Flagler County added 28 confirmed coronavirus cases in a single day today, by far the largest single-day tally of new cases, for a total of 106. But local hospitalizations, at AdventHealth Palm Coast, remain “stable,” says Flagler Emergency Management Chief Jonathan Lord, with a total of eight people hospitalized since the start of the emergency, an increase of just one since the weekend. That suggests the number of serious or severe cases of Covid-19 has not increased, even though the number of positive cases has.
Nevertheless, the overall capacity of intensive care beds at AdventHealth fell to 5 percent today–with just one bed available out of 18–according to live tally by the Agency for Health Care Administration. The hospital has 30 percent capacity in non-ICU beds.
Neither the hospital nor the local health department disclose how many Covid-19 patients are at the hospital at the moment. Nor does the department of health indicate whether hospitalizations of Flagler’s Covid-19 patients are in county or out of county. In other words, it’s also possible that out of county residents, counted as positive cases elsewhere, are being treated locally. Officials are not making that data available.
The sharply rising number of positive cases reflect in part the looser testing criteria at the drive-up testing organized by Flagler County Emergency Management and the Flagler Health Department at the Palm Coast campus of Daytona State College available since last week. The location now has at least 500 testing kits on hand, with a delivery of 250 new ones just this evening, and some 200 contributed by AdventHealth Palm Coast. The new batch of available kits wipes out the loss of an equal number emergency management experienced last week when the state ordered it to return flawed test kits the state had sent in.
Of the 28 new positive cases in Flagler, 23 are from 79 tests conducted at that location on Tuesday, says Lord, and under much looser criteria for testing. “As of yesterday officially, it’s anybody with any one symptom of Covid-19,” he said. Previously the criteria had been that individuals had to be 65 or older, have underlying medical conditions, have symptoms, or be first responders or health care workers. Instead, the drive-up location, is accommodating almost all requests, the threshold being at just one Covid-19 symptom. Even age restrictions don’t apply anymore. “Even before yesterday if someone came up and they were below the age or didn’t have any medical underlying medical conditions, we weren’t enforcing that strictly.”
The batch includes a positive test for a 19-year-old woman, the next-youngest person to test positive. A 17 year old tested positive several weeks ago. The two oldest individuals to test positive in the newest batch are both 81.
The percentage of positive cases is of concern to Lord–29 percent at that one location, in one day of testing–“higher than anything we’ve seen,” he says. It may also suggest that as the testing requirements are relaxed, it may show a far, far greater proportion of the local population to be infected–a finding becoming apparent in many other communities in the nation. That’s no surprise to Lord, who has been predicting such a spike for weeks. “Undoubtedly, we have hundreds if not thousands I guarantee you–well, I can’t guarantee you–my gut tells me we have thousands of people in Flagler County who have Covid-19,” he said this evening, and probably thousands who had it and no longer do. “That’s the next step, is the availability of antibody tests.” Gov. Ron DeSantis has ordered 100,000 such tests, Lord said. Delivery is not known.
Lord notes that the high jump in one day also partly reflects the county consolidating two days’ testing into one, since it conducted no testing on Monday, because of weather. So all those who’d made appointments for that day were channeled through Tuesday’s testing. The same thing took place today: with bad weather on its way for Friday, Friday’s appointments were moved up to today, when 80 tests were administered. Lord expects yet another spike in positive cases because of that. There will be no testing for the next several days as the county retools, trains on how to administer the new tests, and reconfigures the testing area to accommodate more tests. So testing may not resume until the middle of next week.
In total, 1,122 tests have been administered in Flagler, or just shy of 1 percent of the population. A negative test does not clear someone: it only means that the person is negative at that point. Unless the person has immunity, the person is just as susceptible to be infected as anyone else after the test.
A plus with the new testing system: the results were returned in 48 hours, faster than what this and many other communities had been experiencing until now.
Lord says the county hopes to have open testing for people of all ages in about two weeks, regardless of symptoms. “That’s my end game,” he said. Public health officials across the nation have said that much wider testing availability is key to enabling a gradual but guarded reopening of society.
Aside from the fact that local hospitalizations have not increased in proportion to the new positive cases–not yet, anyway–Flagler’s positive cases are a cumulative number dating back more than four weeks, when the first positive case was identified. Two residents with Covid-19 have died. But the Department of Health is not disclosing how many of the remainders have recovered, though it is almost certain that several have, nor is it disclosing how many of the six hospitalized individuals (other than the two who have died and had been hospitalized) have been discharged. The number of hospitalized patients is also cumulative. In the absence of those numbers, the figures tend to skew more grimly than the reality, though the reality is grim enough.
In Florida, total cases are approaching 30,000, with 4,640 hospitalizations and 987 deaths. While the number of daily, new confirmed Covid-19 cases has fallen somewhat since peaking between the first and second weeks of April, the daily number of new cases has remained well above 700 for the past eight days, and was over 900 on Tuesday.
Beyond testing for Covid-19, the county hopes the next step will be the administration of antibody testing, in tandem with Covid-19 testing. Antibody testing will show whether a person has built antibodies. “It won’t say whether you’re fighting it or had it so many weeks or months ago,” Lord said.
“Serologic antibody tests not only can confirm suspected cases after the fact, they can also reveal who was infected and didn’t know it,” the Journal of the American medical Association states. “Up to a quarter of people with [Cocid-19] infection may unwittingly spread the virus because they have mild or no symptoms.”
For now, the effort is on testing as much as possible, within the relatively still-limited means of the county.
“Just because we have rising positive numbers doesn’t mean we have rising actually sick people, especially in the hospital. I think that’s a good sign,” Lord said. But he cautioned: “It’s not time to wave the flag and say we’re good, definitely not time for that. It’s time for people to realize it is still spreading,” even as communities look to the governor for direction on when and how to reopen the economy. “The virus is still spreading, people will still die, people will still get gravely ill,” Lord continued, making the wearing of masks in public places still essential, as is social distancing. “We need to double down on that kind of stuff as the world allows us to do more stuff.”
The testing location at DSC’s Palm Coast campus has chiefly been the work of Caryn Prather, the incident commander at the location and the county’s community paramedic, and the local; health department’s Sue Reese, an emergency planner. They coordinate employees and volunteers from their agencies, Flagler Emergency Management, AdventHealth Palm Coast, DSC, and Flagler Volunteer Services, with assistance from the sheriff’s office for traffic and security. The speedy turn-around in testing is enabled by Palm Coast-based Diagnostic Solutions Laboratories, though its lab is in Georgia.
“I am beyond ecstatic and proud–I’m not the one out there–of all the folks, volunteers, employees from all different entities,” Lord said. “I’m ecstatic about the work being done out there, and the fact that it’s a multi-agency partnership, it’s something our entire community should be proud of.”