As summer temperatures have risen, so have COVID-19 case levels across the Sacramento region and California. That’s all happening alongside a flurry of omicron variants overtaking each other within a couple months — from B.A.2.5 to B.A.4 to B.A.5.
While catching COVID-19 may not lead to immediate hospitalization, it can still be debilitating, resulting in persistent symptoms that can last at least six months after initial infection. Those living with the condition, also known as long COVID, say it’s forced them to restructure their lives, and some worry what impact it’ll have on the healthcare system if more public health measures aren’t taken.
Here are answers addressing the current moment in the pandemic, including why we went from hearing about B.A.4 to B.A.5 in a span of around a month and resources for continuing to keep yourself — and others — safe.
Will we see a return to mask requirements in the Sacramento region?
Public health officials in the region say they’re not planning to re-institute mask mandates at the moment. Sacramento County spokesperson Samantha Mott said via email that the county continues to follow state guidance, under which masking remains “strongly recommended” but not required.
While Yolo County Health Officer Dr. Aimee Sisson says mask mandates “aren’t off the table,” she says she’s currently hinging that conversation on hospitalizations and burden on the healthcare system.
Sacramento and Yolo counties recently moved to the CDC’s medium COVID-19 community level. The COVID-19 community levels are a measure developed by the Centers for Disease Control to indicate levels of virus and burden on local healthcare systems in a community.
However, because testing efforts have ramped down in the region, which Sisson said has led to more people using at-home tests instead of getting tested at a clinic, the CDC data likely reflects an undercount of cases.
How did we get to this current COVID-19 variant?
UC Davis professor Dr. Jonathan Eisen, who studies the evolution and ecology of microbes by looking at their genomes, said the reason this current variant replacement is happening so quickly is because billions of people have been infected by COVID-19.
That gives a virus more opportunity for trial and error, to see what evolutionary adjustments allow it to better survive.
“You have a virus that infects an individual person, and then it replicates within that person … some of the time when it makes a copy, it makes a mistake,” he said. “Occasionally, the mistakes give that particular [virus] variant a slight or sometimes even a big advantage.”
For example, with omicron and the current variants, increased transmissibility gave them an advantage in terms of infecting the population. Reinfection has also become more common with the current variant, with some people getting reinfected as soon as a month after getting COVID-19, adds Eisen.
Increased transmissibility isn’t always accompanied by a stronger illness.
“Most of the omicron variants, on average, don’t make people quite as sick [as delta], even though they still make a lot of people really sick,” he said. “But the next variant could be worse.”
He cautions people from assuming that future variants of COVID-19 will be accompanied by reduced virulence, pointing to delta as a variant that was both better able to spread and more dangerous than earlier variants.
“Many people have made the mistake and claim that we expect pathogens like this to become less dangerous over time and that’s just not the case,” he said. “It’s not the case for any other pathogen on average.”
Why should I still be concerned about COVID-19 if omicron variants cause “less severe” illness than delta variants?
Sisson with Yolo County and Eisen at UC Davis both underscore two things: the risk of long COVID and the fact that the virus can still be fatal.
“It’s still worse than even the flu,” Eisen said of COVID. “And the flu kills 50,000 people a year on average in the United States … I don’t think it makes sense to just say ‘We should live with it.’”
And doctors who have treated patients with long COVID say they’ve seen patients become extremely debilitated to the point of quitting their jobs, with over 200 potential symptoms from fatigue to shortness of breath and memory loss.
A poll conducted by the U.S. Census Bureau in June found 7.5% adults in the U.S. — one out of 13 — still had COVID-19 symptoms at least three months after their acute illness ran its course.
“Right now, there’s so little known about risk factors for long COVID and some people who had very mild COVID ended up with pretty severe long COVID,” Sisson said. “You can’t get long COVID if you never had COVID in the first place.”
While treatments for the condition may be developed in the future, the future isn’t right now.
“It’s possible in the future that it won’t be a problem, but it’s pretty clear right now that it’s a big problem,” he said. “If we let COVID spread over and over and over into populations, it seems like we are taking a huge risk with something that is well-established to be a real thing.”
This CapRadio article includes coping strategies used by people with long COVID, including virtual long COVID support groups.
Given this current variant, how can I keep myself safe right now?
While Eisen is high-risk for COVID-19, he said he still goes out, he’s just careful about it.
For him, that includes getting a good N95 mask or similar-quality respirator, like a KN95 or KF94, and learning how to use it.
“For example, when I have things that I have to be indoors for, I trim my beard very closely because that makes the N95 masks work better,” he said. He also recommends searching for at-home fit tests to make sure your mask fits well on your face.
In terms of activities, Eisen says he’s not going to any giant indoor gathering unless necessary, nor is he taking his mask off indoors to eat.
“You have to think about the probability that any person is infected in your space is pretty high right now, because the infection levels are high,” he said. “If you're going to a place where lots of people are not masked, the probability is there’s COVID.”
