Flagler County’s covid-related deaths reached 73 this week, up five since last week, according to the Flagler County Health Department, as the slow but rather steady pace of vaccinations continue in the ongoing obstacle race toward local herd immunity.
That immunity, considered to be attained once between 50 and 70 percent of people have either been infected or been vaccinated, is still distant, and local infections are still rampant: after a dip to 264 cases in the week ending Jan. 24–the first decline after five successive record-breaking weeks of case loads–total cases again rose to 302 last week. The numbers appear less dire this week, though Friday’s and Saturday’s totals have yet to be recorded.
Even with lower case loads, the weekly totals are almost triple where they were during the summer spike. The positivity rate remains between 12 and 15 percent, high enough that the court system has extended its suspension of all jury trials until further notice. As of Thursday, Flagler had recorded 5,405 coronavirus infections (including 66 cases to non-Florida residents in Flagler), of whom 301 were hospitalized, including three children 14 or younger. Just under a quarter of those hospitalized have died. All but seven deaths involved people 65 and over.
Based on 2019 figures tabulated by Florida Charts on Flagler County’s leading causes of death, the 73 deaths attributed to covid in the 11 months since the first death now make the virus the fifth leading cause of death in the county on an annualized basis, after cancer, heart disease, stroke and chronic lower respiratory disease. More people have died of covid in that 11-month span in Flagler than all deaths in 2019 from suicide, car crashes and Parkinson’s combined.
Hospitalizations on a primary diagnosis of covid-19 at AdventHealth Palm Coast have fallen significantly in the last two days, after peaking at 35 on Jan. 15 and falling to 26 at the beginning of the week, then 15 on Thursday and 16 today.
“There’s kind of a disconnect between perceived risk out there and actual risk,” Dr. Stephen Bickel, the medical director at the Flagler and Volusia County Health Departments, said this morning in a joint appearance on Free For All Fridays with the department’s director, Bob Snyder, and its spokesperson, Gretchen Smith. “There’s still a lot of covid. Don’t get infected before you get vaccinated, please.”
Bickel said the nation may be halfway to herd immunity, “but we want to get the rest of the way there with vaccinations, not with infections.”
Meanwhile, vaccinations continue in the county on four fronts, though numbers are certain on only three of those fronts.
The Flagler Health Department has so far received 5,800 doses, “and only 30 have not gone into arms, so we’re 99 percent effective in getting them into arms immediately,” Snyder said. Publix stores in the county have received 1,800 doses and administered 50 percent of them, Snyder said. AdventHealth Palm Coast received 1,100 first doses and administered them all (it was the first institution in the county to receive doses in December). It has received an additional 1,100 second doses, though Snyder did not know how many of those had been administered. There was no number of shots administered in assisted living facilities and nursing homes, which had been the responsibility of CVS and Walgreens pharmacies until the state decided that the two companies were not rolling out the vaccine efficiently enough, and assigned the task to a different company.
“The largest share came to us that we take care of at the fairgrounds,” Snyder said. The health department administers its shots in systematic rounds at the Flagler County Fairgrounds. Thursday alone, it administered 800 shots.
The state health department’s latest tally indicates that 9,451 people in Flagler County, or 6.3 percent of the county’s population, have received a first dose, and 2,349 have received a second dose. The percentage may not be entirely attributable to Flagler County residents since any Florida resident can go anywhere in the state to receive a shot. But that means the percentage of local residents who have received a shot could be slightly higher or lower. The first-dose vaccination rate in Florida so far is 6 percent.
There have been reactions to the second shot. “It kind of hit me like a truck, and a lot of people say that,” Smith said of receiving her second shot recently. “I’d rather have it for one day than two weeks and possibly end up in the ICU.” She had a fever and “felt terrible” for 24 hours.
“We’re hearing that about 50 percent of the people who get the second shot get a little bit of a greater reaction than the first, and it lasts for less than 24 hours,” Snyder said. Bickel attributes the reaction to a revved up immune system rather than to anything alarming.
But the vaccine in Flagler continues to be severely restricted to first responders such as paramedics, health workers and people 65 and over–not law enforcement officers, not teachers, not anyone else on the front lines.
