‘We don’t want to have to start over’: Experts in La Jolla urge public restraint to continue COVID-19 easing

This 2020 electron microscope image shows particles of SARS-CoV-2, the coronavirus that causes COVID-19.
(Associated Press)

Restoring San Diego County’s long-severed social connections is starting to feel less and less risky now that nearly 80 percent of its residents 65 and older have been vaccinated.

Under state law, only the governor may declare that the pandemic is no longer a public health emergency and, so far, it has technically remained so. Despite mounting public pressure to pull back on emergency powers, the state has followed a cautious path, allowing a gradual return from hibernation that will reach its broadest point Thursday, April 1, with the return of fans at outdoor entertainment venues and visitors to amusement parks.

While many, pointing to much lower COVID-related hospitalizations, are demanding that the state reopen faster still, experts continue to warn that this is not the moment to head to bars sans masks.

While La Jolla is not out of the coronavirus woods yet, the number of new cases reported to the county each week in the 92037 ZIP code has been declining.

March 22, 2021

Dr. Robert “Chip” Schooley, a nationally known infectious-disease expert at UC San Diego in La Jolla, said that while he knows the temptation to start partying has seized many, such exuberance should, for the moment, be reserved for those who are fully vaccinated.

“To have people who aren’t vaccinated going out to indoor places without masks, it just gives the virus more shots on goal, and that’s really not what we want to be doing in this moment,” Schooley said. “It’s not like we’re in a situation where we hope to get a vaccine someday and we’re asking people to wait for an indeterminate amount of time.

“We have one, we know that it works, and we need just a few more weeks to put this thing back in the bottle.”

Many will note, though, that the main stated goal of the massively disruptive public health campaign that began unfolding a year ago was protection of hospital capacity. If the pandemic began producing too many simultaneous infections, it wouldn’t have been long before every hospital bed was full and doctors were practicing “crisis” medicine, granting access to lifesaving care based on a person’s overall probability of benefiting.

It nearly came to that in California just after the holidays, with many emergency departments so inundated that they temporarily had to turn away new patients.

But the demographic most likely to produce such a surge is now in a very different place.

Though they make up 16.5 percent of the population, Americans 65 and older account for 46 percent of COVID-related hospitalizations and 80 percent of coronavirus-linked deaths, according to the U.S. Census Bureau. Local statistics show roughly the same proportions in San Diego County.

Age, many researchers have found, is COVID-19’s clearest risk factor. The chronic diseases that make severe illness and death more likely — diabetes, heart disease, high blood pressure — are more common as we get older.

A study published in September found that those younger than 65 have a “30- to 100-fold lower risk of COVID-19 death” than those 65 and older.

According to a county tally released March 27, 364,052 of the 473,003 people 65 and older who live in San Diego County have been vaccinated.

That’s 77 percent, surely enough to have significantly helped drive the region’s collective hospital census, the number of people with COVID-19 in beds on any given day, down 67 percent over the past 30 days as indicated in the county’s most recent tracking report.

But experts caution against reducing the pandemic picture to hospitalizations alone.

The virus itself is changing, mutating into “variants of concern” that have been seen in the United Kingdom, South Africa, Brazil and California. Many of them show a greater ability to infect than the initial group of pathogens that first spread across the globe from Wuhan, China.

Last week, San Diego County reported the nascent presence of P.1, the more worrisome of two mutated types first detected in Brazil. That viral version is distinguished by its ability to reinfect those already sickened in the first wave.

Locally, the U.K. variant, B.1.1.7, now likely represents half or more of all new cases, said Kristian Andersen, an immunologist at Scripps Research in La Jolla.

Because it spreads more quickly than initial versions, B.1.1.7 is seen as presenting a greater threat as communities allow greater levels of social gathering, especially if that gathering is among people who are unmasked and unvaccinated.

Schooley said the current variants are their own kind of warning. Every time the virus replicates itself, he said, there is a chance that, in copying its genetic material, mistakes will be made, leading to the kinds of mutations that make P.1, B.1.1.7 and others.

So, scientists say, it remains vital that as the world starts to wake up again, unvaccinated people continue doing whatever they can to avoid getting infected. Every generation of viral replication inside humans rolls a set of unpredictable genetic dice capable of landing everyone in a tougher spot.

While vaccines appear capable of crushing the types of virus now circulating, there are no guarantees.

“We just don’t want to be in a situation where we have a variant emerge that we can’t control with the vaccines that we have available,” Schooley said. “We don’t want to have to start over.” ◆