Editor’s note — Highland County Health Commissioner Jared Warner posted an update focusing on COVID-19 on the health department’s Facebook page Wednesday. The update, edited to eliminate news The Times-Gazette has already reported, along with a poem, appears below:
Cases counts are finally headed consistently downward after our recent spike that started in early to mid-August. This fits into the 40-60 day Delta variant spike that has been seen in many other states. COVID-19 hospitalizations seem to have started their peak as well, though ICU numbers continue to be over 100% capacity for SW Ohio Region.
Our 7-Day Case Rate per 100,000 population is 468.02. This is a dramatic decrease from where we were last month and roughly a 50% reduction from two weeks ago.
We are averaging 25 new COVID-19 cases each day over the last seven days. Hopefully, we will continue to see this dramatic decrease in case counts.
Deaths are a little hard to measure in short time frames due to our reporting structure, but they also seem to be leveling out. I know anecdotally of several recent deaths, so this may impact our death rates as these records are added. We have reported eight new deaths in the last two weeks.
Vaccination rates got a boost when Delta first started to appear in the U.S., but are on a steady decline again. Current first dose rates in Highland County are at 34.88%.
We are also going to have to figure out how the state plans to track vaccine doses now that booster and third dose vaccinations are happening. Highland County has been using “First Dose Provided” stats for our vaccination rates, and we should be able to continue using this as a general indicator of vaccination uptake, but it doesn’t tell the whole vaccination story.
Natural Immunity Conversation
I want to talk about natural immunity, as this concept seems to be promoted often as an alternative to vaccination for COVID-19. Natural immunity is a very important part of our population’s path through this pandemic, and we do need to better understand long-term immunity from natural infection. Long-term and effective natural immunity would be the best-case scenario for Highland County in particular with our low vaccination rates.
The problem with relying on a “natural immunity only” path through this pandemic is pretty straightforward. In order to get natural immunity, a person first must become sick with COVID-19, and then recover. I want to say that in another way to make sure that this idea is clear. A COVID-19 illness must occur in a person in order for natural immunity to develop once that person recovers.
Highland County had 1,760 people with confirmed or probable cases of COVID-19 between Aug. 1 and Sept. 23. This was our largest spike in cases to date, and we assume that the number of actual cases was likely higher due to people not performing tests, or using at-home tests on their own. This recent wave of illness brought our health care system to its knees (our ICUs are still over 100% capacity in SW Ohio).
I would like to take you through a thought experiment here. These are not exact numbers, so please understand that I am trying to explain in a practical and simplified way the ongoing risk to our health care systems (Warner noted that in his following comments he is not saying that half the community is protected.)
To date, we know about 5,500 people have had COVID-19 in Highland County. Let’s say that we add another 50% to the number of natural infections due to under reporting and lack of testing, which gives us about 8,250 natural infections (this would be a very optimistic number of natural infections, but stick with me here). Add to that the 15,000 vaccinations that Highland County residents have received (and assuming no overlap with the group who have also had COVID-19, which we know is not the case), and we would have 23,250 people in our county with either natural immunity (assuming that it is effective long-term) or vaccine-induced immunity (assuming vaccine effectiveness is long-term). This would leave roughly 20,000 people in our county of 43,000 people still without any level of immunity.
What happens if that group of 20,000 people relies on natural immunity for COVID-19 and decides against vaccination? How does that impact our health care system? I honestly don’t know, but after a spike of 1,760 identified cases in August and September smashed our health care system in the nose, I am worried what it would look like if we have to go through natural infection for a large part of our remaining unprotected community.
I hope I am painting that picture in a clear way. Even in this simplified best-case scenario, vaccine-created immunity is the safest way for our community to get through the rest of our COVID-19 pandemic by reducing our chances of infection, hospitalization and death. We absolutely should find better policies and processes for recognizing and measuring natural immunity, but relying on natural immunity as the way through this pandemic is not a strategy that makes sense to our community.
Our public conversation surrounding COVID-19 could benefit from a good dose of kindness, humility and honesty. I don’t have all the answers, and neither do you. But, I hope that we share the same goal of having a healthy and safe Highland County (or whatever community you are in). We can argue amongst ourselves about how to reach that goal, but let’s not forget that we all want the same thing. That should unite us, not divide us.