The increase in COVID-19 cases may be leveling out in Flathead County for the time being, although the county continues to see its highest active case numbers of the pandemic.
“My (disease) prevalence graph looks like it’s actually starting to go down, but it’s really too short of a time frame” to say if case numbers are truly falling, Health Officer Joe Russell said. “It’s certainly a leveling off.”
Russell estimated on Jan. 31 that active cases had fallen below 2,700, compared to the more than 3,000 the county began last week with.
Hospitalizations at Logan Health in Kalispell had also fallen at the start of the week compared to the prior week.
On Jan. 24, the hospital reported having more than 90% of its beds occupied, and being 12 patients over capacity. At that point the hospital had 52 COVID-19 patients hospitalized.
A week later the hospital had 40 people hospitalized for COVID-19 and 21 of them were unvaccinated, according to Chris Leopold, a communication specialist for Logan Health. Of those hospitalized seven were receiving intensive unit care, and two were on ventilators. Of the seven people receiving ICU care one was vaccinated. The two people on ventilators were both unvaccinated.
“We’ve never seen this many cases in the Flathead throughout the whole pandemic,” Russell said. “It’s driving our hospitalization numbers up.”
The omicron variant continues to be less severe for people with some degree of vaccination or prior infection, but Russell said the high disease prevalence means that more people overall are being exposed, including those who are more susceptible to severe illness.
Last week Logan Health finished using its last order of Regeneron, the monocolonal antibody that had been used to treat some COVID-19 patients. Dr. Cory Short, the executive physician for the hospital’s acute care service line, previously told the Beacon that some of the monocolonal antibody treatments were ineffective against the omicron variant.
The hospital stopped making additional orders two weeks ago, and is now in what Leopold called a transition phase as it determines what its options are going forward. The hospital does have a limited number of vials of the monoclonal antibody sotrovimab, but “not enough,” according to Leopolod. Sotrovimab has shown to be effective against the omicron variant.
For some patients, the hospital is continuing to intravenously administer the antiviral drug remdesivir but is not yet ready to take the step of setting up a an outpatient infusion program, although it has been considered.
Total hospitalizations are up, but Russell noted that the rate of hospitalization is not.
“There are just so many more people that are active cases that it’s going to lead to more hospitalizations,” Russell said.
Long-term facilities in particular are struggling right now in Flathead County.
“Almost every one of them are in some sort of outbreak status right now, and all of them are dealing with care providers, as well as residents that are cases,” Russell said, adding that some long-term care facilities are in “crisis mode.”
All of this comes as the health department is transitioning away from universal case investigation and contact tracing, and instead prioritizing case investigation and contact tracing among high-risk populations, including residents and providers in congregate care settings. In a press release last week the health department cited new guidance from the Association of State and Territorial Health Officials, and the Council of State and Territorial Epidemiologist.
The health department cited multiple factors for the decision, including the large number of asymptomatic and mild cases being seen, vaccination immunity, the shorter incubation period for omicron making it increasingly difficult to identify close contacts before their quarantine period ends, and COVID-19 transmission occurring prior to symptom onset and during the first few days of symptomatic illness.
Russell argued that the shift in strategy is not a “cop out,” and made the case that the new approach is more sensible based on omicron’s tendency to cause less severe illness. The health department is continuing to recommend quarantine and isolation for COVID-19, but Russell said the new approach means that people who are close contacts will not be receiving notice to quarantine from the health department. People who do test positive will still receive a text message from the health department with an isolation timeframe, as well as a case investigation form that asks them to contact anyone who may have been exposed and should get tested.
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