The covid numbers are falling across the board: in the community, in schools, in hospitals locally and across Central Florida, but with a caveat: the numbers today, while falling, are at the exact point where they were at the height of the winter wave–the third and until then most severe wave of the coronavirus pandemic.
“That’s why we have to it in perspective, I’m so happy about everything coming down, all case, students, and hospitalizations, everything,” Bob Snyder, who heads the Flagler County Health Department, a state agency, said this morning. “We’re not over this yet, matching the peak of the previous surge. So we just want this to continue, encouraging people to please get vaccinated as the only way out of this.”
In the week ending Sept. 17, Flagler County recorded 401 confirmed covid infections, not including home testing, down from 483 the week before and down from the peak of 937 the week ending Aug. 27. The Flagler County school district ended the week Friday with a cumulative total of 1,135 infections among students and employees, compared with 1,048 the week before, for a weekly total of just 87 infections, a sharp drop from the previous week’s total of 175, and the week of Aug. 27, the peak week, that saw a total of 368 infections in the district.
The declining numbers are lessening the pressure on school officials to take stricter safety measures in schools. Flagler County schools have no masking requirement, leaving it to parents and students to opt for masking or not, in accordance with state orders. Those orders are being contested in court, but remain in place pending the disposition of a case. But Snyder said masking, distancing and frequent hand-washing remains the recommendation of public health authorities, especially masking indoors, with gatherings of significant numbers. Snyder rejected the claim that the recommendation contradicts the state orders: the two are not incompatible, he said.
“The order is the order, the recommendation is the recommendation,” Snyder said. “I have not met a reliable, pro-science, intelligent, know-what-they’re-talking about public health official, researcher or scientists who disagree that vaccinations and mask-wearing are mitigation strategies in addition to social distancing and washing our hands and all the other things that we have been talking about since the beginning of the pandemic.”
For the first time in four weeks, vaccinations outpaced covid-positive confirmations in Flagler, but that’s a result of declining covid cases, not increasing vaccinations: the actual vaccination totals declined for the seventh straight week, to just 445 shots. In the county as a whole, 71,109 people have received at least one shot. But the number–the only total the state Health Department is issuing–is misleading, because it does not distinguish between first and second shots–between people who have had only part of their vaccination and those who have completed their cycle, and it isn’t clear whether the figure also now includes people receiving third shots, or booster shots. Based on that incomplete figure, the state projects a 68 percent vaccination rate among those 12 and older in Flagler. That percentage is also misleading, since herd immunity applies to a population as a whole, accounting for all those who are susceptible to infection.
Based on the more accurate figures from the Centers for Disease Control, only 55 percent of Flagler’s total population has been fully vaccinated. The proportion for those 12 and older is 61 percent, not 68 percent. The proportion of those 18 and older is 63 percent. And the proportion of those 65 and over is 83 percent.
The number of patients hospitalized on a primary diagnosis of covid-19 at AdventHealth Palm Coast was 38, down from a peak that had approached 100 in mid- to late August. The number of hospitalized patients across AdventHealth’s Central Florida network was 850, half where it was a few weeks ago, enabling the system, including the Palm Coast hospital, toi return to so-called green status, meaning business as usual. Flagler Hospital in St. Augustine is reporting a similar downward trend, with just 26 patients hospitalized with a covid diagnosis as of today, compared with 51 on Sept. 8.
“The numbers are still very large and although we are happy to see a decline, I think we need to put this in perspective,” Dr. Neil Finkler, Chief Clinical Officer for AdventHealth Central Florida, said in a Thursday briefing, echoing Snyder. “Our peak in the January surge was right around 850, 900 patients. So although we’re really pleased today, the reality is that we are where we were in mid-January during the course of that surge. We’re obviously down and I think the fact that we’re now moving to green really speaks to the fact that we have now learned a lot about what to do with covid, how To Treat covid and how to deal with those three S’s that we’ve always talked about–our space, our staff and our stuff constraints. So I think this really represents a movement in the right direction, but we are by no means out of this and the fact that we move to green, and have moved to green, nobody should think that this pandemic is over yet.” Finkler added: “We need to stick with what we know works. So not only get vaccinated, but socially distanced when you’re in crowds, wear a mask and constant hand washing.”
Finkler sought to dispel continuing if minority assumptions that vaccines may not be as effective as claimed: “Let’s get the record straight,” he said. “The vast majority of patients that are hospitalized and in our ICUs remain the unvaccinated. When we look at the group that is vaccinated and in our hospitals, they tend to have other risk factors, whether they’re immunocompromised, obesity is a big factor that we’re seeing in the vaccinated. But we also know that based on what we have seen in the fully vaccinated group, we do know that immunity appears to wane somewhat over time, and that the delta variant is a far more virulent virus than what we’ve seen before with the other variants. And that really has led to the fact that we do see more vaccinated patients fully vaccinated patients in the hospital today. That’s now at around 14 percent, the last time I looked. But that means 86 percent of the people that are in our hospitals remain unvaccinated.”
Children and teenagers are still the wild card. “Typically throughout this pandemic children have been the age group with the least number of infections but we did see them become the highest number of infections after school started,” Dr. Tim Hendricks, senior medical director for AdventHealth CentraCare, said at the same briefing. “That has declined. But still they’re in the top three age groups. The age group that we’re seeing the most infections right now are the young adults over 18, 18 to 30 year olds, college aged students. That has always been the most common positive test that we’ve had, so it is concerning, we’re watching children very closely. We hear about quarantines in classrooms and kids being told to go get a test. So we’re seeing a lot of that testing at CentraCare.”
CentraCare is on the front lines of the pandemic, so it acts as an early-warning system of what’s ahead. “So I anticipate that we’ll continue to improve in terms of our capacity status at the hospital, probably in the next few weeks,” Hendricks said. “But as Dr. Finkler will tell you, it takes a few weeks to get people out of the hospital. Once they’re in there with covid they do stay longer than your typical patient.” Hendricks downplayed the focus on positivity rate, as used to be the case, noting how even in June, when cases seemed to be very low and positivity rates had fallen to around 7 percent, that did not prevent the next surge from overtaking communities and their hospitals. The focus, he said, should be on vaccination rates. “So we want to really maximize vaccinations overall,” Hendricks said.
Snyder said monoclonal therapy has also played a role in lessening the number of people needing hospitalization, with a monoclonal therapy center open at Daytona State College’s Palm Coast campus.
And adverse reactions to vaccines? “The answer is no, we’re not seeing a lot of reactions,” Hendricks said. “This is a very safe vaccine. The reaction rate reported is about one in a million, and that is the same as influenza vaccines that are about one in a million, they’re allergic reactions. In our urgent care centers at most we’ll see the typical side effects of arm soreness or maybe fatigue and fever afterwards but we see the same thing after the flu shot. So all vaccines will have that and I tell people: Look, if you don’t feel good after your vaccine, that means it’s working. It’s kicking up your immune system. You’re building up good antibodies. But don’t worry if you don’t have any side effects you’re still making those antibodies.”
Meanwhile, the more people get vaccinated, the better for the community as a whole: “It will also give the virus less opportunity to actually find hosts to mutate to get yet another variant,” Finkler said. “Vaccinations help the individual helps your loved ones and helps our community.”