Speaker 1: (00:00)
California has ordered a statewide mask mandate, amid growing concerns of a surge in Omicron variant cases. The decision comes after health officials observed a jump in cases and hospitalizations over the past two weeks, the new mandate will go into effect tomorrow and last until January 15th. Dr. Christian Rams is a, an infectious disease specialist who oversees clinical programs at family health centers of San Diego and sits on the county's vaccine clinical advisory group. He joins us now, Dr. Ramer welcome. Thank you for having me Jade. Are you surprised that the state chose to reinstate a masking mandate?
Speaker 2: (00:37)
No, I don't think this is surprising. This is, uh, one of the several interventions that we works, uh, in the actual CDPH website memo that talked about this. They go through all of the evidence that's accumulated about masks, and it's just irrefutable at this point that that masks wherever they have been deployed widely and consistently and correctly result in decreased cases, decreased hospitalizations and decreased deaths, whether it be in public settings or in schools or in, in cities or in jurisdictions. So looking ahead to the winter and to the only crown variant, uh, coming along, I think it's just a, a re very reasonable thing to be doing
Speaker 1: (01:11)
Several other counties already had mandates, uh, still in place when this news came down, but not San Diego. Do you think the county should have kept masking rules in place this a entire time? Well,
Speaker 2: (01:23)
It's hard to kind of Reigate, uh, the decisions from several months ago and I don't really want to be playing Monday morning quarterback, but, but certainly going forward with a unified approach, the state making this announcement really allows all of the counties to fall in line and, and to do what we know actually does work. And you're correct that other counties with mass mandates or with indoor by vaccine mandates in place such as Los Angeles or San Francisco, you know, there is some evidence that it has helped going forward. So knowing what we know now, yes, it is the right thing to do going forward. How
Speaker 1: (01:52)
Do you anticipate the next few months will compare to last year's winter surge? Yeah,
Speaker 2: (01:56)
Very hard to say. We're, we're in a really different place with a, with a lot of complicating factors and I've looked at the models that the state is using. And as you know, models are only so good because they're, they, they take all these complicated factors and try to blend them together, but they don't look very good in terms of in San Diego, you know, in the next month, a doubling of hospitalizations, roughly from around 300 to 600. And so this is part of what inspired, you know, these changes to try to flatten the curve once a, again, with the tools that we know work, there's new evidence, just coming outta South Africa about what Omicron looks like and how it behaves. And it's actually better news than we expected, because it looks like the vaccines do do a pretty good job at preventing hospitalization. The particular analysis of around 70,000 patients in South Africa show that the Pfizer vaccine, just two doses is still about 70% effective at, at preventing hospitalization, not as effective at preventing cases. So we have these tools in front of us. We have masks, we have vaccines, including full vaccination courses and boosters. Uh, and we do have treatments that still work. Uh, some of the monoclonal antibodies still work as well, and we have antivirals coming shortly. So more tools at our disposal, as long as people remain vigilant with the prevention measures. I think we should make it through this winter. Okay. Is
Speaker 1: (03:10)
Masking still the most effective way to curb the spread of the virus while
Speaker 2: (03:14)
Masking and vaccination, both kind of work a hand in hand, of course, layered approaches incorporating both of those is really the best. Um, and then ventilation and just behavioral decisions is kind of the third major category. We've learned that masks, especially if you use a surgical mask or better, really are a very important mitigation strategy. And as I, as I said, at the beginning in places where they have been consistently introduced such as in schools, it is a very, very effective way to decrease transmission. And we feel like that's what we need heading into this winter with only crown on the way.
Speaker 1: (03:43)
And as the masking mandate goes into effect, remind us what type of masks we should be wearing. And what's most protective. Yeah, there's
Speaker 2: (03:49)
Actually a note in the CDPH announcement that we really should be striving for surgical masks or better. And what that means is those sort of blue and white, uh, surgical masks that are blown material work a little bit better than cloth masks or any other material at preventing things from getting through there now is more availability of higher quality masks than that even the K N 90 S or the N 95 S which do even a better job of filtering. And so if people have access to those, we're not really in such a crunch for those anymore. Um, I would go for one of the higher quality, especially if you're going to, to be indoors for a long period of time as
Speaker 1: (04:22)
This search continues. Do you think further measure such as stay at home orders will be taken to, uh, curb the spread of the virus at all?
Speaker 2: (04:30)
I, I certainly hope not. And I think that we have learned our lesson about strict lockdowns about how damaging they can be. They, they certainly can be effective at decreasing spread, but they have such economic and mental health and, and other financial implications that nobody wants to go back to that. So using a layered approach with the in interventions that we know work like vaccinations and masking, uh, and the treatments that we have, I think hopefully will get us through without having to resort to those draconian measures.
Speaker 1: (04:56)
How is hospital capacity currently faring in San Diego county? As far as I can
Speaker 2: (05:00)
Tell it looked it's okay. It it's a complicated number though. It's not a real simple thing to just say hospital capacity. And that's because even if we have beds, we need personnel. And as you've reported on throughout the last two years, uh, healthcare personnel are really at, at our wits end and especially nursing. Um, and it doesn't make any, it doesn't help any to have 10 beds if you don't have nurses to help staff ask them. So I, I think we're holding up okay. But we are a, a healthcare workforce that has been in crisis, frankly for a year or so. And all of those problems of trying to get traveling nurses and, and, um, and staff things. It's really still a very big problem. And so it really should take everything. We have all the prevention measures that we have to prevent us from getting into a crisis situation. And
Speaker 1: (05:42)
What is specifically is the situation with Omicron here locally? I mean, are we beginning to see community spread of this particular variant?
Speaker 2: (05:50)
Well, as far as I know, there have been two cases, uh, described publicly one of which was a person without any travel. And so that implies that it was a locally acquired, uh, case. Um, I think we have a very robust sequencing operation here compared to other counties, from what my understanding we're sequencing about 10% of the positive, uh, PCR cases that come in, which is a very high level compared to other places in the country. And so I think in the next coming weeks, we'll probably see a whole lot more. We're always a little bit behind, even as fast as, as the sequencing is able to occur, we're always a week or two behind. And so, uh, it, you know, I think it's only a matter of time to see what Omicron does. We also have plenty of Delta variant here. That's causing all the hospitalizations and, and a lot of the cases now, but talking to someone like Christian Anderson, who's really one of the expert it's in the sequencing here. Uh, he thinks it's within about two weeks that we'll see Omicron make a substantial portion, uh, such as maybe 20 or 25% of cases.
Speaker 1: (06:45)
I've been speaking with Dr. Christian Rams, a specialist in infectious diseases who oversees clinical programs at family health centers of San Diego. Dr. Rams, thank you so much for joining us.
Speaker 2: (06:56)
Thanks for having me.
Speaker 3: (07:00)
I.
