our masks. We must avoid gatherings. We must get the vaccine, if we are going to return to normal.
“The more we have people who don’t want to follow any of the guidance, the longer we as a community will limp along,” Lutz added.