Coronavirus Today: Making vaccines go viral

Good evening. I’m Amina Khan, and it’s Wednesday, Jan. 13. Here’s what’s happening with the coronavirus in California and beyond.

As public officials continue driving the slow and bumpy vaccine rollout forward, they’re still worried about a major roadblock that could stop it in its tracks: the reluctance of many people to get these lifesaving shots. That’s why Orange County leaders voted to hire a public relations firm to help them reassure skeptical people about the safety and efficacy of COVID-19 vaccines.

Who are these vaccine-hesitant folks? Officials didn’t specify where they’d like the PR masters to focus their efforts, but a recent survey conducted by the county’s healthcare agency suggests that women, Latino and Black people, adults between the ages of 35 and 54, and residents of Anaheim, Costa Mesa and Santa Ana were the least willing to roll up their sleeves for a jab.

That list is so long, it’s got to make you wonder who’s left. And indeed, only 58% of the survey’s 26,000-plus respondents indicated they‘d be willing to get a COVID-19 vaccine. That’s a problem because vaccines will help us achieve herd immunity only if as much as 85% of the population takes them, experts now estimate. Only then would we be able to contemplate a return to normal life.

This problem is hardly unique to Orange County. An early December survey by the Associated Press-NORC Center for Public Affairs Research found that only about half of American adults planned to get the shots. “It is clear that willingness to be vaccinated for COVID-19 is much lower than past or present willingness to be vaccinated for the seasonal flu,” the survey states.

Why the lower trust in the COVID-19 vaccines? Some people have worried that vaccine development was rushed, given how quickly they were designed, tested and authorized. But there are reasons that it was able to happen so fast — including a decade of behind-the-scenes work that gave researchers a huge head start.

For the record, the scientific evidence is clear that the authorized COVID-19 vaccines are safe and effective — a conclusion reached after clinical trials involving tens of thousands of patients, including the elderly and those with chronic conditions. A review of nearly 2 million doses given during the first 10 days of vaccinations found that reports of adverse events were rare, with only 21 cases of severe allergic reactions. None were fatal.

Here’s the challenge: It takes only one point of contact with an infected person to get the virus. But it’s going to take far more exposure to high-quality information about vaccines even to have a chance in persuading skeptics to sign up, officials say.

“Is there urgency to what we need to do? Yes, because unlike testing, this requires education. Education and awareness takes time,” said Andrew Do, chairman of the Orange County Board of Supervisors. “You are not going to win over people with one ad, one touch, one encounter. You need multiple touches from multiple sources that they believe in ... to educate them of the process and then lower the resistance to vaccines.”

By the numbers

California cases, deaths and vaccinations as of 6:15 p.m. PST Wednesday:

Track the latest numbers and how they break down in California with our graphics.

Across California

Everyone 65 and older now qualifies to get a COVID-19 vaccine in California, under a major expansion of eligibility guidelines announced Wednesday. The move comes in response to new Trump administration guidance aimed at speeding up vaccine rollouts and adds more than 6 million people to the list of Californians who qualify for the shots.

“There is no higher priority than efficiently and equitably distributing these vaccines as quickly as possible to those who face the gravest consequences,” Gov. Gavin Newsom said. “To those not yet eligible for vaccines, your turn is coming. We are doing everything we can to bring more vaccine into the state.”

California has so far struggled to distribute its vaccine allotment. As of Monday, the state had received more than 2.4 million doses but administered fewer than one-third of them. In part, that’s due to lower-than-expected demand from high-priority groups such as healthcare and nursing home workers; up to 40% have been declining the initial opportunity to get their shots. In response, state officials expanded access last week to all healthcare workers and relaxed guidelines for unused doses.

The eligibility expansion poses significant challenges. Counties are scrambling to find more healthcare professionals who can administer the shots, large facilities where inoculations can be offered and more of the vaccines themselves.

And the announcement was met with some confusion. Orange County officials had already decided Tuesday to take the Trump administration’s advice and lower the age threshold to 65. But the websites for other counties, including the one for Los Angeles, continued to advise that only healthcare workers and residents in long-term care settings qualify for the vaccine.

There are signs the post-holiday surge may be abating slightly in parts of Northern California, with the stay-at-home order lifted for the Greater Sacramento area. This means the counties in the region — Alpine, Amador, Butte, Colusa, El Dorado, Nevada, Placer, Plumas, Sacramento, Sierra, Sutter, Yolo and Yuba — have returned to the state’s color-coded tier framework that determines how public and commercial spaces can reopen.

“California remains in its most intense surge to date,” Newsom said. “But there are some good things to report. We’re starting to see some stabilization both in ICUs [and] in our positivity rate. We’re also starting to see the rate of growth for hospitalizations beginning to decline.”

Southern California has not been faring quite as well. The post-Christmas surge is still hitting Los Angeles and nearby counties as more people infected over the winter holidays test positive — which will probably lead to more hospitalizations and deaths. On Tuesday, 14,134 new cases were logged in L.A. County alone.

So are we anywhere near bending the curve? So far, the answer remains unclear. While it’s likely that state and local restrictions are helping to some extent, they’ve been thwarted by holiday gatherings, shopping and travel. My colleagues Rong-Gong Lin II, Luke Money and Maura Dolan have a breakdown of where we are in the pandemic.

