More Vaccines on the Way, in Meantime Orange County Likely Under Stay-Home Orders for Another Month

One vaccine against COVID-19 has already been rolled out and others are on the way in the coming weeks and months, but the virus’s unchecked spread and nearly full hospitals mean restrictions and closures aren’t likely to go away soon.

Southern California is under a three-week stay home order, and “we’re in week two, but I’m not foreseeing that we’ll be able to get out of the lockdown for (another) month at least,” Orange County Health Officer Dr. Clayton Chau said Thursday, Dec. 17.

Chau’s remarks came in a webinar on vaccines that included experts from Hoag Hospital, City of Hope cancer center, MemorialCare Medical Group and UC Irvine. The same day, Orange County reported the greatest number patients hospitalized in the entire course of the pandemic. While hospitals flex their surge plans to open more beds, intentive care unit capacity for the Southern California region is nearing tapped out.

On Wednesday, the Orange County Health Care Agency leaders told hospitals in the 911 system not to divert ambulances to other medical centers for the time being; ambulances typically get sent on to another facility if the closest or most appropriate hospital is busy and backed up, but that isn’t sustainable because many hospital emergency rooms are inundated.

While residents shouldn’t delay needed medical care for fear of the coronavirus or packed hospitals, Chau and others in the webinar asked the public to remain patient and stay vigilant about health protocols such as masks, distancing and not gathering.

“This is a longer game. We absolutely need to keep up all the precautionary measures we have now,” said Jan Hirsch, dean of UCI’s pharmacy school. “We will get out the other end of the tunnel.”

Meanwhile, health officials are preparing to educate and encourage the public to get the vaccine once the highest-priority groups have been inoculated, likely in a few months. Chau said the county will soon make available a new app that will give users information about vaccines, alert them when and where to get a shot and remind them when it’s time for the second dose. (The Pfizer vaccine, which is the first one available, takes two doses several weeks apart for the greatest effectiveness.)

Asked when the county will reach the 70% vaccination threshold at which normal activities are expected to resume, Chau said “it depends on the percentage of folks who are willing to accept the vaccine. Just because we have the vaccine available doesn’t mean at this time everybody would want to roll up their sleeve and get the injections.”

But “vaccine hesitancy” may already be declining here.

An OC Health Care Agency community survey in the fall, which got more than 26,000 responses, showed “a significant number” of people who said they wouldn’t get vaccinated, Chau said. Today, frontline health care workers are lining up to get their dose, and Orange County Business Council CEO Lucy Dunn, who moderated the webinar, said many of the questions viewers submitted were about when the vaccine would be available for them.

“My sense is a survey done in October is not a survey done in December, and folks are ready to move on,” Dunn said in an interview later Thursday. “We all want to open sooner and safer, and that’s what a vaccine is about.”

And by sometime next year, people could have more vaccines to choose from. Hoag, City of Hope and UC Irvine are all researching different vaccines, with Hoag potentially just a few months from requesting federal authorization.

Dr. Philip Robinson, Hoag’s director of infection prevention and hospital epidemiology, said in an interview that second-phase trials involving hundreds of patients started two weeks ago.

Robinson said Hoag’s version aims to produce two types of immunity. The earliest COVID-19 vaccines stimulate production of antibodies, which are “like the archers with their arrows,” and the one Hoag is testing would generate cell-mediated immunity, which is “like the tanks and the aircraft carriers,” Robinson said.

Not only could Hoag’s proposed vaccine potentially provide longer-lasting immunity, it doesn’t need to be kept at ultra-low temperatures and could be given to patients in a capsule or as a nasal spray.

City of Hope is in Phase 1 trials and hopes to have a vaccine available for the public by the end of next year, Dr. Harlan Levine, president of strategy and business ventures, said in the webinar.

While the potential for so many varieties may seem confusing, Robinson said “you never want to have one vaccine against one pathogen.”

“It may take dozens of vaccines that can be distributed throughout the world to all these different populations to get control of this crisis and to keep it controlled for many years to come.”

Levine said knowing about possible future options “should not in any way interfere with the decision that people are making now, which is to take the vaccines that are available.”

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