U.S. Daily COVID Positive Cases - Credit CDC
#16,251
While overall case numbers across the country have declined since early September (see chart above) - it remains near the 100K/day level - and there are some areas of the country that continue to struggle with COVID, and its impacts on local healthcare delivery.
Alaska Activates Crisis Standards of Care Across 20 Health Districts
Montana Governor Sends National Guard To Aid COVID-Stressed Hospitals
Washington State: Gov. Inslee Requests Federal Medical Staffing Resources For COVID Surge
Idaho DOH Expands Crisis Standards of Care Statewide Due to Surge in COVID-19 Patients Requiring Hospitalization
Over the past month, most of these problems have been in western states, but there are signs of heightened transmission east of the Mississippi as well (see map below).
While there are recent models suggesting that COVID may have peaked, and the number of COVID cases, hospitalizations, and deaths are likely to decline over the next six months - what COVID does this winter remains a big unknown - and it may be premature to predict its end.
Add in the potential return of influenza and other seasonal respiratory infections - to co-circulate with COVID - and this winter could still become quite challenging for hospitals, ambulances, and other medical delivery systems.
A week ago, the Larimer County public Health Department warned about the rising burden on their local hospitals (see press release: Larimer County Health Officials Concerned About High Levels of COVID-19 Hospitalizations and the Risk of Additional RSV and Influenza Hospitalizations), which cited:
- On July 14, there were 10 patients with COVID-19 in Larimer County hospitals and today, 86 patients are hospitalized.
- Since September 1, Larimer County has lost 26 residents to COVID-19. The majority of those who have been hospitalized or who have passed away have been unvaccinated.
- Larimer County ICU utilization is currently at 105% of the level of customary care, with 40% of patients in ICU having COVID-19.
- For each of the past four days, Larimer County hospitals have had 10-14 individuals admitted with COVID-19, and the number of people in the hospital with COVID-19 is continuing to increase.
With conditions not improving, yesterday the Larimer County Public Health Department issued a public health order requiring face masks in all indoor public places, beginning Weds Oct. 20th. First some excerpts from the order, then I'll return with a postscript.
Larimer County Public Health Officials Issue Public Health Order Requiring Masks in All Public Indoor Spaces, Effective October 20 at 12:00 PM
Larimer County, CO - The Larimer County Department of Health and Environment (LCDHE) has issued a public health order requiring that face coverings be worn in all public indoor spaces in Larimer County. The order requires that all persons aged 3 years and older wear face coverings and outlines limited exceptions, including for individuals who cannot medically tolerate a face covering. The order goes into effect Wednesday, October 20, 2021, at 12:00 pm.
On August 11, 2021, the Larimer County Public Health Director strongly recommended that all community members wear masks in public indoor spaces to prevent the spread of COVID-19 due to the rapidly increasing threat of the Delta variant. In addition, the Public Health Director called on unvaccinated eligible residents to make the decisions to get vaccinated without delay.
However, for the past four weeks, local hospital ICUs have been operating at or above 100% of the level of customary care, while fewer residents have been getting vaccinated. Currently, 40% of patients in the ICU have COVID-19 and 90% are unvaccinated. Universal mask wearing can help slow transmission of the virus and relieve local hospitals while more people get vaccinated.
“Larimer County hospitals are being overburdened and we cannot allow this to continue indefinitely. Our hospitals need relief so they can swiftly and adequately treat all urgent medical needs in our community, '' says Tom Gonzales, Larimer County Public Health Director. “Vaccination is the best way out of this pandemic, but 35% of Larimer County’s population remains unvaccinated against COVID-19. Universal mask-wearing is the next best prevention tool we have to reduce the strain on our hospitals.”
“Our hospitals and emergency rooms continue to operate with a high volume of patients both COVID and non-COVID. Last year when we all masked and practiced social distancing, there were far fewer flu and RSV cases, which lessened the burden on hospitals and allowed us to get a handle on the pandemic. To put us back in a good position to provide the care everyone needs, we support steps to have community members adopt good health practices and reduce the spread of these respiratory illnesses,” says Margo Karsten, president Banner Health Western Region.
"Our heroic skilled hospital staff are working tirelessly to provide care for all people with an urgent medical condition, but our hospitals have been overburdened too long with COVID-19 patients, and need relief. Universal masking has proven to work by reducing the spread of the virus, says Kevin Unger,” says President /CEO UCHealth North Region.
The Public Health Order will remain in place until Larimer County has met the four metrics below for 21 consecutive days, or until it is extended, rescinded, superseded, or amended in writing by the Larimer County Public Health Director;
- < 65 COVID-19 patients in the Larimer County hospitals;
- Intensive Care Unit utilization at less than 90% of usual and customary levels;
- A Larimer County 7-Day Case Rate per 100k of < 300;
- A Larimer County 7-Day Test Positivity Rate of < 10%.
“We are in a battle with a virus and the sooner we again collectively fight this virus the sooner masks will be a thing of our past,” says Gonzales.
Larimer County facilities that wish to implement mandatory vaccination policies for staff, patrons, and guests have the opportunity to apply to become an Approved Vaccine Verified Facility and be exempted from the mask requirements with approval from LCDHE. More information about this opportunity can be found at https://bit.ly/larimervaxverified.
For more information and to read the full order, visit https://bit.ly/larimermaskorder.
The Larimer County Department of Health & Environment has a webpage dedicated to helping residents find information about COVID-19 vaccination and for registering for an appointment at www.larimer.org/covidvaccine. The direct link to schedule an appointment to get a COVID-19 vaccine is: https://larimerhealth.secure.force.com/Vaccine/. Individuals may also call LCDHE at 970-498-5500 for assistance scheduling an appointment. Phone assistance is available in English and Spanish.
LCDHE is encouraging Larimer County residents to view the latest credible information on COVID-19 at www.larimer.org/covid19 or www.CDC.gov/coronavirus. Additionally, residents are encouraged to follow LCDHE’s Facebook and Twitter accounts at @LarimerHealth.
While the above order only affects the few hundred thousand who live in, work in, or visit Larimer County, CO - as winter approaches and COVID/Flu increase their impact on hospitals across the nation - we will likely see more orders like this spring up across the nation.
In The Realities Of Crisis Standards Of Care, we looked at how overburdened hospitals could affect anyone seeking medical care this fall and winter, making this a bad time to have a heart attack, stroke, or get in a car wreck.
All reasons why getting the flu vaccine on top of the COVID shot, wearing masks in public, and avoiding other types of `risky' behavior, all make sense going into this fall and winter.
