The number of patients hospitalized at AdventHealth Palm Coast on a diagnosis of covid reached 80 today, according to the Flagler County Health Department chief, a number that not long ago was closer to the total hospitalizations in the network’s 16 hospitals across Central Florida, combined. The peak hospitalizations at AdventHealth Palm Coast during January’s covid surge was 35. Hospitalizations in this fourth phase have been rising rapidly, and do not appear to be slowing.
AdventHealth Palm Coast is licensed for a total of 130 beds, though it has capacity to expand in emergencies. “That’s why they went into ‘black status,’ which basically means all hands on deck,” Bob Snyder, the director of Flagler’s health department and previously an administrator at AdventHealth Palm Coast (when it was known as Florida Hospital Flagler) said. “As a former hospital administrator, I can tell you in general that we are always able somehow, somehow, to find additional beds and places for patients to go.” But the current crisis is unprecedented.
Last night Neil Finkler, the chief clinical officer for AdventHealth’s Central Florida Division, issued a new directive, limiting all visitations with Covid patients to virtual interactions only, except for children, who may still get two in-person caretakers’ visits per day. Most non-covid patients may get one visitor at a time, but without limits to the number of visitors.
The flood of patients is the result of an unrelenting spread of the delta variant in Flagler, with confirmed infections in the last seven days totaling 900. The numbers broke down this way over the pasty seven days: Tuesday July 27, 93 infections, Wednesday, 139, Thursday, 157, Friday, 149, Saturday, 180, Sunday, 87 and today, 95.
Put another way, as many Flagler County residents got infected in the past seven days as did the total number of Flagler residents did in the first seven months of the pandemic last year, from January to Aug. 1, 2020.
The numbers have vaulted Flagler County to the tip tier of counties hardest hit in Florida, itself the state hardest hit in the nation after Louisiana, with 17,000 infections reported on two successive days at the end of last week, nearing the highest daily totals of the entire pandemic. Last week Florida accounted for a fifth of the 370 Covid deaths reported on Thursday alone across the nation. Gov. Ron DeSantis called it a “seasonal” wave that would soon subside.
But a lack of sufficient vaccination combined with the more potently infectious delta variant is powering a wave like no other. Snyder outlined the causes behind the wave: “Number one, it is the delta variant. As we know, and as we’ve learned, it can affect vaccinated and unvaccinated people in terms of transmission of the virus. Compared to prior variants and mutations, the viral load is 1,000 times more for the delta variants. Number two, we have seen a very slight uptick in the last two weeks in vaccination rates, but it is still low, comparatively speaking, meaning we’re just not seeing the numbers. It’s almost like the vaccination rate plateaued. And although we are again seeing the slight uptick, I’m going to say vaccination rates here locally are disconcerting. So we got that going. Number three, mask wearing is not universal. With the Delta variant out there, the CDC has recommended that when we’re indoors, that we don masks, and that is not happening universally in our community. It’s unfortunate because masks, based on the science and evidence, are 80 percent effective in stopping transmission of the virus. Number four, we are seeing outbreaks. We’ve seen outbreaks in a few adult homes for the elderly. We’ve seen them at day camps, and other places.”
Local governments continue to be mostly silent on the crisis, in contrast with last year’s waves, when the communications offices of Palm Coast and county governments were churning out information release after information release, and Palm Coast’s mayor at the time, Milissa Holland, was hosting weekly Covid town halls broadcast on YouTube. Individual elected officials have spoken of the importance of getting vaccinated and of wearing masks, starting with Bunnell City Commissioner John Rogers and Flagler Beach Mayor Suzie Johnston. Only today, at the end of a County Commission meeting in which Covid was barely mentioned, County Commissioners Dave Sullivan and Andy Dance delivered extended, explicit pleas to encourage vaccination and mask-wearing, and to resume the issuance of public service announcement and the bi-weekly briefings by Emergency Management Chief Jonathan Lord.
“It’s having a detrimental effect across the community,” Dance said of the ongoing surge at the hospital. ” I think if we can continue to get a message out there on the importance of vaccinations. Because of the mutations, the dangers of close contacts and masking within groups, maybe some more PSA’s that are on the radio, like we did before.”
