DoH issues a stark warning – local and national COVID update for September 8, 2021

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[KING COUNTY, Wash.] – (MTN) The somewhat positive news that new COVID cases continue to try and hold a peak was dampened by a stark warning issued by the Washington State Department of Health over dwindling resources. While new cases plateau, the number of hospitalized patients, ICU patients, and patients on ventilators continues to climb.

There were no new cases or quarantines reported in the Lake Washington School District today, where officials are working on a remote learning solution for students who can’t attend class. Northshore saw more cases, including a significant jump at two middle schools.

Yes, Sounders FC will also require vaccination or a negative PCR test to attend games, and a potential sickout at Seattle City Light didn’t materialize. Washington state poison control is getting a lot of calls about ivermectin, and Cowlitz County requested a mobile morgue.

Amazon gets called out for surfacing books and materials that provide COVID misinformation.

In the south, the Gulf States appear to have reached a peak (we don’t know about Louisiana) while the Pacific Northwest, including Alaska, and Kentucky, Ohio, West Virginia, and Indiana deal with regional surges.

This update uses the latest data from the Washington State Department of Health released on September 8, 2021.

Washington State Update for September 8, 2021

Washington state COVID update

The data today is still a bit hazy, but hospitalization data has caught up with more health systems reporting after the long weekend. Through September 7, Washington’s statewide 14-day rolling average was 506.4 COVID cases per 100K, which is down slightly from the last update. Washington state continues to bounce between 500.0 and 535.0. Columbia (1,147.0 per 100K) and Franklin (1,208.1 per 100K) reported an extreme number of new cases. Counties in the 800.0 to 999.9 per 100K range include Asotin, Benton, Chelan, Clallam, Cowlitz, Douglas, Garfield, Grant, Lewis, Okanogan, Pend Oreille, Stevens, and Yakima.

King County is at 300.4 cases per 100K, another decline from yesterday. The data is encouraging that the state is holding at a plateau for new cases, after some alarming trends last week.

The Washington State Department of Health reports a data backlog for test positivity, with the published number 14 days old. According to Johns Hopkins University Medicine, the positivity rate for the last 30 days is 13.11%, and over the previous 7 days, 13.83%. The rate of hospitalization was unchanged for ages birth to 49, and up for ages 50 and above.

The USA Today COVID Tracker reported 52 deaths yesterday, but that almost certainly includes more than one day of data due to the holiday weekend.

The Sounders FC too

Yesterday we covered how the Cougars, Huskies, Mariners, Kraken, Seahawks, and Storm would require proof of vaccination or a negative COVID test to attend games – you can add the Sounders FC to that list too.

Seattle Sounders FC announced for events at Lumen Field during the 2021 regular season and postseason that proof of COVID-19 vaccination or a negative FDA-approved test for entry to games and events will be required, beginning at the Rave Green’s first home match on September 19.

“Sounders FC is proud to work with our friends at the Seahawks to take steps forward together in supporting public health,” said Sounders FC Owner & President of Business Operations Peter Tomozawa. “As excited as we have been to welcome fans back to Lumen Field this season, we recognize that the COVID-19 pandemic is not yet over and we want to do everything in our power to continue to provide a safe and comfortable matchday experience to everyone who comes out to the stadium. Part of that means executing King County’s expanded mask mandate effectively immediately, and a larger part is working with the Seahawks and Lumen Field to institute vaccination verification for all of our events. The Seahawks are beginning that process on September 19, and Sounders FC is prepared to follow suit starting with our first home match after that point, on October 3.”

Calls to Washington Poison Control about ivermectin triples

Scott Phillips, medical director for the Washington Poison Center, told the Seattle Times that his agency has seen a threefold increase in calls relating to ivermectin since last year, attributing the rise to misinformation about the drug’s effects on COVID-19.

According to Phillips, most calls were inquiring about the safety of the drug, which is used to treat parasites and certain skin conditions in animals and less often in humans. However, the center has also received calls from individuals who were recently hospitalized or were experiencing symptoms of poisoning, Phillips said.

Ivermectin was developed in the 1970s and was first approved for use in animals in 1981. Developed from an organism found in the soil of Japan, it is highly effective against a wide range of internal and external nematodes and arthropods. In 1988 it was approved to be used in humans. The drug is credited for the near eradication of river blindness and lymphatic filariasis. Both diseases were common in Africa and are caused by parasites. River blindness is spread by flies and lymphatic filariasis by mosquitoes.

