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[KING COUNTY, Wash.] – (MTN) Washington State Hospital Association CEO Cassie Sauer along with several state healthcare leaders sounded the alarm today, describing the situation in Washington’s hospitals as, “untenable.” The Washington Department of Health has retired the Washington Ready/Risk Assessment Dashboard today, reducing visibility into granular county and Health Region data.
Misinformation about Ivermectin is spinning out of control as the drug flies off of farm store shelves and calls into poison control centers skyrocket. The CDC releases a new report that indicates that breakthrough cases for Delta are growing at a significant number among people who are over 75 years old and the European Union is restricting travel for U.S. citizens again.
The situation to our east and our south is worse with Idaho hospitals formally applying for permission to go to “crisis standards of care” and Oregon requesting mobile morgues.
The only good news tonight is the statewide vaccination rate increased significantly from last week and we are seeing the strongest indication yet that new cases in Washington state are reaching a plateau.
This update uses the latest data from the Washington State Department of Health released on August 30, 2021.
Washington State Update for August 30, 2021
Washington state COVID update
The state of Washington has retired the Governor’s Risk Assessment Dashboard, which was providing visuals for county and Hospital Region level data. Losing the ability to see acute care and ICU use at a regional level is a disservice to the residents of the state of Washington. We urge the Department of Health to make some of the previous dashboards available to provide better transparency.
We cannot provide insight into the epidemiological curve for new cases compared to last week because the data today is through August 18, 2021. Our report on Friday was from data through August 19, 2021.
Through August 18, the statewide 14 day rolling average for Washington was 514.0 COVID cases per 100K. Columbia (1,147.0 per 100K), Douglas (1,101.1 per 100K), Franklin (1,066.6 per 100K), and Grant (1,002.7) are reporting an extreme number of new cases. Asotin, Benton, Chelan, Cowlitz, Lewis, Lincoln, and Yakima counties are not far behind. Benton and Cowlitz county have shown improvement over the weekend (possibly) and may have hit peaks.
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 13.53%, and over the previous 7 days, 13.07%. These numbers indicate continued widespread community transmission driven by the unvaccinated and under testing of the population. The fastest-growing age group for positive tests is now 20 to 34-year-olds.
The USA Today COVID Tracker reported 36 COVID-related deaths in Washington on Friday.
Hundreds protest vaccine mandates in Olympia
On Saturday, hundreds of people gathered at the Washington state Capitol Campus to protest vaccine mandates for a variety of employees. Liberty, at All Hazards, organized the event to demand vaccine mandates issued by state officials be revoked.
“From prisons, to hospitals, to First Responders of all types, from firefighters, to police, to EMS personnel, to ferry workers, to teachers, coaches, and school volunteers, bus drivers, sanitation workers, and so on — the Governor is unnecessarily threatening the genuine safety and well-being of the citizens of Washington if he forces his mandate to stand,” the group said in a press release.
The Constitutionality of vaccine mandates at a state level was reviewed by the Supreme Court of the United States in the case Jacobson vs. Massachusetts in 1905. In that case, it was determined that citizens did not a fundamental First Amendment right against vaccination when weighed against the public good. The case has been challenged multiple times in the last 116 years.
Washington State Hospital Association calls for canceling of the Washington State Fair
In a press conference today, Washington State Hospital Association CEO Cassie Sauer and Chief Physician Officer with MultiCare Health System Dr. Dave Carlson called for the cancelation of the Washington State Fair. “I think it is a very bad idea,” Carlson stated as he expressed deep concern about dwindling hospital resources across the state. Dr. Carlson added, “our state has no capacity to deal with a mass casualty event.”
“The hospital’s full, and we are over the course of the next three weeks likely going to bring in an additional million people to that community. And I am very, very concerned about the stress that that will put on our emergency room and about the stress that will put on our systems.”
Area Doctor pleas for youth to get the COVID vaccine before starting school
Dr. Susanna Block, a pediatric hospitalist at Kaiser Permanente in Seattle appealed for parents to get their age-eligible children vaccinated before the start of school. She reported that over the last few weeks, 20% of all new COVID cases have been children. In other states where classes have already started, tens of thousands of students and faculty have become infected or landed in quarantine, disrupting school and in some cases forcing an emergency transition back to remote learning.
