Last Updated: 8:34 p.m.
“The biggest thing this illustrates is how utterly predictable all this is,” says Dr. Stephen Bickel, the Flagler Health Department’s medical director, as he sums up what is shaping up to be the fourth Covid wave of the pandemic, now sweeping over Flagler and Florida, as it does over other regions where vaccination rates are lower than they could be.
There were 88 new confirmed covid-positive cases in the week ending July 9 in Flagler, the highest total since the first week of May, when case loads were falling. Since the end of March, case loads had fallen for nine of 11 weeks. Since mid-June, case loads have risen for three straight weeks, and are expected to rise again this week, including outbreaks at Flagler Fish Company in Flagler Beach (which posted a big, red “Help Wanted” and “hiring immediately” sign for cooks and dishwashers this afternoon on its Facebook page), at Palm Coast Lanes, the bowling alley, and at Rymfire Elementary’s summer program. All this despite a significantly lower amount of covid testing.
Flagler’s 14-day infection rate places it 36th highest out of Florida’s 67 counties as of today, though the county has not registered a death in those 14 days even as hospitalizations have risen 17 percent.
Case loads are rising sharply across Florida, reaching a seven-day average of over 5,000 per day today. Hospitalizations are also up locally, in Central Florida and the rest of the state (there are some 20 hospitals and emergency rooms in the seven-county central region), with 12 people hospitalized at AdventHealth Palm Coast, the highest tally since last spring, and 430 people are hospitalized in the network’s Central Florida hospitals, up by 100 over last week–with zero infections of hospitalized people who were fully vaccinated. In other words, every one of the 430 hospitalized patients are either unvaccinated or did not complete their vaccine sequence of two shots.
That tally of 430 people does not include those hospitalized for Covid in the many non-AdventHealth hospitals in the region: writing on his Facebook page this evening, Dr. Stephen Sevingy of Daytona Beach said: “Worked at Halifax today. One of the worst day of ER Covid admits I have seen in the last year and a half. Easily rivaling this January or last April. Please wear your mask and absolutely get vaccinated.” He later added: “In the last two days I have seen 37, 38, 57, 58, 61, 60, and 70y.o.’s with scans classic for Covid pneumonitis.”
Children have not been affected by the rise in hospitalizations, even if they get sick, at least not yet in Florida. That’s not the case in Mississippi, the state with a vaccination rate of 34 percent, where seven children are in intensive care with covid, two of them on ventilators. The children are ages 1 to 17.
“The community’s cases in Florida are up over 200 percent in the last two weeks,” Dr. Vincent Chu AdventHealth executive director of infection prevention and an epidemiologist, said in a briefing this morning. “And what we see in hospitalizations is that it really mirrors what we’re seeing in the community. A certain percentage of those new cases will be hospitalized.” There are reports of fully vaccinated patients that have gotten gotten infected, he said, but “the data is pretty good that it protects against serious infections hospitalizations and deaths.”
Florida has by far the highest number of cases per day, but it ranks third in proportion to its population, with Arkansas and Missouri ahead, and Nevada, Louisiana, Utah, Wyoming, Oklahoma, Mississippi and Arizona in the top 10–all states where vaccination rates are below the national average of 48 percent. Florida is at 47 percent, several states are in the 30s. But Cases are rising across the country, even in high-vaccination states, albeit at much lower acceleration rates in those states, where their baseline had already been significantly lowered (as it had not in Florida).
Meanwhile, vaccination rates in Flagler have slowed “to a crawl,” Bickel said, increasing by a percentage every week or two only. In Flagler, 48 percent of the population is fully vaccinated, including 56 percent of those 18 and older, and 80 percent of those 65 and older.
“The thing about these epidemics, they follow these mathematical formulas,” Bickel said. “You can put in the numbers and crank it out, you know what’s going to happen down the road.” Numerous people who are not at particular risk of death or hospitalization stopped practicing safety norms, but combined with a lack of vaccination, they in essence invited infection. Being younger, they are not at high risk of death or even hospitalization, but some will be hospitalized, and many could feel the effects of “long covid,” the syndrome that the Centers for Disease Control, describes as “a wide range of new, returning, or ongoing health problems people can experience four or more weeks after first being infected with the virus that causes Covid-19. Even people who did not have Covid-19 symptoms in the days or weeks after they were infected can have post-Covid conditions.”
The accelerant in this fourth wave is the Delta variant.
“We have a variant that is probably more than twice as contagious as the original,” Bickel said. “The UK variant, the Alpha, is probably 50 percent more contagious, the Delta is at least 50 more percent contagious compared to the Alpha, so more than double. You can just do the math as to what’s going to happen. We’ve got these people who feel Covid is not just that big a deal. But how big a deal is getting vaccinated? It’s a nothing burger.” Those who oppose vaccination at times make risk-calculations, concluding that they may experience more harm from the vaccine than the risk of getting infected. That approach is factually wrong, given the actual outcomes of covid illnesses as opposed to the overwhelming safety and efficacy of the vaccine. Nevertheless, the false calculus persists.
Dr. Michael Keating, Chief Medical Officer of AdventHealth for children, put it this way: “If you go to the PDR and you look up Tylenol, you wouldn’t give your kid Tylenol because they they list every complication from the medication. What they don’t tell you is the denominator of children that have taken Tylenol and did perfectly fine for it. So in my mind, the risks of the vaccination are far outweighed by the potential problems by getting the Covid itself so I strongly recommend a vaccination for those reasons.”
Bickel places the Delta variant’s prevalence at 50 percent, at least, while Chu said it may be in the 70 to 80 percent range in the United States as a whole.
All this as schools in Flagler prepare to reopen in a few weeks, though it’s not as simple as waiting until the last week to get vaccinated.
“If you were to get a Pfizer vaccine, you’d have to wait two weeks for your second dose,” Keating said. “It’s been shown that you will get some efficiency from the vaccine on the first dose, but to get complete immunity, you’ll probably have to wait another two weeks. So we’re talking about four to five weeks until you’re probably fully protected against the virus. But ‘fully protected’ is kind of a qualified statement because I think there’s a misconception about vaccines.” Keating said that the vaccine “doesn’t make you bulletproof against the Covid viruses, but what it does is it basically puts Kevlar on you so you’re not going to feel the full impact of the virus.” (Vaccine appointments are available to anyone 12 and older at CentraCare.org. AdventHealth is also offering vaccines to all patients in the hospital as part of its efforts to make the vaccine easy and accessible to the community. Elsewhere, see vaccine options here.)
The CDC recommends that in schools, anyone not vaccinated should still wear a mask when interacting with others, such as teachers and older students. “As those who are vaccinated, that’s somewhat of a more loaded question,” Chu said. “The CDC officially in their guidance says it’s optional, but in what we’re seeing with Delta, with the cases rising, with the reports of infections that have occurred in fully vaccinated individuals, it is advisable and I would recommend that we strongly consider wearing a mask, even if you have been fully vaccinated.”
Bickel said this wave is not nearly as damaging as previous waves, especially since most of the elderly, who are most vulnerable, are vaccinated. But the wave is just as unnecessary as previous waves, with each serious sickness preventable.
“If we could get 90 percent vaccination rate there’d just be almost no covid,” Bickel said. “We wouldn’t have to worry about variants, we wouldn’t have to worry about rebounds, reinfections. Because we can’t get there, all these long-term issues are still in play.”
Bickel will be on WNZF’s Free For All Fridays on July 16 at 9 a.m. with AdventHealth’s Wally de Aquino, further discussing the current wave.