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The Looming Fifth Wave ‘Very Frightening,’ Doctor Says
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Friday, January 7, 2022
 

STORY AND PHOTO BY KAREN BOSSICK

Expect you’re going to get the Omicron variant, and get vaccinated to protect yourself and others around you.

That’s the advice a St. Luke’s physician gave during a media conference Thursday afternoon amidst a surge in new COVID cases across Idaho.

Dr. Kenny Bramwell, St. Luke’s Children’s System medical director, told reporters that people avoided getting sick during the initial phases of the coronavirus pandemic by hiding out at home and avoiding people. But now, partially because people are spending more time in public and partially because the Omicron variant is so much more contagious, it’s very likely someone will get COVID, he said.

“People are contagious before they display symptoms,” he added.

Dr. Steven Nemerson, chief clinical officer for Saint Alphonsus Health System, concurred:

“At the beginning of the pandemic two years ago I made the comment that the train was coming but by covering our faces and social distancing we could turn the train around. The train’s coming back, very much like the beginning of the pandemic again. And this time it’s going to flatten us, quite honestly.”

Idaho Health and Welfare reported 1,411 new cases of COVID statewide on Wednesday and 1,765 new cases on Thursday. The 14-day moving average of new daily cases increased from 327 on Dec. 23, 2021, to 621 on Wednesday, Jan. 5.

Hospitalizations statewide have increased from 225 on Christmas Eve to 274 on Jan. 3. At Saint Alphonsus COVID-related hospitalizations have increased from 20 two weeks ago to 43 on Thursday.

Blaine County reported 96 new cases on Tuesday and 67 more on Wednesday—a surge that South Central Public Health District public information officer Brianna Bodily attributed to outbreaks in restaurants and other facets of the hospitality industry in the Sun Valley area. It posted 163 new cases on Thursday for a total of 3,953 official cases since the pandemic started two years ago.

While Bodily expressed hopes the county’s high rate of vaccination will keep COVID hospitalizations in the county low, the surge prompted  St. Thomas Episcopal Church to modify its first-ever Epiphany celebration with the Hispanic community, canceling the fiesta part of the celebration.

“St. Thomas wants to be a church for everyone. It has always considered itself a village church—its new logo says ‘the village church,’” said Marcia Liebich, of the celebration that was originally to have had children dressed up as wise men followed by presents and a buffet of food. “As it was we did have 80 to 90 participants with the King's cake, take-home tamales and chocolate and gifts for the children. We had COVID worries but managed to mask inside and not gather too long outside."

In response to the surge, the Sun Valley City Council voted Thursday afternoon to extend its public health order requiring facial coverings in indoor public places to Feb. 3, 2022, unless it's earlier rescinded or further amended and extended by the City Council.

HEALTH CARE WORKERS GETTING SICK

Dr. Stephen Nemerson called the big picture “very frightening.” St. Alphonsus has 125 employees out with COVID, up from 14 a few weeks ago, he added.

“This dramatically affects our ability to take care of patients. That means longer lines for care, longer time periods to be seen, expansion of staff to take care of more patients, fewer beds available,” he said.

If the trend continues, Idaho’s hospitals could be forced to again operate under Crisis Standards of Care, which provides guidelines on which patients to treat when staff and other resources are limited.

Hospitals may need to go into Crisis Standards of Care sooner than they did during the surge caused by the Delta variant, he said, noting that Saint Alphonsus was caring for 170 COVID patients during the previous Crisis Standards of Care.

Nemerson said hospitals were not forced to ration care while under Crisis Standards of Care in Fall 2021.

“But I’m afraid that may happen this time because our resources are more strained and our flexibility less, and functionally that means we’re going to be able to care for fewer patients” he said.

Bramwell noted that nationally the number of patients with COVID is doubling and quadrupling at many facilities. Some facilities are not offering numbers but they say they’re the busiest they’ve ever been, he said.

Historically, Idaho is two to five weeks behind the rest of the country, he added.

Currently, more than 10 percent of hospital patients in St. Luke’s Health System have COVID and more than 30 percent of those in ICU have COVID, said Dr. Laura McGeorge, St. Luke’s System medical director. Hospitals are extremely busy as they get caught up on surgeries that were delayed by earlier COVID surgeries and as winter-related infections come on strong, she added.

On Thursday there were only three pediatric patients at St. Luke’s Children with COVID. But Bramwell said he is concerned what could come with schools back in session. Only three of Idaho’s 115 school districts—one of them being the Blaine County School District--have mask requirements, he noted.

“That’s a concern when you have 25 kids in a classroom six hours together with a very contagious environment,” he added.

DEMAND FOR TESTING CLIMBS EXPONENTIALLY

Doctors have seen an exponential increase in the demand for COVID testing even since Monday, said Dr. Laura McGeorge. The hospital system has gone from being able to turn around a test the same day or overnight to it taking several days to sign up to get a spot to get tested, thanks to supply chain and staff shortages, she said.

Dr. Mark Nassir, president of the Saint Alphonsus Medical Group, said his system, too, has gone from administering 200 tests a day to as many as 400 a day. And those getting tested have a 27 percent positivity rate. That means one in four people being tested has COVID, reflecting the increased spread in the community, he said.

Those wishing a test should not go to the emergency room or primary care doctor, as everyone’s extremely busy taking care of patients right now, McGeorge said.

“If you have symptoms and are having difficulty getting tested, use your judgment, assume you have COVID and isolate,” she said. Ten days of isolating is ideal but five days is acceptable, she added.

The same measures doctors have been talking about for a long time, including vaccines, masks and physical distancing, can protect people, said Nemerson. Until the risk lessens, people should wear medical grade masks, which trap more of the very tiny particles that carry the virus, when they go out in public. K95 and N95 masks are most protective.

If everyone at the table is appropriately separated and wearing medical grade masks, you can feel comfortably safe, he said. If someone is not wearing a medical grade mask, distancing is very important.

McGeorge noted that “rescue therapies” that were effective against the Delta variant, such as  monoclonal antibody treatments, are not as effective against the Omicron variant as they were against the Delta variant.

“So that’s all the more reason to get vaccinated if you’ve been on the fence,” she added.

 

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