In the United States, particularly in rural communities and through disinformation from anti-vaccination groups, people have been self-medicating using animal formulations as a preventive or treatment. The improper use has led to hospitalizations, blindness, and liver damage in extreme overdoses. Where many online recommendations include daily dosing followed by a wider interval, in impoverished areas where ivermectin use is ubiquitous to prevent parasites, dosing can be a single pill a year.

Ivermectin as a treatment for COVID rose in popularity due to a preprint study earlier this year. The study was pulled after failing peer review, which indicated that data was manipulated and falsified. Media outlets NewsMax, OAN, and InfoWars continue to advocate its use, despite numerous warnings and the single discredited study. Contrary to the accusation from people such as U.S. Senator Rand Paul (KY-R), tests for ivermectin for combating COVID, and a long list of other diseases are not being blocked by any government agency or Merck. Quite the contrary, there are countless studies going on for a wide range of potential applications, almost all of them for the treatment of parasites.

The largest study to date for the effectiveness of ivermectin against COVID, which has received multiple peer reviews, indicated that ivermectin had no meaningful impact, and for sicker patients created worse outcomes. The study done in Argentina was randomized, double-blind, and placebo-controlled – the gold standard. The report concluded the only statistical difference was subjects taking ivermectin who became moderately to severely ill, required mechanical ventilation much sooner than the placebo group.

If you take away one thing from this let it be this. For humans, ivermectin is a Class C Pregnancy Drug that should not be taken by children under 33 pounds, pregnant women, or women who are nursing. In studies during its development, it was shown to cause birth defects in animals. There is no clinical or scientific evidence it has any impact on the prevention or treatment of COVID, and the best available data indicates that for the sickest patients, it produces worse outcomes.

Another threat of a sickout that didn’t happen

Seattle City Light braced for a sickout yesterday over a looming vaccine mandate, which never materialized. Online groups called for the sickout, involving the city’s 250 linemen. Yesterday only 2 called in sick.

Senator Warren (MA-D) urges Amazon to tackle COVID misinformation

Last week we wrote about how Amazon, Google, and Microsoft were amplifying COVID misinformation around ivermectin due to their algorithms. It appears other people are noticing also. In a letter to Amazon CEO Andy Jassy, Senator Warren outlines her staff’s findings when searching the Amazon website for various COVID-related terms, and asks the company to take action.

The senator’s staff found that searches for terms including “COVID-19,” “COVID,” “vaccine,” “COVID-19 vaccine” and “pandemic” led to results such as books offering “falsehoods about COVID-19 vaccines and cures,” including at least one that Amazon tagged as a best seller. We were able to duplicate some of the findings in her letter.

“As cases of COVID-19 continue to rise, Amazon is feeding misinformation loops through its search and ‘Best Seller’ algorithms, potentially leading countless Americans to risk their health and the health of their neighbors based on misleading and inaccurate information that they discover on Amazon’s website,” Warren wrote.

Editor’s Note: Irresponsible headlines like the one used by the New York Times (Elizabeth Warren Accuses Amazon of Peddling COVID Misinformation) for this story do not benefit the general public or support an environment of open dialog.

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Vaccination

King County Health updated its COVID-19 outcomes by Vaccination Status dashboard today. The unvaccinated are sevenfold more likely to test positive for COVID, 50 times more likely to be hospitalized, and 30 times more likely to die from the data compiled over the previous 30 days.

So if vaccines are so effective, why is the number of vaccinated people with breakthrough cases increasing? Those numbers of people who were vaccinated testing positive are alarming!

King County has 2.26 million residents and according to King County Public Health, 67.6% of all residents are fully vaccinated. That would come out to 1,527,760 fully vaccinated, and 732,240 partially vaccinated or unvaccinated. The King County website indicates 1,528,211 fully vaccinated, so it provides a check for our math.

For positive COVID tests during the last 30 days, 6,010 vaccinated people, out of 1,527,760 total had a breakthrough case. That’s 0.39% of all vaccinated King County residents. During the same time period, 12,972 partially vaccinated and unvaccinated residents out of 732,240 tested positive for COVID – that’s 1.79%. Looking only at the 32% versus 68% can lead to a data fallacy if you don’t consider the total population of the two groups.

