Covid-19 update

On Friday, Wahkiakum Health and Human Services was awaiting test results for approximately 30 people who had been in close contact with the four Wahkiakum County residents that tested positive for covid-19 last week.

Some were symptomatic, and WHHS Director Chris Bischoff believed it was likely that a portion of them would test positive.

He was right.

On Monday, four more Wahkiakum County residents tested positive. Two were related to a positive result at Wahkiakum School District, and two more were found not to be related to the school district or St. James Family Center.

“I think we’re at a point where it is fairly safe to say we have evidence of community spread in Wahkiakum County,” Bischoff said. “I think that folks need to understand that we’ve always suspected it’s been here, we just never have seen the cases come out of it. At this point, there’s a lot.

“We need people to be wearing masks. We need people to be taking this seriously. Mask up, wash your hands, stay home when you can, as much as you can.”

With the four new positive tests on Monday, there are now 20 confirmed cases of covid-19 in Wahkiakum County, with 763 tests conducted so far. There have been 340 positive cases in Pacific County after they added 55 last Wednesday, and 93 on Friday. Of those, 141 are considered active. Cowlitz is reporting 1290 cases, with 493 remaining active. Across the river, Columbia County has had 399 cases, with 55 currently considered infectious. Clatsop County has had 332 cases, and 66 are still active.

In Washington state, the numbers of new cases per day have started to let off a little bit, Bischoff said, but only a little. For a few days, there were over 2,000 new cases per day, but it has inched down to the 1,300-1,600 level.

“That is super high,” Bischoff said, “so we are in a very dangerous spot.”

Nearby counties are struggling to keep up with contact tracing.

“Clark and Cowlitz County notified providers that they are unable to do all of the contact tracing any more,” Bischoff said. “Their cases are erupting so fast that they cannot contact all close contacts, is what they are saying. They dialed in the state and said we need your help, but the state is overwhelmed now as well. Many counties are in the same place, where they are just not able to do a lot of the contact tracing.”

Bischoff added that Clark County is so overwhelmed that they will soon be announcing that not only are they struggling to contact everyone who has come in close contact with a positive case, they will not be able to contact everyone who has actually tested positive.

Providers are now going to have to do that work, though they too may already be overwhelmed.

“Pacific County isn’t there yet, although they are sort of stretching,” Bischoff said.

“Wahkiakum is nowhere near there,” he said. “We have some volunteers lined up and some other staff we can divert besides just our public health nurse. We feel like we are good. We will contact every contact directly, work with every case.”

“People are going to hear that public health has given up, and that is not what is going on,” Bischoff said. “Clark and Cowlitz are doing as much as they can and reaching as many as they can, it’s just too much for them, they can’t keep up.”

Bischoff and staff saw a recent presentation specific to the Kaiser region, he said, and learned that hospitals in southwest Washington and nearby Oregon were rapidly approaching bed capacity.

The first wave level of hospitalization and the second wave level of hospitalization were pretty even, Bischoff said, even though the number of cases in the second wave were so much higher.

“One of the reasons for that was because demographically, the second wave skewed toward the 25-45 age bracket and we didn’t see the hospitalizations jump as much,” he said. “What the Kaiser presentation was showing us was that this wave demographically is much closer to the first wave. Not only is it much bigger than the second wave, it’s starting to skew in that older direction. Which means that we are putting more and more people at the most risk in the hospital.”

“So that’s where we are starting to see hospitals fail across the country,” Bischoff said. “Here in Washington we are not there yet, but we are pushing it. And Oregon, and California. We are pushing the edge of those systems already.”

The holidays

“We’re getting a little less cases per day in the state, but we’re taking it into this Thanksgiving holiday, when we know a lot of people who are going to get together, who aren’t normally in each other’s bubbles, who are going to visit mom and dad, grandma and grandpa, cousins and uncles,” Bischoff said. “It’s very hard after a year like this not to, but we are going into that carrying this massive case load. So for everyone we know about that is symptomatic and tested, or a close contact, we have several more that we don’t know are exposed.

“Those people don’t know they are carrying it. We have this massive load in our society headed into these indoor, all day, closed events. And even if it is kept only at family, we don’t have any friends there, it’s family we are not normally around. So we are really expecting 7-14 days after Thanksgiving is over that we are just going to see this wave accelerate rapidly again.”

“We would largely consider what we have had up to this point a Halloween bump, a big bump, and I think we are going to see something equally as large, maybe larger for Thanksgiving, and then we have Christmas, New Year holidays around the corner too. It’s very concerning to many of us in public health,” Bischoff added.

“I know it’s Thanksgiving and it’s tough for people but we really need to keep that social distancing and keep our households together and exclude anyone else. Have a digitally separated Thanksgiving if you can from people not in your household,” he said.

Vaccines

“Pfizer has officially applied to the FDA for their emergency use authorization, we do expect doses in the next couple weeks,” Bischoff said. “I was listening to Dr. Fauci in a great interview. He explained that the federal government put up a billion dollars to a couple of the vaccines that they knew, early on, seemed to be pretty effective and were probably going to make it through to start production early. So we are actually well ahead of where we would be otherwise. So basically the federal government gambled. And they said, we’re going to give you money. Start your production lines and finish your testing. If the testing had gone badly, they would have had to scrap it all and throw it all away.”

“Since the testing has gone very well for these, they really hit the ground running. The first two vaccines that we’re probably going to see, Pfizer and Moderna, they are extremely efficacious.”

This vaccine is about 95 percent effective, Bischoff said, while the flu vaccine is generally about 50 percent effective.

“It is really aimed, not at keeping you from getting the virus, but it will keep you from getting sick,” Bischoff added. “You are very unlikely once you get the vaccine of ever actually showing any symptoms. As far as we know you could still carry the virus and pass it on, you just won’t get sick.”

The state already has plans for distribution, Bischoff said, starting with medical professionals, and then to long term care facilities.

“As doses become available, we are going to be able to get it out really fast,” Bischoff said.

What is causing people to exhibit symptoms but test negative for covid-19

The first symptoms of anything are almost always “flu-like,” Bischoff wrote in an email. This is due to the fact that many of your early symptoms aren’t the pathogen, like the flu, a cold, allergies, covid-19, salmonella, e-coli, etc., they are your body’s reaction to the pathogen.

It is flu and cold season, he continued, and strep is always more abundant in the winter. Some people have allergies.

Flu is in the state. Allergies can trigger illness, people with weakened immune systems because of rheumatoid arthritis or other issues struggle more in the winter, and stress can suppress the immune system as well.

Finally, Bischoff expressed gratitude to Wahkiakum County Commissioners.

“Our commissioners have done a very good job of supporting us and making sure we have what we need,” he said. “I feel that they are really trying to do the right thing for the community, I am greatly appreciative of them.”