Skagit County reopens testing and vaccination site as COVID cases soar
Starting Monday, Aug. 30, you can get COVID-19 testing and vaccinations at the Skagit County Fairgrounds. Tests and vaccinations will be free at the site, which is now opening Monday through Friday from 5 p.m. to 8:30 p.m.
Reflecting the increase in vaccination rates, the Washington state Department of Health is reporting that 73.3% of state residents 12 and up have received at least one dose of COVID vaccine. That is up almost a full percentage point from last week. Almost 4.8 million age-eligible Washingtonians have received at least one dose, but 1.75 million remain unvaccinated.
Vaccination effectiveness for preventing hospitalizations drops for oldest residents
New data presented on Monday indicates that the effectiveness of COVID vaccines against hospitalizations drops over time among adults over 75. This mirrors other studies indicating that effectiveness has dropped from 97%, based on data from the original and Alpha strains, to about 81% for the Delta strain. Officials admitted that it’s hard to read the data and determine cause and correlation.
“It actually may be very difficult for us to disentangle time, since vaccination and the impact of the Delta variant, especially in some populations that we know were vaccinated earlier in the time course. So if we see waning in the last couple of months, it could be really difficult,” Dr. Sara Oliver, a key CDC vaccine official, told the panel.
CDC breaks with the Biden Administration on COVID booster shots
A Centers for Disease Control and Prevention (CDC) advisory panel on Monday indicated it could take a substantially different approach to booster doses of COVID-19 vaccines than the one proposed by the Biden administration.
Members of the CDC’s Advisory Committee on Immunization Practices (ACIP) said the evidence on boosters is not clear and indicated it would likely consider a risk-based approach that would prioritize residents of long-term care facilities and health workers rather than all eligible Americans at once.
The panel is recommending prioritizing healthcare workers, people over 65 or 75 years old, and those who are immunocompromised and in other high-risk groups.
Washington doctor says vaccination rates statewide need to reach 85% to 90% to stop COVID
Dr. Mark D. Johnson of Confluence-Health, an infectious disease specialty, said the state vaccination rate will have to get much higher to beat COVID.
“Delta has changed the game,” Johnson said. “Unfortunately, the math keeps changing. And that’s because this virus does what RNA respiratory viruses do: it mutates. It just wants to infect us.”
The Washington state Department of Health is no longer providing data on total acute care and ICU beds within Washington state. According to the DoH COVID Dashboard, 17% of all acute care patients hospitalized in Washington have COVID, the highest level ever recorded. ICUs are at 88.5% of capacity statewide with 33.4% of ICU patients with COVID.
The new hospital admission rate for COVID patients is 164 per day, also a record and far exceeding the January 2021 peak. On August 29, there were 1,440 patients hospitalized with COVID and 182 on ventilators. In contrast, the Washington Hospital Association reported a total of 1,570 COVID patients statewide and 188 on ventilators. We have a request into the Department of Health to explain the variance and are awaiting a response.
Data for pediatric patients for acute care and PICU is not available.
Hospital administrators painted a grim picture for medical resources, reporting shortages of life support equipment, exhausted and demoralized staff, and packed hospitals. Dr. Mark D. Johnson of Confluence-Health reported that none of the ICU patients at their Wenatchee facility are vaccinated, and 40% of their hospitalized patients are under 40 years old.
Chief Physician Officer with MultiCare Health System Dr. Dave Carlson said, “I have not ever in my career been concerned like I am now about the very real possibility that we are on the edge of not being able to care for people in our community.” He reported there were 275 COVID patients across the MultiCare Health System, 80 in Spokane alone. He echoed other leaders indicating that 96% of all hospitalized patients are unvaccinated.
“We have canceled almost all inpatient surgery. If you need a joint replaced, that is canceled. We are canceling everything we can,” Dr. Carlson continued. “This is frankly the most severe restrictions we have had to put in place.” He went on to explain that their hospital in Puyallup is full and currently treating 100 COVID patients.
The Washington Hospital Association also reported a serious shortage of BIPAP machines. The equipment is the last line of defense before going on a ventilator. Patients on ventilators have exceptionally poor outcomes with the Delta variant and require additional support. At one point this weekend, there was only one available BIPAP machine in the state.
