Triggered by a new crop of variants, COVID-19 cases have been rising in Sonoma Valley during the past few weeks and masking requirements might again be implemented, but a new booster is on the way.

“We have seen a small increase in positive cases, but our monthly positive COVID-19 numbers are under five per month,” said Cheryl Johnson, CEO of Sonoma Valley Community Health Center. “In the past, COVID increases at about this time as people return to school.”

An uptick has also been reported at Sonoma Valley Hospital, where 42 patients have tested positive for COVID-19 tests from July 1 to Aug. 25, and seven patients have been hospitalized.

The number of positive new cases reported, while providing an indication of trends, can be misleading, though.

Matt Brown, communications specialist for the Sonoma County Administrator’s Office, says that the county does not track case rates anymore because the measurement is unreliable.

“Many people are testing with at-home test kits and do not report results to the county or state,” he said, adding that hospitalization rates and wastewater surveillance findings are more reliable measures for tracking COVID-19.

Sonoma County’s wastewater surveillance program tracks the presence of SARS-CoV-2, the virus that causes COVID-19, and other microorganisms that are known to cause the disease, in wastewater samples from Laguna (Santa Rosa and Rohnert Park) and Windsor. Sonoma doesn’t participate in the program.

Data shows that the COVID-19 viral concentration in Laguna’s wastewater has been steadily increasing since July.

Also, COVID-19 hospitalizations in Sonoma County rose to 20 on Aug. 25, from 10 on July 25.

Statewide, hospital admissions increased to 370 on Aug. 15 from 210 on July 16, a 76% jump. Available hospital beds have decreased 7% between July 19 to Aug. 19.

Some 15.5% of people statewide tested positive for COVID-19 on Aug. 25, a jump from 6.7% on July 24 and 4.1% on June 26.

“We expect that there will be an increase in COVID-19 infections as well as flu and RSV in the fall and winter,” said Dr. Sujatha Sankaran, chief medical officer for Sonoma Valley Hospital. “This is an expected seasonal pattern.”

This pattern consists of low COVID-19 rates in the spring and early summer, a surge in midsummer and late summer, a fall decline and a greater surge in winter.

Some health care professionals have said that the recent uptick in COVID-19 cases and hospitalizations is unlikely to become a surge or wave because many people have developed immunity to the virus through infection, vaccination or both.

“We agree with public health experts that this increase is unlikely to become a surge of the magnitude of previous COVID surges,” Sankaran said.

Updated booster vaccines are expected to be available by the end of September, once both the Food and Drug Administration and the Centers for Disease Control and Prevention approve them. They are designed to target the XBB variants — strains of the virus descended from the original Omicron variant — which are now the most common form in circulation.

Three manufacturers — Moderna, Pfizer and Novavax — are expected to offer the revised shots. The U.S. Food and Drug Administration plans to approve the Pfizer and Moderna vaccines for people ages 12 and up. It is expected to allow the Novavax vaccines — which contain an ingredient to boost the immune system to make antibodies — as well as vaccines for those age 11 and younger, under an emergency use authorization.

“When they are available, people will be able to obtain them through their primary care provider or health clinic,” Brown said. “The county is no longer staffing vaccine clinics.”

Also, a mask mandate, which was lifted for most situations at Sonoma Valley Community Health Center several months ago, could return.

“There have been early warnings that mask recommendations will return, and at that time, we may require them while inside the clinic,” Johnson said.

Sankaran said that Sonoma Valley Hospital is strongly recommending that masks be worn in clinical spaces and when near others.

“We may start mandating masks again (at the hospital) in the fall if COVID rates continue to increase,” she said.

Sankaran added that in general, Sonoma Valley Hospital recommends masking when participating in indoor gatherings or in crowded settings.

“In particular, we strongly encourage individuals with risk factors for severe COVID-19 infection to follow these recommendations,” she said.

More recommendations are available at the Centers for Disease Control and Prevention’s “How to Protect Yourself and Others” page.

Some population groups are more susceptible to becoming infected, she said.

“Patients who have not received vaccination against COVID-19, who have not been previously infected with COVID-19 and who have depressed immune systems due to medical comorbidities (the simultaneous presence of two or more diseases or medical conditions in a patient) and advanced age remain at the highest risk for contracting COVID-19,” Sankaran said.

The Centers of Disease Control and Prevention has created a list of common COVID-19 symptoms, including those that require immediate medical attention (see sidebar).

Reach the reporter, Dan Johnson, at [email protected].

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