Weekly Coronavirus Disease 2019 (COVID-19) Surveillance Report

Epidemiology and Immunization Services Branchwww.sdepi.org (619) 692-8499

COVID-19 WatchWeekly Coronavirus Disease 2019 (COVID-19)

Surveillance Report

Prepared by Epidemiology and Immunization Services Branch

www.sdepi.org

Page 2: SummaryPage 3: COVID-19 Infections by Vaccination StatusPage 4: COVID-19 Hospitalizations by Vaccination StatusPage 5: Daily COVID-19 Counts by Vaccination Status – Previous 3 MonthsPage 6: Weekly COVID-19 Counts by Age – Previous 3 MonthsPage 7: Selected Characteristics of COVID-19 Cases, Hospitalizations, and DeathsPage 8: Age-Adjusted COVID-19 Case Rates by Race/EthnicityPage 9: Age-Adjusted COVID-19 Hospitalization Rates by Race/EthnicityPage 10: Case Rates by Zip Code of ResidencePage 11: COVID-19 Potential Exposure Settings

Community Setting OutbreaksPage 12: Number of Vaccinations Administered and Cumulative Number of Persons Fully Vaccinated

Percent Fully Vaccinated by Zip Code of ResidencePage 13: COVID-19 Vaccinations by Race/Ethnicity and Health Equity Page 14: COVID-19 Cases in Children and Outbreaks in School SettingsPage 15: COVID-19 Cases in SchoolsPage 16: COVID-19 Laboratory Test Positivity Rate – Previous 12 Months

Emergency Department Data – Previous 12 MonthsPage 17: COVID-19 Pandemic at a GlancePage 18: Pandemic at a Glance: Summary of COVID-19-associated Deaths

Report Content Links

Cases

358,108Deaths

4,081Outbreaks

2,779

October 6, 2021

Data through 10/2/2021

http://www.sdepi.org/


COVID-19 WATCHWeekly Coronavirus Disease 2019 (COVID-19) Surveillance Report



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Figure 1. COVID-19 Confirmed and Probable Cases and 7-Day Rolling Average Case Rate by Date of Illness Onset*, San Diego County Residents, N=79,494

Probable Confirmed 7-day Rolling Average Combined Case Rate

Since July 4, 2021:Confirmed N=74,305Probable N=5,189

*When onset date is unavailable, specimen collection date, date of death, or date reported is used instead.**Probable cases are antigen positive tests received since August 1, 2020.

9/26 – 10/2/2021 9/19 – 9/25/2021 Cumulative

Cases 3,667 5,158 358,108

Avg Daily Cases 524 737 624

Deaths 30 45 4,081

Outbreaks 39 45 2,779

Table 1. Summary of Cases, Deaths, and Outbreaks by Date Reported





COVID-19 Infections by Vaccination Status

Not Fully Vaccinated* Case Rate

Fully Vaccinated** Case Rate

County Overall Case Rate

33.4 8.8 18.9

Not Fully Vaccinated* Fully Vaccinated** Total

Cases 73,569 (78.4%) 20,228 (21.6%) 93,797

Hospitalizations 2,461 (94.7%) 139 (5.3%) 2,600

Deaths 318 (85.3%) 55 (14.7%) 373

Table 2. COVID-19 Cases Among San Diego County Residents by Vaccination Status Since March 1, 2021

*Not fully vaccinated includes individuals with one dose of the two-dose series, no doses, or unknown vaccination status. Individuals less than 12 years of age who are not yet eligible for the vaccine are also included.**Cases who first tested positive (based on specimen collection date) greater than or equal to 14 days after receiving the final dose of COVID-19 vaccine.Percentages are among total cases, hospitalizations, and deaths for the time period.***If case did not have symptoms or illness onset date is unavailable, the earliest of specimen collection date, date of death, or date reported is used instead.San Diego County Population from SANDAG 2019 Population Estimates (Prepared June 2020) = 3,351,784. The fully vaccinated population for each day is the cumulative number of county residents documented to have received the final dose of COVID-19 vaccine more than 14 days prior to that day. The not fully vaccinated population is the estimated total county population minus the fully vaccinated population.

Dates: 9/12-9/18/2021Case rate for not fully vaccinated residents

is 4 times higher than fully vaccinated

residents

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Figure 2. 7-Day Rolling Average COVID-19 Case Rate by Vaccination Status in San Diego County Residents since March 1, 2021

Not Fully Vaccinated Residents Fully Vaccinated Residents All County Residents





COVID-19 Hospitalizations by Vaccination Status

*Not fully vaccinated includes individuals with one dose of the two-dose series, no doses, or unknown vaccination status. Individuals less than 12 years of age who are not yet eligible for the vaccine are also included.**Cases who first tested positive (based on specimen collection date) greater than or equal to 14 days after receiving the final dose of COVID-19 vaccine.San Diego County Population from SANDAG 2019 Population Estimates (Prepared June 2020) = 3,351,784. The fully vaccinated population for each day is the cumulative number of county residents documented to have received the final dose of COVID-19 vaccine more than 14 days prior to that day. The not fully vaccinated population is the estimated total county population minus the fully vaccinated population.

