Covid-19 update:

As of Tuesday, Wahkiakum County’s covid-19 case count held steady at 10, with 663 tests conducted so far. Pacific County was reporting 120 total cases, with five new ones on Monday. Of the 120, ten are considered active. Cowlitz County has 808 confirmed cases, with 667 considered recovered. Across the river, Columbia County has 252 total cases, with eight considered infectious, and in Clatsop County, they are reporting 245 cases with 11 considered active.

“A number of states in the US are surging,” Wahkiakum County Health and Human Services Chris Bischoff said, noting that Oregon had more than 42,000 cases, and Washington went over 100,000 cases last week.

A couple cases that Wahkiakum County picked up the week before last are getting ready to enter the recovery stage, according to Bischoff.

How covid-19 affects hospitals and staff

Hospitals are for-profit systems, Bischoff explained, which means they operate as close to capacity as possible.

“When you overwhelm a hospital system, any fatalities you add, some percentage of those are people who did not need to die, but could not get appropriate medical care,” Bischoff said. “If you have a staff—nurses, doctors, administrative—that are working 80 hours a week in extremely stressful conditions, things are going to get missed. When we drive hospitalization rates back up, people are not going to get the best possible care.”

A decade-long nationwide shortage of nurses has also meant that nurses were already getting as much overtime as they could work during a regular flu season. Covid-19 has only compounded the matter, and it's contributing to burnout, and the loss of more nurses.

“We’re losing professionals at this point, even the ones who want to stay around can’t keep up any more,” Bischoff said.

Treatments that mimic the immune system

Convalescent plasma, or plasma treatment, which Bischoff described as follows:

“If I have covid-19 and I recover, they filter out my plasma and give my plasma to people with covid-19 to help them recover faster,” he said. “The theory being that they are going to use the antibodies and other things that my body produced to get rid of covid-19, to help the other person get rid of covid-19.”

Bischoff said that studies have found that it works best for people who are going to be very symptomatic, before they are symptomatic.

“It does require a crystal ball,” Bischoff said. “It’s limited on how much you can get, but even in the trials that are going on, it isn’t super great. It’s not horrible, but it’s not overly promising.”

Monoclonal antibodies are a more concentrated cocktail of the antibodies that are believed to be most effective against covid-19, harvested from the convalescent plasma.

There are clinical trials underway, and while it shows promise, there are “no silver bullets in this,” Bischoff said.

Interferons promote the immune system to start and they keep it from going too far, Bischoff said. They keep what is known as a cytokine storm, or an immune system that is overreacting, under control.

“One of covid-19’s first effects on the body is to reduce the interferon level,” Bischoff explained, “and that can lead to the immune system over responding.”

“[Scientists] are taking synthesized interferons and injecting them back into people with covid-19 to see if that will help them recover more quickly,” Bischoff said.

Interferons are already used in treatments for other things, like multiple sclerosis, and therefore have already been clinically tested.

Because the cytokine storm isn’t one of the most damaging effects of covid-19, Bischoff said, interferons help, but won’t fix everything.

Corticosteroids, like Dexamethasone have been around for awhile, and work for things like asthma, and pneumonia.

“They started to use them early on,” Bischoff said, “but have been working on which ones are the best ones.”

Timing is really important for corticosteroids.

“They don’t want to give you one of these too early.” Bischoff said. “The steroids do a lot of things in the body, and can make the course of the disease worse. Given at the appropriate time, they’ve found there is an overall reduction by a third, so 33.3 percent less folks succumb to covid-19 when using corticosteroids as part of their treatment.”

Bischoff also spoke briefly about cytokine inhibitors and blood filtration systems, both used to respond to cytokine storms.

Finally, he touched on stem cells.

“Some have an anti-inflammatory effect,” he said. “Right now the FDA has indicated that no one should be using them clinically until trials are done. It’s not super promising at this point, and pretty early in the trials.”

WHHS is still screening

If you are symptomatic, contact your primary care physician first. If they will not test you, you are encouraged to call the WHHS screening number, 360-849-4041.