“We’re very disappointed that the governor changed his executive order,” Sheriff Rick Staly said this morning. Law enforcement had originally been on the priority list, only to be removed by the governor. “I understand his reasoning behind it,” Staly said. “The problem is that my deputies are interacting with a few hundred people a day and we don’t know if they have it or not. And if my deputies get sick, it impacts our budget, it impacts overtime, it impacts our ability to serve the community, so unless they have a medical-qualifying or age, right now they’re not getting it. But yet that’s not the same across the state, because I talked to the Franklin County Sheriff up in the Panhandle, and all his people have gotten it. So there’s either some health departments that aren’t following the governor’s direction in allowing it. Dennis [Lashbrook, the detective] told me just this morning that Volusia County deputies had received theirs when he was working with them. So there’s clearly differences across the state, which is unfortunate.”
No Flagler County Sheriff’s deputies have been hospitalized because of covid, though family members of deputies have died from it. “We’re not immune by any means to it,” Staly said. “We saw a spike in the Sheriff’s Office after Christmas and New Year’s, so our employees do what the community does, and unfortunately, some of them contracted it.”
Flagler County Emergency Services has logged some 11,000 names of local residents who have called to be placed on a waiting list to receive vaccines. Those residents are now getting priority as the health department receives its weekly allotment of 800 first doses.
Those not on that list may call 866-201-1541 to get on a new list administered by the state. It’s an automated process. Callers are asked their basic information and placed on the list. Once the county has run through its existing list, those on the state list will start getting calls and notices with appointment times for their first shot. Those who want to talk to an actual person and ask questions about the process can call 833-540-2038.
But for now, the flow of vaccines remains slow, even as a third vaccine readies to join the market. That’s the Johnson and Johnson vaccine. But it’s not as effective as the Moderna vaccine being administered in Flagler, or the Pfizer vaccine being administered elsewhere. Snyder said it’s about 72 percent effective, but 85 percent effective when it comes to preventing grave hospitalizations. The Moderna and Pfizer vaccine’s effectiveness–before the new strains of covid were detected–was in the 95 percent range. Moderna saw a ” a six-fold reduction in antibodies against the South Africa variant,” according to Axios, the news site. “Even still, the neutralizing antibodies generated by the vaccine “remain above levels that are expected to be protective,” according to the company.” Moderna is developing booster shots to protect against the new strains.
Regarding the Johnson and Johnson rollout, “people are going to have to make a decision,” Bickel said. “Do they go for this now versus wait a few more weeks or a month or two for the other one.”
Toward the end of the radio segment this morning David Ayres, host of Free For All, asked Snyder and Smith a pointed question about vaccine deliveries to Flagler: “Are we getting our fair share?”
“That allocation decision is made by the Department of Health,” Snyder said after a moment’s hesitation. “I expect 800 first doses next week. We would love more.”
“I thought it was a yes or no question,” Ayers said.
“I would say no,” Smith said. “No, absolutely,” Snyder said.
“I know you make Tallahassee nervous being on this radio show,” Ayers said, an allusion to a state health department that has tended to want its message strictly controlled, though the department is not in charge either of how much vaccine Florida gets, or of how it gets distributed. That’s a decision originating with the state emergency management division, which is itself hamstrung by what it receives from the federal government, with only a few days’ notice. “Come on Tallahassee, let’s get some more over here to Flagler County, I’ll say that,” Ayers said.
Even if more vaccines flood in, Bickel said, “the key here is how many people we eventually get vaccinated,” which may become a challenge even when there will be enough vaccines to ago around–and possibly more vaccines than can be absorbed, given the multiplicity tracks of companies preparing to market their version. Flagler’s population has a reputation for being among the more vaccine-resistant in the state, a resistance Bickel and Snyder have been trying to overcome since well before the covid pandemic.
“We can achieve herd immunity even locally in Flagler County,” Bickel said. “There’s nothing to say we can’t get 70 or 80 percent of the population here vaccinated, in which case we’ll be kind of a little bubble of pretty good herd immunity. That’s when March, April, when we’re going to have a lot of vaccine, is going to be really important, is how high we can get that percentage of vaccinated in the community number up.”