Patients that move out of ICU are brought into step-down units, but the leaders expressed that these essentially require ICU levels of care. MultiCare Health System reported they had COVID patients in their Post-Anesthesia Care Units (PACU), which exacerbates the ability to provide surgical care to non-COVID patients.
EvergreenHealth provided their patient update on Monday reporting 44 COVID patients at the Kirkland facility and none in Monroe. This is an increase of 4 patients between the two facilities from last week.
Back to School
It is reported that since the Lake Washington School District reopened enrollment into virtual learning, over 800 students will be starting school on Wednesday doing remote learning.
First day of school for area districts:
- Lake Washington School District – September 1
- Bellevue School District – September 1, 1st through 12th, September 3, kindergarten
- Northshore School District – September 1, 1st through 12th, September 1 or September 2 for kindergarten on a staggered start
The next board meeting for the Lake Washington School District is September 13, 2021, at 7:00 PM and will be remote only.
The number of people seeking COVID tests in the area is exploding, with reports of two-hour waits past scheduled appointment times in Bellevue, Washington. Dozens of cars snaked through a parking lot with occupants awaiting their turn to get a COVID test.
Johns Hopkins University reported over 36,383 new cases and 277 deaths today. Most states do not report data over the weekend, so the number does not indicate a sudden improvement in new cases in the United States.
The European Union has dropped U.S. travelers from the EU safe list as COVID surges amid the unvaccinated. The 27 member states recommended that Americans should be banned from nonessential travel, including the nations of France, Italy, and Germany. The same guidance also applies to Israel, Lebanon, Kosovo, Montenegro, and the Republic of North Macedonia. The decision is non-binding and for EU member states, leaving each country to decide what is in their best interests.
Also today, the CDC added seven destinations to the “very high” COVID travel risk list. The seven destinations were moved up from the Level 3 – COVID high risk to level 4; Azerbaijan, Estonia, Guam, North Macedonia, Puerto Rico, Saint Lucia, and Switzerland.
Ten other destinations were moved from to Level 3; Bermuda, Canada, Germany, Moldova, Bahrain, Indonesia, Namibia, Oman, Rwanda, and Zimbabwe. The CDC continues to recommend avoiding international travel if you are unvaccinated.
Robert David Steele, a former CIA agent and one of the first adherents of the QAnon conspiracy died of COVID over the weekend. Steele was one of the first people to declare on programs such as Infowars that COVID was a “hoax.” Steele continued to publish conspiracy theories and misinformation from his hospital bed before being placed on a ventilator.
On August 17, we wrote his final blog post declaring, “I will not take the vaccination, though I did test positive for whatever they’re calling ‘COVID’ today, but the bottom line is that my lungs are not functioning.”
Despite stating he was lucky to have gotten into a “trusted” hospital in Florida, a friend who reported his death, Mark Tassi, stated that Steele had been forced onto a ventilator against his will because “they” wanted to make Florida and Governor Ron DeSantis look bad.
Total hospitalizations continue to decline in Arkansas but the number of patients requiring the ICU and ventilators continues to climb. Data indicates that Arkansas has hit a peak for cases, but the 361 patients on ventilators is a new record, along with 533 in the ICU.
Arizona became the 13th state to have more than one million COVID cases as hospitalizations surged 400% in the last eight weeks. Hospitalizations, ICU utilization, and new cases have reached February 2020 levels and almost all of the critically ill are unvaccinated.
The plateau may be at risk. After the first four days of classes at the University of Arkansas, Fayetteville, 105 active COVID cases have been reported. This exceeds the prior record set in January 2021.
Much like Arkansas, new cases have plateaued but hospitalizations continue to hover at near-record levels. There are 8,679 Californians in the hospital on Monday, just 30 short of the old record.
Rural areas in Northern California continue to deal with a huge surge of cases. In Crescent City, the mortuary is filled beyond capacity and officials have asked for a mobile morgue.
Florida officials have reported 4,900 COVID-related deaths in the last four weeks as Delta continues to tear through the state. After dipping for four days straight, hospitalizations increased again, with officials telling residents not to read into daily fluctuations. The state has 15,788 COVID patients in the hospital, 3,526 in the ICU, representing 53% of all ICU patients statewide.
Tampa Bay radio host Marc Bernier, who dubbed himself “Mr. Anti-Vax,” died of COVID over the weekend in a Florida hospital. He became sick three weeks ago and passed at the age of 65.