Not Fully Vaccinated* Hospitalization Rate

Fully Vaccinated **Hospitalization

Rate

County Overall Hospitalization

Rate

1.15 0.05 0.51

Dates: 9/5-9/11/2021Hospitalization rate for not fully

vaccinated residents is 23 times higher

than fully vaccinated residents

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Figure 3. 7-Day Rolling Average COVID-19 Hospitalization Rate by Vaccination Status in San Diego County Residents since March 1, 2021

Not Fully Vaccinated Residents Fully Vaccinated Residents All County Residents





Figures 4-6. Daily COVID-19 Counts by Vaccination Status – Previous 3 Months

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Figures 7-9. Weekly COVID-19 Counts by Age – Previous 3 Months

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s September 19, 2021 – October 2, 2021 February 14, 2020 – October 2, 2021

Confirmed cases 8,825 358,108

Median age 34 years 34 years

Age range 0-100+ years 0-100+ years

Male 4,373 (50%) 173,737 (49%)

Female 4,367 (50%) 181,767 (51%)

Table 3. Confirmed Cases by Date Reported, Last Two Weeks vs. Cumulative

Table 5. Confirmed Deaths by Date of Death, Last Two Weeks vs. Cumulative

*Data are incomplete for this time period.**Refer to the graph on page 18 for more details.

Sex is unknown for one hospitalization for the last two weeks and for 29 hospitalizations cumulatively.Note: Percentage hospitalized is calculated based on the total number of cases; information may be unknown in some cases. Hospitalization counts are likely underreported and may increase as additional information is obtained.

Table 4. Confirmed Hospitalizations by Date of Admission, Last Two Weeks vs. Cumulative

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ns September 19, 2021 – October 2, 2021 February 14, 2020 – October 2, 2021

Hospitalizations 173 (2%) 17,705 (5%)


Age range 0-92 years 0-100+ years

Male 107 (62%) 9,516 (54%)

Female 65 (38%) 8,160 (46%)

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September 19, 2021 – October 2, 2021 February 14, 2020 – October 2, 2021

Deaths 39 4,081

Case Fatality Ratio N/A* 1.1%

Underlying Conditions** 33 (85%) 3,895 (95%)


Age range 44-93 years 10-100+ years

Male 24 (62%) 2,441 (60%)

Female 15 (38%) 1,640 (40%)

Selected Characteristics of COVID-19 Cases, Hospitalizations, and Deaths





Age-Adjusted COVID-19 Case Rates by Race/Ethnicity

The black lines represent the 95% confidence intervals (error bars). Rates are not calculated for fewer than 20 events.*NHPI=Native Hawaiian/Pacific Islander, AIAN=American Indian/Alaska Native.

1,692

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Figure 10. Age-Adjusted Rates of Confirmed Cases by Race/Ethnicity, San Diego County Residents

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Figure 11. Age-Adjusted Rates of Confirmed Cases by Race/Ethnicity, San Diego County Residents





Age-Adjusted COVID-19 Hospitalization Rates by Race/Ethnicity

The black lines represent the 95% confidence intervals (error bars). Rates are not calculated for fewer than 20 events. Hospitalization rates were not calculated for the last three months for Multiple Race and AIAN because these categories have fewer than 20 events.*NHPI=Native Hawaiian/Pacific Islander, AIAN=American Indian/Alaska Native.

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Figure 13. Age-Adjusted Rates of Hospitalizations by Race/Ethnicity, San Diego County Residents

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Figure 12. Age-Adjusted Rates of Hospitalizations by Race/Ethnicity, San Diego County Residents





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Figure 15. Cumulative Confirmed Case Rate by Zip Code of Residence,

San Diego County(Countywide Rate = 10,684 per 100,000

Population)

Rates calculated using 2019 population estimates from the San Diego Association of Governments. Rates not calculated for counts under 5 cases or populations less than 10,000. Zip code is zip code of residence, which may not be location of exposure. Case counts and rates for each zip code are updated routinely on the County of San Diego COVID-19 website.