Dance said it was important for the commission to send out the message. “Getting the vaccinations is step one, and then taking other precautions is very important in order to get this wave back down. We’ve seen the waves happen. As we take notice of waves happening, we start to get proactive in our messaging again, people become more aware and the waves come back down, and that’s the part that we’re in now is getting the messaging out about how dangerous this variant is, and the impact it could have on the community. Again, I think I support some additional PSAs and some announcements that we can get out there to the public.”
Commissioner Dave Sullivan was equally explicit. “There’s no easy solutions to this and we don’t want to go backward,” Sullivan said. “But one of the easiest solutions is that people get vaccinated provided their doctor says it’s okay to be vaccinated if they have concerns. But vaccination is the number one way to keep things under control, and I don’t really think that’s political. I think that’s just factual. There are people who have had the disease and have antibodies and that helps too, but I think we ought to continue to push towards a 70 percent rate of full vaccination, and that may help us in the long run.” Fewer than half the county’s population is currently vaccinated, and children under 12 have not yet been cleared to be vaccinated, though they can still be carriers of the disease, the delta variant especially. Sullivan, too, urged mask-wearing and renewed updates from Lord and Snyder.
Commissioner Joe Mullins also addressed the surge, but spoke mostly about himself and about how the surge should not lead to forcing businesses to close or force people to be vaccinated or wear masks, though no one in Flagler or Florida is considering such forcible measures–nor have forced vaccinations been considered nationally by governments. Some private businesses, among them Disney in Florida, are now requiring employees to be vaccinated.
Previously, the county and Palm Coast echoed Health Department messaging and releases, listing where and when residents could get tested and vaccinated. That has not been happening. The county’s and cities’ marketing departments (Palm Coast’s and Flagler County’s marketing budgets exceed a combined $1 million) remain silent on the latest surge.
The Health Department this week reconfigured its testing and vaccination strategy. Starting on Aug. 9, the department will offer testing at the county airport annex location, Monday through Friday, from 4:30 to 6:30 p.m., to accommodate Flagler County school staff, teachers and students, with rapid testing. At the same time, testing and vaccination will be taking place for everyone else at the Health Department, Monday through Friday, same times, at 301 Dr. Carter Boulevard in Bunnell.
The Health Department is again ramping up its staff to accommodate the necessary contact tracing and testing and vaccination regimens. The department used to have a staff of 56, pre-covid. Today, it’s 120 (part-time and full-time).
Snyder addressed one other point, regarding skepticism about the Centers for Disease Control’s changing guidance regarding masks. Only a few weeks ago, it had issued guidance that allowed vaccinated people to remove masks indoors. The CDC now is urging universal masking indoors again.
“The CDC is not flip flopping,” Snyder said. “This is a novel virus, meaning it’s a new virus. We have talked about the various mutations and variants that have taken place. What they are doing as new data and as new reporting that is reliable, and based on science, that as changes occur to the mutations and to the variants, as the variants become more transmissible, all the CDC is doing is responding to that reality. The reality being that the delta variant is more transmissible, and it’s more dangerous in our communities. And that is why they change their stance on masking–masking indoors. Because of the changed situation regarding the mutation and this delta variant. So it is all for good reason. This is expected. And we are not surprised, but they are not flipflopping, they are basically reacting to the reality that is before us today.”
Had the vaccination rates been significantly higher, Snyder said, the current wave would have “absolutely been avoided, Snyder said. “Case in point would be this the states up north in places that have come close to reaching herd immunity, they are not experiencing what we are here in the southeast.” Snyder said he agrees that it is “a personal choice as to whether or not you’re going to get vaccinated or to don a mask. But however, because the viral load that the delta variant carries is 1,000 times more than any previous variant, I’d like to make the case for whether you’re vaccinated or not, and whether you’re masked or not, you are part of the transmission chain, and you do have a responsibility to society to not put others in danger. And that would be people who are unvaccinated, in particular individuals who could be your family member, your neighbor, your parent or your grandparent or an innocent stranger who, by chance, is not vaccinated either and who was elderly and has chronic conditions. So yes, you have a responsibility to society to do the right thing.”