Last Updated: 3:41 p.m.
In Flagler, in Florida and elsewhere, it is a tale of two communities: the vaccinated and the unvaccinated. The protected and the slammed, the hospitalized, the dying.
The now-dominant Delta variant of the coronavirus, which is 50 percent more contagious than its predecessor, itself 50 percent more contagious than the original virus, has resulted in the fastest week-over-week surge of covid cases in Flagler, going from 88 cases two weeks ago, 240 cases last week, and 360 cases this week–52 cases per day–according to the Flagler Health Department. Wednesday alone, the Flagler Health Department conducted 75 case investigations. The week ending June 3, there were just five cases a day.
Hospitalizations at AdventHealth Palm Coast and at Advent’s hospital in Daytona Beach are unprecedented. In Palm Coast, hospitalizations for covid broke a record Tuesday, with 32 people hospitalized (and six in intensive care), and broke the record again yesterday, with 37 hospitalizations (the ICU number was not available).
But in as stark a divide as the covid pandemic has provoked, those most gravely affected are almost all unvaccinated. “Across AdventHealth’s 41 hospitals in seven states,” an internal AdventHealth document that circulated this week states, “approximately 95% of 12,700 COVID-19 patients treated this year were unvaccinated or partially vaccinated. Fortunately, the current vaccines appear to ameliorate the severity of the disease, as we have not seen many hospitalizations in the vaccinated population.” The Associated Press reports that nationwide, fewer than 1,200 of more than 107,000 Covid-19 hospitalizations affects the unvaccinated, or about 1.1 percent of the hospitalized.
In an even starker divide, more than 99 percent of the 300 people dying of covid every day are unvaccinated, or were only partially vaccinated–a proportion that applies to all the covid deaths of the last six months. Put another way: The unvaccinated have unleashed a deadly, daily carnage on the unvaccinated.
“Regarding the people who refuse to get vaccinated, my message to them is this,” Bob Snyder, the director of the Flagler Health Department, said this morning. “You do have the right to say no, but it is one thing for you to not get vaccinated to protect yourself. But is another thing to put others in harm’s way. And that can include family members, elderly neighbors, complete strangers that you pass in Publix or at the grocery store who may be unvaccinated like you, but that you unwittingly pass on that virus to others, and then they pass it on to others. And that, to me, I find that to be unconscionable. And I find that to be heartbreaking. That that that is about as brutal and as stern as I would like to get.”
But vaccinations have stalled in Flagler and in the rest of Florida. “We have been at 59 percent of eligible population now vaccinated for the last three weeks , 59 percent of our community, eligible,” Snyder said. But the actual number, population-wide, is 52 percent. “And that that equates to last Friday that equated to 61,632 people. And that hasn’t changed hardly at all. Of course we’re doing some, but it’s nowhere near the volume that we were doing two months ago, in terms of vaccinating people.”
There are no immediate plans in Flagler County or Flagler Beach government to change meeting or event protocols. “Right now no changes. But if this trend continues, then it’s going to have to be a conversation in the future,” William Whitson, the Flagler Beach city manager, said this morning. “Any surge that’s beginning to happen is from the unvaccinated so I would encourage and the city would encourage people to do the right thing now.”
“The City of Palm Coast has not changed any policies or procedures at this time,” a city spokesperson said this morning. “We continue to have a work from home policy that employees can use when appropriate. The 911 Communications Center has re-implemented Covid screening questions for medical fire calls. Our Fire Department has recommended PPE to their first responders since the pandemic began and that is still in place. The Health Department is continuing to recommend that people go and get vaccinated if they haven’t already. We do let employees know that if they wish to receive the vaccine, it is available for free at the health department and all local pharmacies.”
Palm Coast is in the midst of a special election for mayor, culminating on July 27 with in-person voting. Early voting is ongoing until Saturday. “We cannot require voters to wear a mask or face covering, nor could we during the 2020 election cycle,” Elections Supervisor Kaiti Lenhart, who is running the election for the city, said today. “Many of our workers prefer to wear a mask. Others have been vaccinated and have chosen not to wear one. For those who have not been vaccinated, we encourage them to wear a mask or face covering. With only one race on the ballot, the voting process is not taking a very long time. There have been a few waiting to vote when the polls open at 10:00 A.M., otherwise no lines. Voters are not spending much time together in the polling room.”
To those concerned about mingling too closely with others, Lenhart recommends taking advantage of the last days of early voting specifically at the Elections Office in Bunnell (at the Government Services Building, 1769 East Moody Boulevard), where turnout has been lower than at the two other early voting locations.
The school board had not yet responded to questions before this article initially published.
