SAN JOSE, Calif. — COVID-19 cases are surging in the Bay Area and California since Thanksgiving, as holiday gatherings appear to have fueled the virus’ spread among a pandemic-weary public no longer masking or lining up for the latest vaccine booster.

Cases in the nine-county Bay Area have jumped from an average of eight daily cases per 100,000 residents in late October to over 13 at the end of November, an 80% increase. Every Bay Area county is in at least the Center for Disease Control and Prevention’s second-highest substantial transmission level, and Santa Clara and Solano counties already are at the high level. Santa Clara and Marin counties have risen from the CDC’s low to medium community level, reflecting the virus’ impact on local hospitals.

“We are seeing a Thanksgiving effect,” said Dr. John Swartzberg, clinical professor emeritus of infectious diseases and vaccinology at the University of California, Berkeley. But he’s not surprised, as the rise started before the recent holidays. And with Christmas and New Year’s celebrations around the corner “there is no question in my mind that we’re going to see a rise in cases,” he said. “The question is what the slope will look like.”

In Los Angeles County, where transmission levels also are high and the community level medium, the sharp rise in case and hospitalization rates has raised the specter of reinstating an indoor face mask requirement.

In Santa Clara County, Santa Clara County Health Officer Dr. Sara Cody said data that monitors local wastewater for the virus causing COVID-19 were rising heading into Thanksgiving and show a sharp spike afterward throughout the region.

Perhaps most troubling, hospitalizations are rising as well, more than doubling from a statewide low of just over 1,500 in late October to 3,793 COVID-positive patients on Nov. 30.

And adding to the misery, influenza and RSV — or respiratory syncytial virus, which can be dangerous for infants — are spiking. The CDC now lists California among 11 states with the highest influenza-like illness activity. And Kaiser Permanente Northern California reports RSV admissions at the highest level since the winter of 2017-2018, though they appear to have peaked.

Cody said that we’re in a “serious respiratory viral soup” of COVID-19, influenza and RSV, and she urged people to get the flu vaccine and updated COVID-19 booster tailored to the current omicron variants of the virus and to wear masks indoors.

Though she doesn’t foresee a new mask requirement, “that doesn’t mean wearing a mask indoors isn’t incredibly important.” Cody said she wears a KN95 mask in indoor public places and an N95 respirator aboard aircraft.

“Many people emotionally have moved on — that’s completely understandable — and are going about their lives,” Cody acknowledged. “But I feel it’s important to let the public know that the weather’s not good out there. There’s lots of virus circulating, and there are things you can do — get a flu shot, get a COVID booster, wear mask indoors. We’ve got not just COVID but flu and RSV, and masks help protect you from all of them.”

Dr. Bob Wachter, who chairs the medical department at UC-San Francisco, said the number of COVID patients at the hospital there has doubled to 30. That’s still well below the 175 back in January during last winter’s omicron surge. But he’s playing it cautious, and even though he’s had the updated booster, he wears a mask to the grocery store, isn’t dining out indoors — he and his wife plan to eat outside at a restaurant this weekend — and insists that his friends test before gathering to play poker.

“I’d really prefer not get infected if I can avoid it,” he said.

Many Bay Area residents have seen friends and relatives go down with COVID after Thanksgiving.

Leigh Foster, of El Cerrito, said she kept her two daughters, ages 4 and 3, home from preschool this week after two of the youngest child’s teachers and a child in their class tested positive.

“We’ve heard of so many people who got sick either with COVID, RSV or otherwise over the holiday,” Foster said. “We’re trying to be extra careful since our girls already caught COVID once at school.”

Foster is frustrated that so many people even in the Bay Area seem to have given up on efforts to tamp down the spread of the virus, putting her kids who are too young to effectively protect themselves at risk of being reinfected.

“We spent the first two years of this pandemic watching the Bay Area be one of the safest places in the country due to our masking policies, and as soon as we dropped mitigation measures, COVID has run rampant,” Foster said. “Almost all of the families we know with young kids have watched their kids bring it home at least once. It’s so depressing that adults won’t take easy measures to help protect our youngest children, who are so much more defenseless through this.”

Jacquelynn Herrera, of Mountain View, said she and her husband and 7-year-old daughter are all vaccinated and boosted, and she has had COVID twice before, most recently in September. After a “friendsgiving” gathering with nine adults and two children, no one in her family has tested positive so far.

“I had so much anxiety,” Herrera said. “No one masks anymore.”


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