Study from Yale University and published in The Lancet indicate average age for hospitalized breakthrough cases is 80-1/2 years old

In a study of hospitalized patients in the Yale New Haven Health System, researchers identified 969 individuals who tested positive for the SARS-CoV-2 infection during a 14-week period between March and July 2021. Of that group, 54 were fully vaccinated.

These patients tended to be older — between 65 and 95 years old with a median age of 80.5 — and had preexisting comorbidities, such as cardiovascular disease and Type 2 diabetes. A subset of patients was also on immunosuppressive drugs that may affect vaccine efficacy.

“The majority of fully vaccinated patients experience mild or no symptoms if infected with SARS-CoV-2,” Chun said. “This research identifies those who suffered more severe disease, and we need a better understanding of how to best manage these patients.”

Chun noted that many of the patients with severe breakthrough infections in the study were hospitalized before the Delta variant became the predominant variant of SARS-CoV-2 in the United States. Additional research will be needed to determine the impact of the Delta variant on the rate of breakthrough COVID-19, he said.

Researchers noted the study was done before Delta became the dominant variant, and they are continuing to gather data.

Hospital Status

Washington State Department of Health sounds the alarm with available hospital resources dwindling

The Washington State Department of Health released a statement today, indicating that the state is running out of options to stretch healthcare resources further.

Hospital capacity is currently stressed across the state of Washington. The surge in hospitalizations is one that the Washington Department of Health (DOH), with its healthcare partners, has been monitoring closely. At this time, partners across Washington have undertaken a number of strategies to stretch resources and mitigate current challenges.

DOH has adopted and plans to use the ethical framework developed by the National Academy of Medicine, which stresses the importance of an ethically grounded system to guide decision-making in a crisis standard of care situation. It also defines surges capacity within the healthcare systems, during normal operations and disaster operations, as a continuum: from conventional to contingency and finally crisis. The goal is to prevent ever having to utilize crisis standards of care anywhere in Washington.

DOH is working with state, federal, and private partners to mitigate Washington’s health care surge by accessing additional volunteer and contracted resources, coordinating information sharing, and supporting efforts to shift patients to healthcare facilities that can best support their care. DOH encourages Washingtonians to help by doing their part such as getting vaccinated, wearing masks in crowded or indoor public places, and taking other preventive steps.

Hospital status update

According to the DoH COVID Dashboard, 22.2% of all acute care patients hospitalized in Washington have COVID, unchanged from yesterday. A hospital system caring for this many COVID-positive patients in acute care is considered to be under “severe stress.” ICUs are at 88.7% of capacity statewide, with 34.3% of ICU patients fighting COVID.

The new hospital admission rate for COVID patients is 188 per day, indicating that the state has caught up on reporting from over the weekend. The Department of Health adjusted the number of total COVID patients reported on September 6 to 1,775, a new record. On September 7, the number dropped slightly to 1,743 with 265 on ventilators.

Cowlitz County commissioners declared an emergency and formally requested a mobile morgue for the county. Coroner Tim Davidson said the morgue and the county’s funeral homes are maxed out on capacity and are “being creative” to maintain cold storage. All together, the facilities can typically hold 45 bodies and right now have about 65, he said.

PeaceHealth St. John Medical Center in Longview ended COVID testing at the hospital on August 19 because they were overwhelmed with patients. Yesterday hospital officials reported 30% of all patients are fighting COVID, and 80% are unvaccinated.

Data for pediatric patients receiving acute care or in a PICU due to COVID is not available.

Back to School

The biggest change overnight was in the Northshore School District, where 19 students at Kenmore Middle School and another 27 students at Skyview Middle School were put into quarantine. Cases slightly increased in the Bellevue School District, while no new cases or additional closures were reported for Lake Washington. LWSD is setting up virtual learning for the 81 students in quarantine at Kamiakin Middle School.

The next board meeting for the Lake Washington School District is September 13, 2021, at 7:00 PM and will be remote only.

Kirkland-Bellevue-Woodinville

No update

National Round-Up

Johns Hopkins University Cumulitaive Case Tracker 261,683 new cases and 1,513 COVID-related deaths on Wednesday. The new case number would include a backlog of data from the holiday weekend, while the COVID-related death number is likely incomplete.

Alabama

Alabama may be reaching a plateau in cases, as officials hold their breath to see the impact of the Labor Day weekend. According to Dr. Don Williamson with the Alabama Hospital Association, when looking at the numbers of hospitalizations during the last couple of weeks, the state of Alabama might have hit a plateau. He said only the coming weeks will tell.

