The Highland County Health Commissioner Jared Warner, the Highland County health commissioner, posted a new update focusing on COVID-19 on the health department’s Facebook page Wednesday. The update appears below in its entirety:
Statistics and case counts
Highland County continues to see record-breaking COVID-19 case counts with our highest ever per capita rates occurring in late August. Our current 7-day per 100,000 capita rate is 741.4 cases. At a couple of points last month, Highland County had the highest per capita rate in all of Ohio, though now we have dropped to the 4th worst county for per capita COVID-19 cases. We are currently averaging about 46 new cases each day. This means that our staff are doing their best to reach out to new cases, but much of our work is automated. If you are a newly diagnosed case, you can expect an automated phone call from our office with instructions on what to do next. We then ask new cases to complete an online survey, and we use those survey results to them reach out to close contacts to let them know about their exposure and to place them in quarantine. Please be patient with our staff as we work through this recent surge.
Cumulative hospitalizations have increased to 247. We have seen 14 Highland County residents hospitalized over the past 10 days in Ohio. Highland District currently has 10 people receiving care for COVID-19 in their hospital.
We also have our highest ever active sick count, with 537 people currently sick with COVID-19 in our community. As we have talked about before, there is usually a two week or so delay on hospitalizations after a spike in cases. Our current case spike began in early August, so my guess is that we are just now starting to feel the increase in hospitalizations that we can expect from the current surge. I hope that I am wrong, because I know how hard our local hospital staff are working, and I hate to think that an even higher patient counts might be coming their way.
Vaccination rates continue to be much below the state average, with Highland County at 33.6% compared to Ohio’s 52.4%. With the FDA recently granting Pfizer full approval status, some predicted an increase in new people getting vaccinated. We have not seen any definitive “post-FDA approval” increase in Highland County.
We may be nearing a leveling off in our current surge of cases, as we have seen a decrease in how quickly our case rates are accelerating. We aren’t losing ground yet, but I am hoping that we are seeing a peak. I think there are two important factors locally that influence how quickly we level off. First, schools have been in session for only a part of our current surge, and they have been closed for fair break this week, which may lead to new spikes in case count when schools resume again next week. Second, the county fair is going on right now, and we have a lot of households interacting with each other this week that normally don’t get together. These two factors make it hard to predict what things will look like in a couple of weeks.
School mask mandates
It is encouraging that many local school districts have chosen to implement universal masking in schools as a way to slow down disease spread in the school districts. In the 2020-21 school year, we saw a total of 248 student cases and 152 staff cases of COVID-19. So far in the current 2021 school year, we have seen 161 student cases and 44 staff cases. Within the first month of school, we are at 65% of last year’s total student cases, and 29% of last year’s total staff cases. Some of this can be attributed to the removal of many of the safety measures that were in place last year, and also to the much more virulent nature of the Delta variant. It wasn’t uncommon at all last year to quarantine a group of close contacts and have none of them end up becoming ill. That just isn’t the case anymore. Close contacts in our schools seem to be getting sick at a much higher rate than what we were seeing last year.
Masks are not a perfect solution, and they don’t fix all of our problems. But they can be helpful, as shown in a new study released for preread on August 29th. This study performed studies on the effectiveness of several interventions in a classroom, including masks, ventilation, and HEPA filtration. Universal use of surgical masks reduced disease transmission significantly. The study also highlighted the important of ventilation, which was the single most important factor identified in reducing disease transmission. We need to continue providing multiple layers of protection in our schools in order to keep kids and staff healthy, and to keep our schools in session and in person.
We don’t expect to eliminate all cases from our schools, but we do want to reduce the likelihood that COVID-19 will spread between households due to student interaction at school. If we want our schools to remain healthy enough to be in-person, then I believe that we need to use every tool available to us. This includes masks.
Waning immunity and Delta severity
There are a lot of questions right now about how to differentiate between waning immunity from COVID-19 vaccination and previous infection, and the increased transmissibility of the Delta variant. Is Delta getting good at evading vaccination and causing illness, or are we beginning to see a reduction in the effectiveness of our vaccines as many people reach their 6-month (and longer) vaccination anniversary? Recent case increases in Israel seem to point to waning effectiveness of vaccination, though the vaccine still seems to be incredibly effective at reducing hospitalization and death. Israel has enjoyed one of the highest vaccination rates in the world, and they implemented this vaccination effort way faster and earlier than many other countries. They are currently experiencing their largest ever spike in COVID-19, and a spike that seems to be much higher than other developed nations. Could this be evidence of waning vaccine effectiveness given that they provided vaccines so early in the pandemic? Below is a very good review of the current situation in Israel and some analysis on whether the US may be headed down this path as well. See it at https://yourlocalepidemiologist.substack.com/…/whats…
Stay home if you are sick
Parents, please don’t send your sick kids to school. I know it is tempting to dose them with Tylenol and send them in, but this is not the time for that kind of thing. We have heard so many times from our school nurses that sick kids are being sent to school, and we really need to cut that out. If you kid is sick, please keep them home so we can keep our other students, school staff, and community healthy.
For those of us not in school anymore: Stay home if you are COVID-19 positive. Stay home if you are quarantined. Stay home if you are sick, period. You wouldn’t believe how many times I get calls from frustrated co-workers, neighbors, and other people who know someone who is COVID-19 positive and is still running errands, going to work, and generally out and about in the community. Please, stay home if you are sick.
Our local emergency departments continue to have people show up asking for COVID-19 testing. Please, please stop going in to our emergency departments unless you are experiencing a medical emergency. The Highland County Health Department has partnered with our local libraries and with Community Action to provide free rapid at home COVID-19 test kits to our community. Many other health care providers offer testing. For more information, visit http://www.highlandcountyhealth.org/…/covid-19-testing….
Over the last two weeks, our health department has distributed over 2,500 test kits to our community partners.
One of the interesting side effects of handing out so many at home COVID-19 test kits is that many of these test results are never reported to the health department. Many people perform the tests at home and isolate or quarantine themselves without interaction with any health care agencies. This can influence our case counts and positivity rates quite a bit, and adds to the assumption that overall we are undercounting COVID-19 activity in Highland County.
Quarantine vs. isolation
I have been seeing the same Facebook post pop up recently that says, “Quarantine is when you restrict the movement of sick people, and tyranny is when you restrict the movement of healthy people.” This feels like a teachable moment. Quarantine is the restriction of movement of people who may currently be healthy, but have been exposed to a disease and might later become sick. This practice has been in place for literally hundreds of years, for as long as we have understood that if I hang around a sick person, I might get sick later too. Many diseases are transmissible before a person shows any symptoms, and so it can be important in some cases to keep a person in quarantine until we can be sure that they are not going to spread disease to others.
Isolation is when a person that is actively sick is kept away from others in order to prevent the spread of disease. We isolate people that we know are sick and keep them away from other people.
Maybe everyone already knows this, but it is frustrating to me how often these and other core concepts to public health and disease prevention are misunderstood or intentionally misrepresented.
Also, if I am supposed to be part of a secret tyrannical conspiracy aimed at controlling the population, someone needs to send me a script or something, because I have no idea what is coming next.
Have a safe and healthy fair this week!