Santa Clara County officials said on Friday that major health care providers are giving only a sliver of their share of COVID-19 vaccinations and testing.
At a noon press conference, county Counsel James Williams noted the disparity, which he said has left many residents having to go to county services rather than their providers for the vaccines and tests. The county's announcement for other providers to step up to the plate comes at a critical time when testing and booster vaccinations are key to reducing the spread of infection and hospitalizations.
Sutter Health/Palo Alto Medical Foundation has approximately 320,000 Santa Clara County residents among its primary care patients, or 16.5% of the county population. Yet, since the vaccination program began, it has administered a total of 3.5% of all vaccines, including boosters. It has provided 2.4% of boosters and conducted only 2.4% of testing, Williams said.
Although Stanford Health Care claimed not to have figures related to its primary care patient count, a self-reported number given to the county Public Health Department showed it has 329,400 primary care patients in the county, 17% of the county's population. Stanford administered 6.7% of vaccinations, including boosters, and 3.7% boosters, to county residents.
Stanford Health Care spokesperson Lisa Kim said on Jan. 7 that the provider has now given a total of 41,500 booster doses, but she didn't know how that number broke down between Santa Clara and San Mateo county residents. Williams didn't specify the number of tests Stanford has provided and a county health spokesperson said that data wasn't readily available on Friday.
Kaiser Permanente, with 600,000 Santa Clara County members, or 31% of the county population, has provided 14.8% of total vaccinations, including boosters; it has provided 15.3% of boosters and performed 12% of testing, Williams said.
Williams didn't provide data at the press conference about El Camino Health, which has locations in Mountain View and Los Gatos, but it has 140,000 primary care patients, or 7.3% of county patients, but administered 1.4% including boosters; 0.2% boosters, according to a Dec. 17, 2021, off-agenda report to the Board of Supervisors.
In contrast, the brunt of vaccine administration has fallen on the county health system, which serves 300,000 residents, or 15.5% of the county population. It has administered 37.3% of the total vaccine doses and 31.6% of booster shots. The county has provided 20.7% of tests, Williams said.
Retail pharmacies have administered 25.9% of total doses and 39.4% of boosters.
Other providers, including outside health care systems, community health clinics and other county health care centers, make up the balance.
"The data is clear that the large systems are not providing their proportion of testing" and vaccinations, Williams said. "Unfortunately, the county itself has had to provide (the majority of) testing and vaccinations."
Neither Sutter/PAMF nor Stanford have provided the county and this news organization with any reason for the low numbers, and Sutter hasn't provided any specific data requested.
"I can tell you that Palo Alto Medical Foundation doubled appointment availability for both COVID testing and COVID boosters over the past three weeks," a Sutter Health spokesperson said in a statement to this news organization this week.
Stanford said in a statement provided by Kim that Stanford Medicine has administered more than 41,500 COVID-19 boosters to its community as part of more than 480,000 vaccine doses administered overall. It has also provided more than 12,000 booster doses to its health care workforce.
"While we are experiencing high demand for boosters, appointments are currently available throughout our network of care and can be booked by visiting our website.
"We will continue to expand our vaccination and testing operations to meet the needs of our community through expanded hours of operation and additional days of operation," she said. Stanford has recently provided vaccination clinics in East Palo Alto to boost coverage in the underserved community, notices to the community have shown.
An El Camino Health spokesperson wouldn't provide specific data on its vaccinations and boosters, saying they have no way of separating out how many of their clients received the shots and that the vaccines have been offered to the community at large. The low figures could be due to people going to other locations, he added.
County Executive Jeff Smith said during the Jan. 11 Board of Supervisors meeting that the county surmises the reason might be staffing shortages. Referring to vaccines, there's no issue with having adequate vaccines and boosters. The county itself has added dozens of vaccination sites large and small, some of which allow walk-ups, and an online system for making appointments.
In a statement released on Friday, Kaiser Permanente pushed back on the county's assertion that it isn't doing enough.
Kaiser said that on a weekly basis, it is currently processing more than 140,000 tests in northern California and administering more than 80,000 vaccine injections. At the same time, it is caring for an increase in patients who are sick with the virus.
"The highly contagious nature of this variant and its ability to infect even some who are fully immunized is challenging everyone, including those of us in health care. We are seeing significant staff illness as a result — similar to what is happening in the community.
