Flathead’s July COVID Surge Marked by Six Deaths, Steeply Rising Hospitalizations

Fueled by a low vaccination rate, Flathead County is the epicenter of the state’s current COVID-19 surge, accounting for more than one-fifth of all active cases in Montana while experiencing hospitalization numbers that are nearing the pandemic’s November-December peak.

In addition to COVID-19 patients exceeding 20 at Logan Health every day last week, including 26 on July 30, six Flathead County deaths were attributed to the virus in July, although that number could potentially grow. Due to lag times in officially reporting and confirming deaths, any deaths occurring during or stemming from the surge’s end-of-month acceleration likely wouldn’t yet register in the data.

Flathead County’s rolling average of new daily cases during the last two weeks of June was a mere six, according to local health department data. From Monday through Friday last week, new cases averaged 43 per day, followed by 75 new cases reported on Saturday alone, a massive one-month uptick. The county had more than 350 active cases on Monday.

Health Officer Joe Russell said the health department is now redirecting staff and hiring new temporary staff for contact tracing investigations in an effort to keep up with the soaring caseloads.

“The cases are just blowing up,” Russell said. “We’re trying to get back to a COVID response staff that can handle the work.”

Health officials point to the county’s low vaccination rate, as the majority of new cases and nearly all hospitalizations are among the unvaccinated population. Only 40% of Flathead County’s eligible population is fully immunized, the lowest among the state’s most populated counties. Missoula County leads the state at 61%, followed by a number of counties in the mid to high 50s.

Public health experts say unvaccinated Americans represent about 97% of COVID-19 hospitalizations nationwide and more than 99% of recent deaths. Those numbers are reflected in local trends.

Dr. Cory Short, a hospitalist and acute-care physician leader at Logan Health, said a “handful” of hospitalized COVID-19 patients have been vaccinated, typically elderly. But the vast majority of patients are unvaccinated. While some have underlying conditions that impact their vaccine eligibility, most of the unvaccinated have chosen to decline the shot.

“If I was going to give one message, it’s get vaccinated,” Short said.

The health department hosts a vaccination clinic every Tuesday, which Russell said saw more walk-ins last week, perhaps providing anecdotal evidence of residents responding to the surge by seeking protection through vaccination. Russell, however, acknowledges that overall “we’re not seeing a tremendous uptick in people wanting to get vaccinated.” He hopes pharmacies offering vaccines are getting traffic.

 “I’d love to see more people get vaccinated,” Russell said. “I really do believe it’s the key.”

Russell said on Aug. 2 that the county has only identified 66 breakthrough cases since Jan. 1, which he says is evidence of the vaccine’s effectiveness. 

“That’s an extremely low number,” Russell said.

Public health experts note that as the virus circulates among unvaccinated populations, the chances increase both for breakthrough infections among vaccinated people, including the most vulnerable, and further mutations, potentially worse than the current ones. Even when the highly contagious Delta variant produces breakthrough cases, the symptoms, if any, are rarely worse than mild.

“There’s a lot good data out there that suggests if you get vaccinated you’re likely going to avoid the hospital; your severity of illness won’t be great,” Short said. “If people can do what they can to get vaccinated, that goes a long way toward protecting the vulnerable population.”

Short said people appeared to have gotten comfortable with the low daily cases in spring into early summer. The combination of a population letting its guard down amid a reopened economy, the boom of summer gatherings, the emergence of the Delta variant and a lagging vaccination rate set the stage for the current spike, Short said.

“We had all exhaled and everybody had hoped that the trend was going to continue,” he said. “It’s a good reminder that we can’t let our guard down.”

Russell said some local cases have been linked to big events such as Under The Big Sky, but more are tied to smaller, routinely scheduled affairs, such as church camps and gatherings at venues. He also notes that it can be hard to pinpoint the specific origins of infections. 

The rise in hospitalizations comes amid a record-breaking summer at Logan Health’s emergency department. This time of year always brings an uptick in ER visits, but the frenzied nature of this post-lockdown summer has produced a significant spike. Patient volumes in the emergency department from April to July were the highest ever, up 15% from the average over the previous four years. 

July was the emergency department’s busiest single month on record, with patient volumes up 25% from the preceding years’ average, breaking a record set in July 2017. Despite the dramatic uptick, a Logan Health spokesperson said the ER “is prepared and willing to take care of all those seeking treatment.”

Short said the hospital isn’t currently planning to curtail services such as elective procedures to accommodate the COVID patient influx, but potential operational shifts are “definitely being monitored.” 

Some COVID patients at Logan Health are out-of-area visitors, but the majority are Flathead County residents. Of the 26 COVID patients on July 30, only four were non-county residents. While many are unvaccinated older residents, Short said anecdotally he’s seeing a higher number of younger patients than early in the pandemic.

The Montana Department of Public Health and Human Services published a report on July 28 about COVID-19 variants showing that “variants of concern” — Delta, Alpha/UK and Gamma — and other “variants of interest” have been identified in 46 Montana counties. All three variants of concern are present in Flathead County, according to the report.

The state report also noted that Delta overtook Alpha/UK in July as the “most predominant variant” in Montana. Nationwide, the highly transmissible Delta variant now accounts for more than 80% of new cases. Short said it’s fair to assume the variant represents a similar percentage of new cases in Flathead County.

Last week’s 20-plus COVID hospitalizations each day were by far the most of 2021, following months in which the number was routinely in the single digits, at times zero. With 136 new cases reported in Flathead County over the weekend and Monday, Russell is hoping that vaccinations will accelerate and begin reversing the surge’s concerning trend-line.

“My guess is there are people out there who want to get vaccinated,” Russell said. “I’m really hoping more people do it.”

For more information on how to receive a COVID-19 vaccine locally, visit flatheadhealth.org/covid-19-vaccine or vaccinefinder.org.