Nor has the local health department proposed any changes, or is aware of any change in course from the school board, which is preparing to reopen schools fully, without remote options (other than the standard virtual school option that was in place before the pandemic). The back-to-school “jam” is scheduled for Aug. 7 at Flagler Palm Coast High School. But, Snyder said, “if you are unvaccinated. You need to reconsider wearing a mask, especially when you’re in indoor congregate settings.”
In the Central Florida region of AdventHealth’s facilities, which include some 20 hospitals and emergency rooms, there were 720 patients hospitalized with Covid, which surpasses the May peak of 500 hospitalized patients. In January, it was 900. ” I will tell you that the the rate of rise is somewhat concerning,” said Dr. Neil Finkler, Chief Clinical Officer for Adventhealth Central Florida Division, in a morning briefing. “We are now seeing about the fastest rate of increase that we have seen during the course of this entire pandemic.
The chance of a patient coming into a CentraCare facility with an illness is one in four that the patient has covid. Just a month ago, it was a 7 percent chance.
Masking is again essential. “Our biggest problem with this virus is asymptomatic spread,” Dr. Tim Hendricks, Senior Medical Director at Adventhealth Centracare, said. “So we see people that have the virus, don’t know they have the virus, and have the potential to spread. So as the numbers rise in the community and there’s a higher rate of transmission our community, it’s best that we all wear masks because even though we’re vaccinated, there still can be some breakthrough cases and there’s still the possibility of transmission. So it’s safest for everybody to wear masks at this time because we know they are highly effective. The evidence shows a mass can stop the transmission of the virus from 70 to 80 percent in terms of effectiveness.”
The AdventHealth system in central Florida is again on yellow status, with elective surgeries limited or deferred, visitation restrictions back in place, and masking requirements even in non-clinical spaces. Outpatient sites, labs pediatric surgeries continue as scheduled. Regarding visitations, patients that do not have covid will be allowed no more than two visitors at a time. Covid-positive patients will be allowed one visitor per day, or two adult caregivers per day if the patient is under 18.
The system’s many hospitals enables it to transfer patients from hospitals that are overrun to hospitals that aren’t, and it has the capacity–in Palm Coast as elsewhere–to convert regular beds into ICU beds, though that has not yet been necessary this time around.
The physicians attribute 85 percent of all covid cases to the Delta variant. “We do see breakthrough cases,” Finkler said, “but the vast majority of people that have been vaccinated and get Covid have mild cases. And rarely do they require hospitalization and even rarer do they ever require intensive care unit stay, and in fact in our facilities today, about 95 percent of all of our inpatient beds for Covid positive patients are in the unvaccinated.”
In Palm Coast, the average age of the patients in the hospital was 67. Today, the average age is 47. “I don’t see any differentiation between African American, white, Hispanic, it’s just in general, the younger population groups have obviously not decided to get vaccinated,” Snyder said. The department is conducting a radio campaign to get more people vaccinated. It will be recording children to encourage younger people to get vaccinated. It’s encouraging the hesitatnt to speak with their primary physician or with Health Department officials “so that we can walk you through it and answer your your questions from data,
evidence based viewpoint, but listen to your concerns.”
What about those breakthrough cases–cases of covid infections in people who are vaccinated? “These vaccines, especially the Moderna and Pfizer, with this, mRNA technology, these protects us all, the majority of us, and that it’s still 95 percent effective,” Snyder said. “Yes we’re seeing breakthrough cases but they are rare, and if there is a breakthrough case, the evidence indicates that people have less severe disease, and they don’t end up in the hospital.”
Locally there is no evidence of a vaccinated person dying. And where there is evidence of it in the United States, it’s almost statistically insignificant: Texas has had 9,000 Covid deaths since February. Only 43 were vaccinated (0.5 percent). The Pfizer vaccine is 88 percent effective against symptomatic cases of the delta variant, the Texas Tribune reports, “and 96% effective against hospitalizations, according to Yale Medicine. Researchers are still studying the efficacy of the Moderna vaccine against the delta variant but believe it may work similarly to Pfizer.” The Johnson and Johnson vaccine is less effective, as are some of the vaccines used in Europe.
“And aren’t we better off getting the vaccine to avoid getting getting sick, getting the Covid disease, ending up in the hospital,” Snyder said. “I mean all you have to do is just look around you, and look at what’s happening, happening nationally, regionally at an every single county in the state. I mean to go from five cases a day to 52 cases a day is just an unbelievable surge, and it should tell us a lot.”
It was “all avoidable, all preventable, all preventable,” Snyder said.
Flagler County Health Department Chief Bob Snyder will discuss the surge on his weekly appearance on Free For All Fridays on WNZF starting a little after 9 a.m. Friday.