“We had 27 hundred and 76 patients in the hospital, and that is about 300 below our historic highs but we are running that number now for over a week,” Williamson said.

Like other hospital officials and researchers, models are being based on the Delta variant and its spread in the United Kingdom, where cases reached a peak about 60 days after it first arrived.

Alabama is ramping up test capacity statewide and has partnered with CVS to provide 13 additional testing locations.

Alaska

Alaska is the forgotten member of the Pacific Northwest states and is in a state of crisis that mirrors Washington state. According to the state’s data, almost all of Southcentral and Interior intensive care units are full or near capacity. Doctors in the state have repeatedly warned that the system is at its limit. Hospitalizations have roughly doubled since state hospital officials sounded the alarm about a month ago.

The state also reported more than 840 new cases of COVID-19 for Tuesday — among the highest single-day counts since the pandemic began. Alaska is dependent on Washington state to take their critical patients that need orthopedic, cardiac, and burn care.

Currently, almost 21% of all patients hospitalized are fighting COVID, with 23 on ventilators.

Arizona

Last week reported on an alarming incident at Mesquite Elementary School in Tuscon, Arizona where three men confronted the principal and threatened to citizen arrest her. All three men have been identified and all three have been criminally charged. Frank Tainatongo, 48, was charged on Tuesday, Kelly Walker, the owner of a Viva Coffee Shop was charged Monday and Rishi Rambaran was charged last week.

All three men face a single count of third-degree trespass, which has a maximum sentence of 30 days.

In another high-profile incident of Arizona’s acting badly, Janene Hoskovec, 55, went viral after harassing people in a Nebraska grocery store for wearing masks. In the video, she coughed on people intentionally, while mocking their mask wear and calling them, “sheep.”

Lincoln, Nebraska, where Hoskovec was visiting family, currently has an indoor mask mandate. The video went viral after being posted on Tik Tok, and internet sleuths quickly tracked down her identity. The father of the 13-year old girl who shot the video, and was the target of Hoskovec said, “She instigated the whole thing. Picked a mother/child to harass. Think they just wanted to getaway. Lady kept following them. Some other folks stepped in.”

Earlier today her employer, SAP, said it was investigating the situation and at press time released a statement.

“We have reviewed the incident and can confirm that the individual in question no longer works for SAP.”

Florida

In Florida, Leon County circuit court judge John C. Cooper ruled the state cannot enforce a ban on public schools mandating the use of masks against the coronavirus while an appeals court sorts out whether the ban is ultimately legal.

Cooper said the overwhelming evidence before him in a lawsuit by parents challenging the DeSantis ban was that wearing masks does provide some protection for children in crowded school settings, particularly those under 12 for whom no vaccine yet exists.

“We’re not in normal times,” Cooper said, in a hearing held remotely. “We are in a pandemic. We have a variant that is more infectious and dangerous to children than the one we had last year.”

Idaho

Yesterday the Panhandle and the North Central Health Districts in Idaho had to move to “crisis standards of care.” Today there was a report of a non-COVID-related cardiac patient who died in the northern part of the state because there was no oxygen available for their care.

Now, other parts of the state are sounding the alarm, as the hospital system is collapsing despite all efforts to prevent it.

According to the South Central Public Health District (SCPHD), southern Idaho is right on the edge.

“What we’ve been warned as a health district is that we’re very close in our region, the situation is very extreme,” said Public Information Officer with SCPHD, Brianna Bodily. Department of Health and Welfare officials stated that Treasure Valley hospitals are “really close” to activating crisis standards of care too.

Editor’s Note: We strongly recommend not to travel to Idaho during this time of medical crisis. Any health emergency requiring hospitalization could result in you receiving inadequate care.

Kentucky

A house bill in the Kentucky legislature that would end the student mask mandate failed to pass in a special session called on Tuesday. The bill, House Bill 1, would give schools more flexibility to respond to the COVID-19 pandemic. It would give schools 20 flexible remote learning days and create a “test-to-stay” program, so they can test out of quarantine. Students who are exposed to COVID-19 can stay in school as long as they continue to test negative each day. The mask mandate survived by one vote.

Mississippi

Mississippi COVID cases appear to have peaked (along with Alabama, Arkansas, and Florida) but pediatric cases in particular, and deaths continue to rise. Currently, more than 15,000 students in Alabama are in quarantine and over 18,825 tested positive for COVID in the last 28 days.

Officials recorded another death of a child – a 4-month old baby.