Figure 14. Confirmed Case Rate by Zip Code of Residence, 9/19/2021-10/2/2021,

San Diego County(Countywide Rate = 263 per 100,000

Population)


https://www.sandiegocounty.gov/content/dam/sdc/hhsa/programs/phs/Epidemiology/COVID-19%20Summary%20of%20Cases%20by%20Zip%20Code.pdf




COVID-19 Potential Exposure Settings

Potential exposure settings are places case-patients visited during their exposure period, not confirmed sources of infection. Persons may be exposed in multiple locations and types of settings, including the household, the workplace, educational settings, other community settings, and during travel. Community settings are defined as indoor or outdoor locations in which cases came within 6 feet of anyone who was not a household member for at least 15 minutes during the 2-14 days prior to symptom onset, even if the case wore a mask or facial covering.

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Figure 16. All Potential Exposure Settings Identified Among Confirmed Cases, San Diego County Residents

Cases within last 3 months (N = 21,790) Cumulative Cases (N = 155,085)

COVID-19 Community Setting Outbreaks

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Figure 17. Community Setting Outbreaks* by Date Outbreak ConfirmedTotal Number of Community Outbreaks=514

*Community setting outbreaks are defined as at least three probable or confirmed COVID-19 cases within a 14-day period in people who are epidemiologically-linked in the setting, are from different households, and are not identified as close contacts of each other in any other case investigation. Examples include workplaces, adult and child daycare facilities, K-12 schools and colleges/universities, and day camps.





The bars show vaccines administered, not individuals vaccinated. The line shows the cumulative number of persons fully vaccinated per the dose and schedule regimen for the vaccine received.

COVID-19 Vaccinations

Figure 19. Percentage of the Total Population

of San Diego County Residents Who are

Fully Vaccinated, by Zip Code of Residence

Only includes vaccines that have been recorded in the San Diego Immunization Registry (SDIR). Some healthcare providers, including Veteran’s Affairs, the Department of Defense, some tribal entities, and prisons do not report to SDIR. See this dashboard, updated daily, for more detailed vaccine status information for San Diego County.Data source: San Diego Immunization Registry, SANDAG 2019 Population Estimates (Prepared June 2020).

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Figure 18. Number of COVID-19 Vaccinations Administered and Cumulative Number of Persons Fully Vaccinated by Week Among San Diego County Residents

Vaccines Administered = 4,358,378Persons Fully Vaccinated = 2,029,556


https://sdcounty.maps.arcgis.com/apps/opsdashboard/index.html#/c0f4b16356b840478dfdd50d1630ff2a




COVID-19 Vaccinations by Race/Ethnicity and Health Equity

*The California Healthy Places Index^The percentage and rate of the population vaccinated with at least one dose of COVID-19 vaccine may approach, or exceed, 99% or 999 per 1,000 San Diego residents aged 12 years and older. The most recent race/ethnicity populations are 2019 estimates, which may underestimate the current population. When these demographics are analyzed, the population estimates may not reflect social and environmental changes of a community, possibly leading to an under- or overestimate of a population.Individuals vaccinated by Veterans Affairs or Department of Defense are not included. COVID-19 vaccine is not approved for those under age 12 at this time.Data source: San Diego Immunization Registry, SANDAG 2019 Population Estimates (Prepared June 2020). Total population 12 years of age and older=2,833,418.

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Figure 20. Vaccination Status by Race/Ethnicity, San Diego County Residents Age 12 Years and Older

77.8% 68.8% 66.7% 62.6%

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Figure 21. Vaccination Progress by Healthy Places Index Quartile,* San Diego County Residents Age 12 Years and Older

696,294 708,727 701,259 681,633


https://healthyplacesindex.org/




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Week Ending

Figure 22. COVID-19 Confirmed Cases for Ages 0-18 Years by Week of Illness Onset,* San Diego County Residents, N=15,979

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*When onset date is unavailable, specimen collection date, date of death, or date reported is used instead.

COVID-19 Cases in Children and Outbreaks in School Settings

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Week Ending

Figure 23. COVID-19 Outbreaks in School Settings (Tk-12th Grade) by Week of Illness Onset (N=98)

Sports Team (N = 17) Other (N = 81)





COVID-19 Cases in Schools

*Cases are among students and non-students physically present at a K-12 school 48 hours prior to symptom onset (or lab collection date if asymptomatic) with COVID-19.**If case did not have symptoms or illness onset date is unavailable, the earliest of specimen collection date, date of death, or date reported is used instead.

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Figure 25. Confirmed Cases Physically Present at K-12 Schools During Communicable Period* by Week of Illness Onset**, San Diego County Residents, N=2,329

Student (N = 1,956) Non-Student (N = 373)

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Figure 24. Confirmed Cases Physically Present at K-12 Schools During Exposure Period* by Week of Illness Onset**, San Diego County Residents, N=2,536

Student (N = 2,161) Non-Student (N = 375)

*Cases are among students and non-students physically present at a K-12 school 2-14 days prior to symptom onset (or lab collection date if asymptomatic) with COVID-19.**If case did not have symptoms or illness onset date is unavailable, the earliest of specimen collection date, date of death, or date reported is used instead.