Honolulu Mayor Rick Blangiardi announced the new Safe Access Oahu program on Monday. Starting on September 13, patrons entering restaurants, bars, gyms, and other establishments will need to show proof of vaccination or a negative COVID test taken within the last 48 hours. The program is scheduled to last 60 days. Children under 12 will be exempt from the program.
State officials are also pushing back on rumors of pending lockdown, but are also requesting residents cancel their Labor Day Weekend plans.
“The reality is [the pandemic] is still here, and we right now in Hawaii, are going through the most severe part of the pandemic in almost this two-year period,” said Hilton Raethel, Healthcare Association of Hawaii president and CEO.
Kootenai Health in Coeur de Alene formally requested permission to go to “crisis standards of care” on Sunday night. The hospital has been hinting since Wednesday it would make the request, and on Thursday evening, Idaho narrowly missed making a statewide declaration. Under “crisis standards of care,” resources are rationed to the people with the highest chance of survival, and so-called “black tag triage” could be employed. Patients who are not expected to survive would be moved into a category called, “expectant,” and would be given comfort care. If more resources became available they would be moved into a priority group for treatment.
In a worrying sign, Idaho Governor Brad Little has scheduled a press conference for Tuesday at 12:30 p.m. New cases remain below the January 2021 records, but Idaho can’t send COVID patients to neighboring states with Washington and Oregon in crisis.
On Friday I wrote about my concern that Hurricane Ida could be pulverizing blow to an overtaxed Louisiana healthcare system. By Sunday night it was apparent the sum of all fears had come true.
For the first time in modern history, the power went out for all of Orleans Parish, knocking out power, impacting water, sewer, and communications. At least six hospitals reported significant damage including a 174 bed Level II trauma center and a 194-bed acute care facility. At one hospital backup generators failed, forcing staff to scramble to hand bag ICU patients to keep them alive. After two hours power was partially restored, with COVID patients moved into hallways and the Post-Anesthesia Care Unit. One hospital reported losing oxygen when the delivery tank became damaged.
Almost 200 patients were transferred from hard-hit hospitals in southern and central Louisiana to facilities in Baton Rouge, Morgan City, and New Orleans. Officials are reporting there were no injuries among patients or staffers during the peak of hurricane Ida, and that hospitals on generator power can run for another nine days.
The collapse of a major steel truss tower into the Mississippi River plunged the city into darkness and could take 3 to 6 weeks to rebuild.
Officials are concerned about people huddled in shelters spreading COVID, but so far reports are indicating that people are wearing masks. It is likely that data on COVID and hospitalizations will be hard to process for the next couple of weeks.
Judge Gregory Howard ordered a Cincinnati area hospital to allow Dr. Fred Wagshul to treat a 53-year old COVID patient on life support with Ivermectin. Dr. Wagushul is part of the Front Line COVID-19 Critical Care Alliance, a group that touts Ivermectin as both a treatment and preventative for COVID. The doctor originally prescribed the medication and the hospital refused to administer it, with the judge intervening on the behest of his wife. The man tested positive on July 9 and was admitted to the hospital on July 15 where he received monoclonal treatment, plasma, and steroids. He was placed on a ventilator on August 1 and his condition has deteriorated since.
Dr. Leanne Chrisman-Khawam, a physician and professor at the Ohio University Heritage College of Osteopathic Medicine, called the Front Line COVID-19 Critical Care Alliance “snake oil salesmen.”
She reviewed the association’s research on the drug’s uses and said there are some serious problems with its cited studies: many of them don’t show positive results, and those that do bear design flaws like small control groups, unaccounted for variables, nonblinded studies, not accounting for mitigations like vaccines and masking practices, and others.
Two Oregon counties, Tillamook and Josephine, requested mobile morgues over the weekend. In Tillamook County, the one mortuary in the county is past capacity and so many staffers are sick with COVID, they can’t transfer bodies. Tillamook County had more COVID deaths last week than the prior 18 months combined.
In Josephine County, the hospital system is completely overwhelmed by low vaccination rates and rampant misinformation through the rural county. You can read more about it in this story we published over the weekend.
The city of Portland announced that 6,800 city workers will need to be fully vaccinated by October 18 or obtain an exemption to maintain employment.
Taking the day off
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