Nevada

Officials are enacting a statewide mask mandate as cases continue to rise in rural areas. Nevada Health Response reported all of Nevada’s 17 counties are currently experiencing substantial or high COVID-19 transmission.

Ohio

The Ohio Children’s Hospital Association released a 17-page statement, signed by dozens of members issuing a dire warning on pediatric hospital resources in the state.

“Twelve to 15 kids hospitalized per day in the ICU and on ECMO,” said Grace Wakulchik, president and CEO of Akron Children’s Hospital, during the press conference.

“We currently have 26 children in the hospital, nine of which are in the ICU and five on ventilators,” said Tim Robinson, CEO at Nationwide Children’s Hospital.

“We have been very full, and we anticipate being very full again this week,” said Patty Manning-Courtney, MD, chief of staff at Cincinnati Children’s Hospital.

Ohio, Kentucky, and Indiana are seeing a similar surge to the one ongoing in Washington, Oregon, and Idaho.

Oregon

The models that predicted Oregon would hit its peak this week appear to be coming true with hospitalization numbers starting to trend down. But like in other states where cases are tailing off, the final phase where fatalities increase has now begun.

Douglas County Public Health reported the death of an infant from COVID, who passed on Monday.

Portland Mayor Ted Wheeler (who is in open competition with Jenny Durkan for least popular large city major in the United States) has dropped the vaccination requirement for Portland Police officers.

The city attorney’s office advised city staff on Tuesday that the order issued last week that all employees be fully vaccinated against COVID-19 or risk losing their jobs could not be extended to the city’s police force. That was due to new guidance from the Oregon Health Authority, which said the Governor’s order mandating vaccines for health care workers likely did not apply to police.

The issue in question was whether police officers were medical first responders, similar to firefighters. The city attorney determined that this was not the case.

South Carolina

If South Carolina was a country, it would have the third-highest rate of COVID cases on the planet behind only Mongolia and Grenada. When asked who bears responsibility for South Carolina’s latest surge, Dr. Brannon Traxler, director of public health at the S.C. Department of Health and Environmental Control, on Wednesday said, “I don’t think that this is a matter of who to blame.

“From a public health standpoint, we know that the answers to stopping the spread of this virus are vaccines, wearing masks, washing hands, and practicing physical distancing,” Traxler said.

“DHEC is not interested, myself included, in pointing fingers or blaming one person or a group of people because this pandemic, which really is unprecedented, as we’ve all heard so many times, is just so complex. … We all have individual choices to make.”

Three South Carolina cities, Columbia, West Columbia, and Cayce passed emergency mask orders today.

South Dakota

Active cases of COVID in South Dakota are now at levels not seen since January 7. Active cases are now at 6,182, up from Friday (5,970) while hospitalizations ticked down slightly.

Texas

The state of Texas is seeing a trend similar to Alabama. Hospitalizations appear to have peaked for adults, while pediatric hospitalizations continue to increase. The state has been hit with COVID and RSV cases, stretching pediatric ICU resources to the limit.

Dr. Jim Versalovic from Texas Children’s believes that we are seeing this spike right now because so many kids are back inside classrooms.

He says Texas Children’s is at a high plateau right now, which hopefully means their numbers will start to go back down at some point.

“We’ve had a census exceeding 50 children and adolescents per day most of the past two weeks,” Dr. Versalovic said about Texas Children’s. “We continued to have numbers above 40 just in the past 24 hours. We set a new record in the past week in terms of the number of children testing positive at Texas Children’s, well over 380 positive tests in a 24 hour period.”

Over the holiday weekend, Texas had more than 300 children hospitalized for confirmed COVID cases.

West Virginia

Governor Jim Justice announced Wednesday “West Virginia leads the nation in the acceleration rate of new cases.”

He also outlined that 10 schools have closed due to an increase in cases and one entire county, Clay County, has closed schools in the district due to COVID-19 cases and exposure. 29 districts have issued masked mandates for students K-12.

As of Wednesday, 813 West Virginians are in the hospital battling COVID-19 complications. According to DHHR data, 252 have been admitted to the ICU and 132 are currently on ventilators. Gov. Justice said the number of patients in the ICU and on ventilators is at an all-time high for the state.

Governor Justice is a bit of a minor star on social media due to his mannerism and delivery of his COVID updates to his state. You can watch for yourself in this clip that went viral today.

Misinformation

Taking the day off

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