On top of getting baseline vaccinations if you’re 6 months or older, Sisson emphasized booster vaccines, especially for anyone over the age of 50 or anyone between 12 and 49 who is moderately to severely immunocompromised. She encouraged people to get their second booster, rather than necessarily wait for a revised booster in the fall.
Those groups are eligible for a second booster if it has been at least four months since their first booster.
“We have boosters because immunity fades over time, particularly in older adults,” she said. “Now is the time to get that booster … the risk is high right now, people need that protection right now.”
To get more information about where to find a vaccine or booster near you, visit vaccines.gov or call the COVID-19 vaccine hotline at 1-800-232-0233. There’s also a disability information and access line that provides COVID-19 vaccination support for people with disabilities, reachable at 1-888-677-1199 or [email protected].
What do we now know about COVID-19 transmission that we didn’t before?
The long-held six-feet social distancing rule doesn’t account for the fact that COVID-19 is an airborne pathogen.
“The problem is that the virus spreads in the air — in particular, indoor spaces — really well,” Eisen said.
One example he offered: If you’re 20 feet away from someone but it’s a confined room without air circulation and that person has COVID, you’ll probably be exposed to it.
“If the air circulation is poor, it’s [COVID] going to linger in an indoor space for a very long period of time,” he said. “You should think about places that open their windows and open their doors and have good ventilation, good filtering.”
Air circulation can replace the air with clean air from outside and air filtration helps kill the virus more quickly, Eisen explained.
“Portable filters or whole-building filters can massively reduce the load of virus in a particular space,” he said.
How can I best understand current levels of COVID-19 in my area?
Look to the sewers.
Because test positivity data on county COVID-19 dashboards comes from PCR tests only, case rates are highly influenced by testing volume. PCR tests are considered more accurate than at-home antigen tests and are administered at labs or clinics.
Sisson says she’s started to talk more about wastewater data as testing initiatives in the region ramp down, meaning fewer PCR tests are administered.
Right now, Sisson’s one-word summary of what the wastewater is saying about COVID-19? “High.”
“That’s an indication of how much disease there is in the community and what I’m using to say ‘Hey, everybody, be careful out there,’” she said. “‘Take additional precautions like wearing a mask indoors, because there’s a lot of virus in the community.’”
Dr. Heather Bischel, an associate professor of civil and environmental engineering at UC Davis, helped start the Healthy Davis Together wastewater monitoring program in 2020. She said the program looks at wastewater before it's treated.
“That contains viruses that are shed … and we can measure the concentration of particles in the wastewater to track the trends in infection rates through time,” she said.
Through the initiative Healthy Central Valley Together, wastewater data is available for Merced County, Stanislaus County and Yolo County.
This dashboard, created with data collected as part of the sewer coronavirus alert network project out of Stanford University, shows relative levels of COVID-19 in wastewater for Sacramento, Davis and the Bay Area.
What options do I still have for COVID-19 testing?
There are seven free community testing sites open in Sacramento County from Monday to Friday, open to anyone regardless of citizenship or insurance status.
Sacramento County spokesperson Samantha Mott said the public health department is “not considering reopening additional testing locations at this time.”
At the end of February, Sacramento County cut down its number of community COVID-19 testing sites from 13 to 7.
“At-home tests are widely available and we have several community testing sites open,” she said via email.
There are also seven Curative COVID-19 testing sites in Sacramento County, also listed on the county’s COVID-19 testing information page.
For more testing options, myturn.ca.gov/testing allows you to search for free COVID-19 testing near your zip code.
Additionally, every household can order up to 20 free COVID-19 tests from the U.S. government through the U.S. Postal Service.
Yolo County libraries are offering free COVID-19 at-home tests by request at their front desks, added Sisson. The county is also rolling out a pilot program — it has placed free at-home test vending machines in outdoor community locations in West Sacramento, Esparto, Davis, Winters and Woodland. Anyone, regardless of residency, can use the machines.
The Woodland location is still being decided, but the current machines are at West Sacramento City Hall, the Esparto Public Library, the Mary L. Stephens Public Library and Winters City Hall.
What other COVID-19 resources are available?
Yolo County public libraries also offer free high-quality masks by request at the front desk, including N95s, KF94s and KN95s.
Additionally, antiviral treatments like Paxlovid are available for immunocompromised and older people who develop COVID-19, to help keep people out of the hospital if they take the medication within five days of symptom onset.
Sisson said the biggest barrier to getting Paxlovid isn’t supply, it’s getting a prescription for a provider and having a provider in the first place. If that’s the case, she said, she recommends using a Test-to-Treat location, where you can get tested for COVID-19 and walk out with a prescription same-day if you test positive, no provider necessary.
“There are a lot more appointments than there are people taking advantage of those appointments,” Sisson said.
To find a location, you can use the Test-to-Treat finder or call 1-800-232-0233.
Before taking Paxlovid, be sure to speak with a healthcare provider about any medications you’re currently taking or review the potential medication interactions you may have with the treatment.
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