This Sunday marks one year since we diagnosed our first COVID patient at VHC. Since then, we’ve had almost 10,000 patients require our COVID isolation status in the ER, with about 40% of those patients requiring at least 1 night of hospitalization. Since then, the hospital has cared for over 2400 patients with COVID. My testing data only goes back to April 5th. The ER has tested over 4600 symptomatic patients with a 27% positive rate. Overall, we’ve tested over 16,000 patients in the ER with about a 12% positive rate.
For the second week in a row, we saw increases in the numbers of patients requiring our COVID isolation status and in the total number of patients we diagnosed with COVID. Our numbers declined for about 7 weeks in a row and then were the same level for two weeks in a row. But this past week marks the second week in a row we’re seeing increases. It’s small increases and we’re still only about a third of the totals compared to our peaks, but we’re not seeing a continued decline. I’m not quite sure what to attribute this to. It’s certainly possible that there is some behavior fatigue and people are starting to gather or not wearing masks. Maybe people are comfortable knowing the vaccine is around, though I’m not seeing fully vaccinated people test positive. Finally, we have to consider if the numbers are increasing due to more variants in the area. Time will tell as the CDC continues to sequence and test for variants. On the good side, our hospital COVID census is the same as it was last Friday. It actually went up about 10% midweek but went back this morning. For the first time in more than a month, we saw a drop in our admission rate of our COVID isolation patients. So despite our percent positive rate being up a bit, the severity seems to be down. This may be related to the older population being vaccinated so we’re seeing younger patients test positive. I actually haven’t been tracking the median or average ages of the patients in these categories.
We are continuing to vaccinate staff at the hospital. Some of these are new employees and others are people who initially didn’t want the vaccine and have changed their mind. I think that’s great and gives me hope that others who didn’t initially want the vaccine will get it when it’s available. The great news about the vaccine is that we’re not seeing vaccinated employees test positive after high-risk exposures to patients. We do not have the J&J vaccine, but I would be happy to get that one or have my family members get it. I know some of you have concerns that the J&J vaccine didn’t get the same “test grade” as the other two. However, J&J was taking a tough test and faced better competition during its season (apologies for the mixed metaphors). J&J was in an environment with higher COVID rates and more variants than Pfizer and Moderna. Therefore, it’s probably unfair to compare a 72% success rate to a 95% rate. However, all 3 vaccines are really good (not quite 100% but pretty close) at preventing severe disease and hospitalization, and that’s huge.
Part of what we need to wrap our heads around over 2021 will be forming a peaceful coexistence with COVID where we live our lives with concerts, sporting events, eating and drinking inside a restaurant with friends, while COVID is still in the community. We’re not going to eradicate it and while I don’t endorse fully opening up society and throwing out our masks today, I do recommend looking at the data as we return kids to their activities like competitive sports and better defining where an acceptable risk tolerance threshold should be by public health standards. When COVID started, I knew there wasn’t enough in the community where I feared going to a store. Once it hit hard in the ER, I was pretty sure I was going to get sick and even cancelled a small home improvement project because I wanted to protect the cash that I had on hand in case I couldn’t work or died. Long before I was vaccinated, I got comfortable with COVID and my PPE and stopped washing my face in the middle of shifts and washing every piece of clothing I had on when I returned to the house from the store. We’ve learned a lot since COVID hit a year ago and we need to be willing to change our internal risk tolerance to what the science supports.
Just as we are seeing the light at the end of the tunnel for COVID, there is another infectious disease issue on the horizon. The CDC has announced that since early February, there have been small Ebola outbreaks in the Democratic Republic of the Congo (DRC) and Guinea, N’Zerekore Prefecture. The DRC had previously declared the Ebola outbreak there over on June 25, 2020. The outbreak in Guinea was declared over in 2016. There is an Ebola vaccine but DRC is seeing positive cases among vaccinated patients. The CDC and World Health Organization are actively involved in trying to stop the outbreak and at VHC we’re starting to plan for a possible Ebola patient. VHC is an assessment hospital for the state as we’ve been since the initial Ebola outbreak in 2014. We’ve never had a confirmed Ebola patient at VHC but we certainly had a handful that were potentials, so we know the drill and are getting prepared. And we are in full prep mode so we’re ready if and when we get a possible patient.
Fortunately, travel is decreased from these countries compared to years ago and travel screening is going into place at airports around the country that receive patients from these countries. Arriving travelers are also asked to self-monitor for 21 days just like they were last time. I’ll keep you posted.
Next week marks the one-year anniversary of my first Friday night update. I never imagined I’d be writing these a year later. Are you tired of these yet?
Science matters. Wear a mask. Practice physical distancing.
Mike