Recommends vaccines as
best bet against Omicron
“We’re heartbroken. We’re overwhelmed.”
That is the message delivered to the Pierce County Board by Western Wisconsin Health CEO Alison Page and Pierce County Public Health Officer AZ Snyder at the Dec. 28 county board briefing on the COVID-19 pandemic.
Page’s message was bleakly matter-of-fact. Six out of the six Intensive Care Units in western Wisconsin are full. Less than 1% of ICU beds and medical surge beds in the Twin Cities are available. Supplies and staff are limited. People with non-COVID medical emergencies are not receiving timely care in some cases. And, Twin Cities emergency departments will be on a no-divert order beginning Jan. 3.
“We are keeping people on ventilators, which is fairly unheard of (at a rural hospital),” said Page. “We see the perfect storm forming.” Right now, hospitals are still in the midst of treating the Delta surge,
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Pierce County Public Health Officer AZ Snyder shared a graphic showing the percentage of people vaccinated per school district. Prescott had the most while Spring Valley had the least. Graphic courtesy of AZ Snyder HEALTH
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she said. But Omicron is going to spread like wildfire compared to Delta, she added, right on the cusp of flu season.
“All hospitals in the region are doing what we can do,” Page said. “We must provide ICU-level care in rural hospitals, which is stretching things thin.”
The nursing staff is stretched thin, almost to a critical level, Page said. Hospitals are flying in temporary staff, the military is being deployed to hospitals on the eastern side of the state.
A graphic Page and Snyder put together is evidence that vaccines work, Page emphasized. At WWH, of the six patients currently hospitalized with COVID, five are unvaccinated and one is vaccinated but due for a booster. Of the 43 COVID-positive patients hospitalized at WWH in the last 60 days, 35 were unvaccinated and eight were vaccinated but due for a booster. Of the 355 COVID-positive patients seen in the clinic in the past 60 days, 274 were unvaccinated, 73 were vaccinated but due for a booster, and eight were fully vaccinated. Of the 125 COVID-positive patients seen in WWH’s emergency department over the past 60 days, 105 were unvaccinated, 16 were unvaccinated but due for a booster, and four were fully vaccinated.
Page shared a personal story to illustrate the dire situation hospitals are facing. A couple of weeks ago, her aunt had a stroke. She was seen at the River Falls Area Hospital emergency room, but there were patients lined up waiting.
“They were calculating how fast she would die so they’d have her bed,” Page said. “Two people were waiting for her bed. She’s gone.”
She shared another sobering story about an unvaccinated man who came to WWH in Baldwin, but could barely get his name out before he had to be intubated.
“Our health care system is on the verge of collapse. I know that’s not very happy, but it’s the truth,” she said.
Hospitals are seeing more unvaccinated people in their 50s die, rather than the older populations, who are mostly vaccinated, Page said. Hospitals are not doing elective procedures that might require someone to be stay in a hospital bed.
Omicron has become the dominant variant in the US in just two weeks, Snyder said. One percent of COVID samples are sequenced in Pierce County. So far, Omicron hasn’t been detected (as of Dec. 28), but it’s probably here, Snyder said. As of last week, all 50 states have reported at least one case, with it representing 73% of sequenced cases nationally. The first US death was an unvaccinated man in his 50s, with a documented previous infection, Snyder said.
“Given South Africa and the UK, we know it spreads incredibly quickly,” Snyder said. “We know there is partial vaccine escape, especially for people who aren’t boosted.”
But, South Africa’s hospitalization rates remain about 50% of what they were for the Delta wave, which is promising news. Health professionals don’t know if this is because immunity is working or because Omicron is less severe.
“We do know that once hospitalized, outcomes have not been better for Delta vs. Omicron,” Snyder said. “We do believe it likely has a shortened incubation period. If transmission in the US is like it has been elsewhere, Omicron could overwhelm our already strained healthcare system.”
It’s clear that boosters are key to protect from Omicron, Snyder said emphatically.
Most common treatments for COVID may have little to no effectiveness in patients infected with the omicron variant, Snyder said. There is a monoclonal antibody treatment that appears to be effective against Omicron, but supply is extremely limited.
Patients, should not however, take Ivermectin, which is an anti-parasitic drug. Not only is it not effective, Page said, but WWH has seen patients in its ER with Ivermectin overdosing. In fact, one man had COVID and gastrointestinal bleeding caused by overdosing on Ivermectin.
Public Health activities
The Ellsworth National Guard testing site at Pierce Pepin Cooperative Services is done Jan. 6. The Guard is being deployed to hospitals and health care facilities. Snyder was in talks with a private vendor to potentially replace the Guard, but due to the government taking all antigen tests, that option is delayed. However, UW-River Falls will continue its community testing site, Snyder said.
PCPH vaccinated 900 people last month (mostly boosters), and is currently offering pediatric vaccinations for ages 5-11. PCPH will likely transition away from Pfizer and J& J, as J& J is not as good at protecting people against Omicron, Snyder said.
As for disease investigation, PCPH is operating under crisis standards, which means shortened conversations focusing on timelines for isolation, quarantine of household members, and treatment options. Staff are making limited attempts to contact via phone, but are sending letters.
In the line of outbreak management, PCPH is continuing to work with childcare centers, schools, businesses and longterm care facilities to manage large outbreaks.
“There has been an outbreak in every single school district,” Snyder said.
In the first week of December, cases peaked at 338 new positive cases in Pierce County. While case numbers have decreased throughout the month, the lag before hospitals see these patients is two to three weeks, Snyder explained. There have been 12 deaths in the last three months, ages 54 to 92. Last year, K-12 schools did pretty well, Snyder said. This year in November, schools had 218 positive cases, with one child being hospitalized.
“The spread doesn’t stay in our schools,” Snyder said. “It jumps to households.”
Changes to quarantine and isolation timelines Per the CDC, as of Monday, Dec. 27, if someone tests positive for COVID-19, they should stay home for five days after onset. If symptoms are improving and you have no fever after five days, you can leave your house. Continue to wear a mask around others for an additional five days, Snyder said.
Quarantine guidelines are (assuming no symptoms):
•People who are unvaccinated OR are due for a booster when exposed should stay home for five days and mask for five additional days. Testing on Day 5 is recommended.
•Boosted people OR people within six months of vaccination series (Moderna, Pfizer) OR people within two months (J& J) do not need to quarantine, but should mask for 10 days. A test on Day 5 is recommended.
The graphic shows the number of vaccinated vs. unvaccinated patients seen and treated for COVID at Western Wisconsin Health in Baldwin in the past 60 days. The numbers show that unvaccinated individuals far outweigh vaccinated. Graphic courtesy of Alison Page/AZ Snyder