Nationally, 49 out of 50 states are either in a surge or recovering from one, said Dr. George Rutherford, an epidemiologist and infectious disease expert at UC San Francisco. The only exception is Hawaii.

“Cases are all over the place,” Rutherford said. Arizona and Rhode Island have the worst case rates in the nation over the last 14 days, surpassing California. And there are 16 states whose per-capita death rates over the last two weeks are worse than California’s.

On the plus side, the number of COVID-19 patients in hospitals has plateaued to just under 22,000, and new admissions have also declined from about 3,500 per day last week to between 2,500 and 2,600 now, according to Dr. Mark Ghaly, California’s Health and Human Services secretary. The slowdown in the hospitalization rate was “a very encouraging sign,” he added, “but we’re not out of the woods.”

See the latest on California’s coronavirus closures and reopenings, and the metrics that inform them, with our tracker.

Around the nation and the world

Public health officials warned for months that they had too little federal support, including funding, to get vaccines into people’s arms — and the slow rollout seems to be bearing out those worries. Now that the Trump administration has moved to speed up the process by urging states to lower the age threshold to 65, many Americans are wondering when their turn will come.

The answer depends on your age, your health and where you work or live. States ultimately determine the order in which people qualify, and California is one of several states that now allow those 65 and up to be vaccinated. Drugstore pharmacists are providing the shots in many places, and big vaccination clinics are planned for sports arenas and fairgrounds.

For the time being, vaccination sites will require people to sign up for an appointment ahead of time and verify that they are eligible for a shot, but there might still be some waiting involved. One thing looks certain: The shots should be free.

Older Americans have been among those at highest risk from COVID-19 as the virus continues its insidious spread through our communities. But while they’ve been medically vulnerable, U.S. senior citizens have shown a surprising level of mental and emotional resilience in spite of their struggles with loneliness and isolation, according to a new study.

The latest data from the ongoing National Social Life, Health and Aging Project show that only 9% of older adults reported having “fair or poor overall mental health during the pandemic,” which is similar to previous answers, the authors said. General happiness had declined, however, and an increasing number of older Americans report occasional feelings of depression or isolation.

“It should sensitize everyone to the reality of isolation’s impact but also the reality that people are resilient — and maybe even more so older adults than younger adults,” said Louise Hawkley, the study’s lead researcher. The information comes from 1,284 people between ages 55 and 99 who were interviewed in September and October.

“This isn’t their first show. They’ve been through things already. They know how to handle stress,” Hawkley said. “This is something we can learn from them — that there is survival.”

In northwest Spain, a judge in the Galicia region has overruled a family’s objections and decided to allow health authorities to administer a COVID-19 vaccine to an incapacitated woman in a nursing home. The case may be the first known instance of a European court requiring someone to get a COVID-19 vaccine.

The judge said the court had a legal obligation to intervene to protect the woman’s health, and that the “existence of tens of thousands of deaths” from the virus in Spain was irrefutable evidence that not taking the vaccine was riskier than any side effects.

The nursing home company that made the request to vaccinate the woman said that 98% of the 15,000 residents in its Spanish nursing homes had agreed to take the vaccine. The remaining 2% refused to get vaccinated, but unlike the woman in this case, they were considered fit to make their own health decisions.

The World Health Organization has previously said it does not recommend making COVID-19 vaccination compulsory, fearing this could undermine public confidence. But some ethicists have said the court’s decision to order the woman’s vaccination was probably justified.

“The court has to look at the balance of probabilities, and if the woman is elderly, she has a far higher risk of dying from COVID than from a low-probability adverse event,” said Julian Savulescu, director of the Oxford Uehiro Centre for Practical Ethics at the University of Oxford.

Your questions answered

Today’s question comes from readers who want to know: If I‘ve had COVID-19, do I still need to get vaccinated?

Some folks may assume that they don’t need a vaccine if they’ve already survived a bout with COVID-19. But the Centers for Disease Control and Prevention is pretty clear on this: Even if you’ve had the disease, you should definitely plan on getting vaccinated.

“Due to the severe health risks associated with COVID-19 and the fact that re-infection with COVID-19 is possible, vaccine should be offered to you regardless of whether you already had COVID-19 infection,” the agency says here.

And there’s more: “At this time, experts do not know how long someone is protected from getting sick again after recovering from COVID-19. The immunity someone gains from having an infection, called natural immunity, varies from person to person. Some early evidence suggests natural immunity may not last very long.”

Dr. Amesh Adalja, an infectious disease expert and a senior scholar at the Johns Hopkins Center for Health Security, agreed that COVID-19 survivors should still line up for their shots.

“People who have recovered from COVID-19 should get a vaccination because it is unclear how strong natural immunity is and for how long it will be operative,” Adalja said. “A vaccine will boost natural immunity and likely make it more robust. However, because natural immunity does develop post-infection, those that have recovered from COVID within the past 90 days can postpone their vaccination and let others without natural immunity go first.”

We want to hear from you. Email us your coronavirus questions, and we’ll do our best to answer them.