Emergency Department Data – Previous 12 Months

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Figure 27. Percent of Emergency Department Visit Chief Complaints for ILI, Respiratory Symptoms, or COVID-like Illness* by Week, San Diego County

Respiratory Symptoms Influenza-like Illness COVID-like Illness*

Categories are not mutually exclusive. *COVID-like Illness includes fever and cough, shortness of breath, or difficulty breathing OR coronavirus diagnostic codes.

COVID-19 Laboratory Test Positivity Rate – Previous 12 Months

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Figure 26. COVID-19 Testing Volume and Positivity by Week of Specimen Collection, San Diego County

Total Tests Performed % Positive

Includes PCR tests performed by COSD Public Health, hospital, and reference laboratories and reported via Electronic Laboratory Reporting (ELR) and line lists. Excludes invalid, indeterminate, and unsatisfactory results.





COVID-19 Pandemic at a Glance

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Figure 28. COVID-19 Confirmed and Probable Cases by Week of Illness Onset*, San Diego County Residents, N=378,841

Probable** Confirmed

*When onset date is unavailable, specimen collection date, date of death, or date reported is used instead.**Probable cases are antigen positive tests received since August 1, 2020.

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Figure 29. COVID-19 Deaths by Week of DeathSan Diego County Residents, N=4,081

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Pandemic at a Glance: Summary of COVID-19-associated Deaths

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Number of Deaths 1,772 1,449 169 418 32 24 3,878

Rate 105.5760421 49.75949668 193.2810062 87.79341698 114.8951613 64.40381195 233.793093

Figure 30. Age-Adjusted Rates of COVID-19-associated Deaths by Race/Ethnicity, San Diego County Residents, N=3,878*

The black lines represent the 95% confidence intervals (error bars). Rates are not calculated for fewer than 20 events.*Race/ethnicity are unknown for 203 deaths.**NHPI=Native Hawaiian/Pacific Islander, AIAN=American Indian/Alaska Native.

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Figure 31. Common Underlying Conditions, COVID-19-associated Deaths

Persons may have more than one underlying condition. These data are abstracted from death certificates and available medical records and may not reflect a complete list of underlying conditions for each person.

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The purpose of the weekly COVID-19 Watch is to summarize current COVID-19 surveillance in San Diego County. Data are preliminary and may change due to delayed reporting and additional information obtained during investigations.

COVID-19 Watch Data SourcesThe following sources of data are used to produce this report:• COVID-19 case reports: Medical providers and laboratories report individual cases of PCR-confirmed and antigen-positive

probable COVID-19 via fax or electronic laboratory reporting (ELR) to the County of San Diego Epidemiology Unit.• COVID-19 deaths: The County of San Diego requests that all deaths related to COVID-19 be reported for surveillance purposes.

Medical facilities may report these deaths directly to the Epidemiology Unit or they may be identified by the Office of VitalRecords through death certificate registration. The Epidemiology Unit compiles the data, and only reports deaths that can be verified by a death certificate.

• Emergency Department Chief Complaint Data: Electronic emergency department data are reported to the Epidemiology Unit daily. The number of respiratory chief complaints and the number of total emergency department visits are used to calculate percentages for all respiratory-related visits and visits specific to influenza-like illness and COVID-like illness.

• COVID-19 outbreaks: o Skilled Nursing Facilities: at least one case of laboratory-confirmed COVID-19 in a resident.o Non-SNF Institution/Congregate Settings: At least three probable or confirmed COVID-19 cases within a 14-day period in

epidemiologically-linked residents and/or staff.o Community settings: At least three probable or confirmed COVID-19 cases within a 14-day period in people who are

epidemiologically-linked in the setting, are from different households, and are not identified as close contacts of each other in any other case investigation.

• COVID-19 vaccinations: Number of vaccinations registered in the San Diego Immunization Registry (SDIR) by participating providers. Some providers, including the VA, DoD, other military, some tribal, and prisons do not report to SDIR.

• SANDAG population estimates, vintage 2019: Rates are calculated using 2019 population estimates from the San Diego Association of Governments. Rates are not calculated for counts under five cases.

For information on influenza in San Diego County, please see the weekly Influenza Watch surveillance report. Additional influenza data and resources and a link to subscribe to the Influenza Watch are available on the Epidemiology Unit website.


https://www.sandiegocounty.gov/content/dam/sdc/hhsa/programs/phs/documents/InfluenzaWatch.pdf

https://www.sandiegocounty.gov/content/sdc/hhsa/programs/phs/community_epidemiology/dc/influenza.html

Weekly Coronavirus Disease 2019 (COVID-19) Surveillance Report

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Transcript of Weekly Coronavirus Disease 2019 (COVID-19) Surveillance Report