There was a line at the post office, where, under winter coats, scarves and masks, neighbors said their hellos. Just a few storefronts were open on a crisp afternoon. It seemed like a normal day in downtown Pescadero, albeit a bit quiet for Christmas week.

It certainly did not look like the site of the highest per capita COVID-19 case rate in San Mateo County.

But on the county’s official “cases by city” map, Pescadero is tinted a dark blue, reporting nearly 1,500 cases per 10,000 residents — the highest proportion of cases reported on the map.

Rita Mancera, executive director of South Coast nonprofit Puente de la Costa Sur, said the numbers don’t necessarily reflect what’s going on on the ground in Pescadero, where just 33 cases of the virus have been reported since the start of the outbreak in March.

“I think the ratio is an issue because it ties to the census numbers,” Mancera said. “Every time I look at the map, I feel really bad. I think (COVID-19) has been relatively well contained in Pescadero.”

The case rate appears bloated because Pescadero’s population is so small, with just 226 people reportedly living in Pescadero 2018. This is the population number used by the county in its chart, drawn from five-year estimates from the American Community Survey conducted by the U.S. Census Bureau, which is updated yearly. The 2010 census, however, reported 643 residents. And from 2013 to 2016, the five-year estimates put Pescadero’s population above 1,000. It’s not clear if there’s actually been much movement in or out of the town, or if the deviation comes from counting such a small area, where the margin of error is often wide.

“Pescadero is always at risk of being undercounted in the census due to being rural,” wrote Amy Wooliever, the La Honda-Pescadero Unified School District superintendent.

Monthly, targeted and on-demand local COVID-19 testing has continued throughout the pandemic, Mancera said. While they aren’t privy to the test results, Puente staff often hear about positive COVID-19 cases in the community, sometimes while walking the food distribution line to catch up with their neighbors. Staff has been keeping track of the cases that residents report directly to them. They don’t ask questions about where people think they got the disease — she said many people feel shame or guilt about getting COVID-19, and they don’t want to contribute to that — but Puente staff have noticed some trends.

The majority of people calling to let Puente know they got the virus are Latino, and many live in a household with more than one family, where the virus has more easily spread from one person to another. But Mancera said that might just be a result of who is willing to reach out, and said Puente’s data is incomplete.

“I don’t know where they are getting it,” Mancera said. “... I wish that contact tracing did some reporting on how people are getting it because then we could be more diligent on the outreach and targeted on where cases are coming from.”

The county declined to answer specific questions about the results of contact tracing in Pescadero. In a statement to the Review, County Health Deputy Chief Srija Srinivasan wrote that the small number of residents living in Pescadero explains its high case rate, and that the county is seeing spikes in transmission across all regions, ages and ethnic groups.

“There is more risk for those living in congregate settings, those living in crowded conditions in which one or more members is exposed to others through their work, and those whose work puts them in close contact with those who could be COVID positive,” Srinivasan wrote.

For the most part, Mancera said South Coast residents are now taking the virus seriously. The skepticism and conspiracies from March have faded, especially as neighbors have shared stories about the lasting effects of COVID. Mancera said she’s talked to several people who, months after their positive diagnosis, were still feeling fatigued or missing their taste and smell.

“It is more realistic now,” Mancera said. “People know it's around and that they have to protect themselves.”

Mancera said while the dreaded post-Thanksgiving surge hasn’t quite materialized in her community, with just two additional cases reported in the last two weeks, she’s more worried about Christmas. It’s a traditional Latino holiday, when families might be tempted to gather and celebrate.

Mancera thinks the real reason for the local spread was likely the CZU wildfire, which prompted the entire region to evacuate. Suddenly, South Coast residents were forced to stay with relatives or in hotels, some for more than a month, and to visit restaurants and stores just to survive.

Butano resident Haydee Felsovanyi, who was in line at the post office on Monday, agrees. Like many of her neighbors, she had to evacuate her home in August. She found a place to stay with family, but said the confusion and desperation of the evacuation seems the most likely culprit for a rise in cases.

“When we had the evacuation, some went to hotels, but many could not,” Felsovanyi said. “They had a hard time.”

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