"We object to any suggestion that our front line health care workers are not doing their fair share. We are baffled by the county's suggestion that anyone is holding back.
"The last 24 months of this pandemic have been an incredibly challenging and stressful time to work on the front lines of health care. And yet our staff and physicians continue to show their commitment to providing care and service, every day. Their work right now, and throughout the COVID-19 pandemic has been nothing short of inspiring."
More information about COVID-19 symptoms and care is available at kp.org.
A lack of easy access?
Santa Clara County Supervisor Joe Simitian has been raising the question for two years regarding the small contributions by the large providers. Earlier this week he said by phone that he has heard from many constituents. In December, they said they were told all booster appointments were booked for a month and PAMF was not booking any appointments for the following month. Simitian tried the system himself and received the same response after being placed on hold for an extended period of time.
A check by this news organization found that availability appeared better this week, with open slots for same-day appointments.
Sutter said patients can book an appointment by contacting its call center at 844-987-6115 on weekdays from 7 a.m. to 6 p.m. Appointments may also be scheduled via the My Health Online patient portal.
"While appointment availability can be limited, those interested in COVID-19 vaccinations or boosters have several options outside the Sutter network as well, including retail pharmacies and various community clinics. The MyTurn site features information on available options nearby."
PAMF didn't show up after multiple searches for providers on the state's MyTurn appointment site, which shows other providers such as Stanford and retail pharmacies.
Appointments are not being offered at the PAMF Palo Alto location; just at Mountain View, locally, a scheduling staff member said.
The appointments are also supposed to be available to anyone regardless of whether they are members of a health provider under the county's "no wrong door" system, but that option was not given upfront when calling PAMF for an appointment. Phone staff asked for information that assumed the caller is a Sutter/PAMF patient. No one asked whether the caller was not a patient of the provider. When asked if the shots are open to non-Sutter/PAMF patients, the appointment staff did affirm that, but the patients would have to fill out a questionnaire.
Stanford allows patients outside of its system to also receive vaccines, according to its website, but they must register first at myhealth.stanforhealthcare.org as a patient to gain access to online scheduling.
A check on the state's MyTurn website shows on-campus sites for Stanford. A couple of same-day appointments were available on Friday. A date-range search through Jan. 31 showed a handful of appointments for Jan. 16 and Jan. 19 at sites in Palo Alto, Stanford and Redwood City. An appointment staffer said by phone that many vaccine doses and appointments are available for 5- to 11-year-olds, despite a notice on Stanford's website of limited supply.
Simitian said that "convenience is key." People have had to stand in line for hours or have been told no booster shot appointments have been available for a month. There are also multiple warnings on provider websites of shortages of vaccine doses for 5- to 11-year-olds.
"In a perfect world, people would keep trying," he said, but noted that many people will simply be discouraged. He added that the number of administered booster shots has been falling.
"Not everyone will have the patience and persistence to keep coming back," he said. When people give up, "it's not just themselves put at risk but everyone else."
"We're in one of those moments where everyone's got to do everything they possibly can on vaccinations and testing. It's an all-hands-on-deck moment," he said during a phone interview this week.
Although the county is and should be doing all that it can to get tests and vaccines out, the supervisor said there's no doubt that the urgency of that effort is exacerbated by the other health care providers. "We have never seen a moment where people say, 'We've got this covered,'" he said of their response.
"The county is a public health agency, not the health care provider for every resident of the county," he said.
Simitian hopes and expects that other health care providers would step up and do their proportional share. "I regret that's not always been the case," he said.
"If we don't up our game. We're not going to master the pandemic."
Simitian emphasized that many people in health care organizations up and down California have "truly been heroic" in their efforts during the pandemic. "It's the organizations' leadership that has to step up to the plate."
County looks to enforce testing order
Williams said on Friday that the Public Health Department will enforce its Sept. 16, 2020, health officer testing order, which requires a health care provider to give a COVID-19 test if the patient has any symptoms of COVID-19; has been exposed to a person who has tested positive for COVID-19; has been referred by the County of Santa Clara Public Health Department to their health care provider for COVID-19 testing; or is an "essential worker."
The provider is required to give a COVID-19 test when the patient shows up in person, or if they ask for the test by phone or online, no later than the end of the next day; the limit extends to three business days if they are a health care worker.
The county is encouraging anyone to report any concerns or violations directly to their health care provider or to the county at scccovidconcerns.org.