COVID-19 endemic: hoping for change

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Tri-County Health Care has gone through some noticeable changes over the past weeks. Some plexiglass dividers have come down, visitors and guests have been invited back into the hospital setting, everything seems to be slowly returning to normal. Are we entering the COVID-19 endemic phase?

As the winter cold has left us, so has COVID-19 for the most part. According to the Centers for Disease Control, our area and the entire nation have seen a steady decline of COVID-19. On February 3, the CDC data tracker listed 351,465 new cases of COVID-19 in the United States. Less than two months later, that number has dropped to 9,011 new cases on March 20. Also, on February 3, the CDC data tracker showed 2,693 deaths, but on March 20, that number plummeted to 77 new deaths. At least for now, we are in a far better place going into spring.

COVID-19 Endemic

The drop in community prevalence has many throwing their masks away and returning to bars, concerts, and shopping centers. The decline has many experts speculating if the spread of omicron was the precursor to an endemic phase of the virus. An endemic phase would imply that COVID-19 is still present but localized to certain areas. Health organizations have not officially announced a transition to an endemic phase of the virus. People should still be taking precautions like avoiding crowds and social distancing.

The calm after the storm

We all want the pandemic to end, but we shouldn’t drop our guard just yet. Of course, breathe a sigh of relief. It was a hard winter fraught with illness and death. We all deserve some time to relax and hope for a better future, but we have to be steadfast in our mitigation to get there.

According to statistics gathered by the Joint Commission, on a county level, we have seen a slight increase in community spread. This could only be the natural rising and falling of data or a signal of the next surge. Over the last two years, we have experienced intense waves followed by lull periods. These moments of decreased activity were a welcome change of pace but ultimately fleeting. Cases rocketed upward only a short time later.

Active adjustments

Tri-County Health Care holds patient safety above all else. We have reformulated our standards of mitigation to offer increased protection while allowing for a certain level of convenience in our care. Our level of mitigation will rise and fall with the community prevalence of COVID-19. Numbers are on the downswing, so we are opening up, but we are ready to swiftly reinstate the same level of mitigation techniques in the event of a surge.

The only way to end the pandemic is with collective effort. Mitigation needs to be at the forefront of our efforts. COVID-19 vaccination needs to be fully embraced if we are to finally end the pandemic. As of now, Wadena County is far below the vaccination rate required to achieve herd immunity. We are at 47.3 percent, according to the Minnesota Department of Health statistics prepared on March 17. 70 percent of our county residents need to be vaccinated to achieve herd immunity.

What do you think?

Do you think COVID-19 will ever end? Ask yourself that question and be reasonable in your answer. Do you think we are entering a COVID-19 endemic phase? We are curious about your thoughts on the current state of our pandemic. Feel free to share in the comment section.

To schedule vaccination, call 218-631-3510. Patients can also receive the COVID-19 vaccine during a regular appointment with their provider. Please follow Tri-County Health Care on social media or visit TCHC.org/covidvaccine for regular updates.


Flu and masks

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Healthcare systems across the country have been battling COVID-19 for nearly two years. Face coverings are proven to be one one of the most important tools in keeping this virus at bay. Cloth masks are a popular infection control method worldwide, but they are a new prevention strategy in American life. Although they have become controversial, it is undeniable they slow the spread of COVID-19 and the flu. The flu and masks should be a common association.

Please take a few minutes to watch this PBS program on the importance of masks.

The impact

It seems like every year, thousands of people contract the dreaded flu. This terrible illness has become a part of our seasonal culture. The Centers for Disease Control & Prevention estimated that 28,000 people died from influenza from 2018 to 2019 in the United States. From 2017 to 2018, an estimated 52,000 people died in our country alone. Every year thousands meet an untimely death from this virus. Data trends and studies on the effectiveness of masks have some wondering if they should be worn more often.

Masks aren’t about necessarily protecting ourselves. They are about protecting others from contaminated droplets. Wearing a mask during the flu season might be the best way to protect our communities.

Infection prevention

Cheryl Houselog is Tri-County Health Care’s infection preventionist. She has the duty of stopping the spread of contagions. For the last two years, she has worked non-stop to provide safe working environments for the staff and patients of Tri-County Health Care. When asked what she felt was the best way to prevent the spread of the flu, she quickly stated the importance of respiratory hygiene. To her, a cloth mask is one of the most important barriers between you and sickness. Cheryl doesn’t think you need to constantly wear a mask but choosing to wear one in certain situations makes sense. When you plan to be around several different people, wearing a mask, especially during the flu season, can be a very wise decision.

“The fact that we did not see a lot of colds or influenza last year indicates that masking helps prevent transmission of many respiratory diseases,” – Cheryl Houselog

Masking is more important than ever! They may not be convenient or fashionable, but they can save lives. Data from the Influenza Surveillance Network has been included below. If you compare rates of influenza in the State of Minnesota, it is clear that mitigation efforts were having a strong impact on the spread of the flu and other respiratory illnesses. This winter, make sure you’re protected from the flu by wearing your masks and getting your flu shot.

Flu and Masks statistics.


COVID-19 vaccine: Everything you need to know

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The announcement of a COVID-19 vaccine has many breathing a sigh of relief. Several months of staying home, social distancing, and wearing masks has led to a major change in everyday life. People are in a hurry to return to the way things were and a vaccine seems like the only way out. Others are more hesitant; they may believe the vaccine has not passed through proper testing.

This article is designed to be a fact sheet about the upcoming vaccines. It is a condensed and simplified record of information gathered from sources like the Minnesota Department of Health, the CDC and the U.S. Department of Health & Human Services.

Operation Warp Speed

Operation Warp Speed (OWS) combines scientific testing and government quality control. Essentially, OWS removes several administrative hurdles during the production of an effective vaccine. The methodology associated with OWS uses processes that would normally take years and compresses them down. This change is done by running the various steps simultaneously rather than one at a time.

Medical workers and seniors will be among the first to get the vaccine.

The breakdown

Creating an effective vaccine requires multiple steps and extensive testing. Generally, the process includes:

  • Methodology and lab research
  • FDA approval for clinical trials
  • Volunteer testing
  • Safety and efficacy testing in a large group
  • Large population testing with control groups
  • Final FDA approval
  • Distribution

The facts

  1. There is currently no approved vaccine available in the United States. Testing is underway, and a vaccine is expected before 2021.
  2. You will not contract COVID-19 by receiving the vaccine. The vaccines do not use a live virus. It will be similar to other widely used vaccines. It may cause symptoms like fatigue or muscle pain. These symptoms mean the vaccine is working.
  3. COVID-19 vaccination will not make you test positive for COVID-19. You may test positive for antibodies. This positive antibody test suggests either a previous infection or that the vaccine successfully created antibodies.
  4. People who were previously infected with COVID-19 should still consider being vaccinated. Studies suggest that reinfection is possible, and antibodies may last just a few months.
  5. Testing shows that receiving the vaccine does provide antibodies in around 90 percent of people. Receiving the vaccine could be the best option for fighting COVID-19.
  6. The vaccine was not rushed. Instead, administrative red tape was removed. The development and testing trials are still extensive.
  7. Once distribution begins, the first rounds of the vaccine will most likely go to health care workers and people with compromised immune systems.
  8. The COVID-19 vaccine is not mandatory.
  9. The COVID-19 vaccine will be available at no cost. However, providers of the vaccination will be able to charge an office visit fee.
  10. An mRNA vaccine will not harm your DNA. mRNA, which stands for messenger ribonucleic acid, makes protein. It does not interact with DNA at any point.

The problem with herd immunity

Herd immunity is a common talking point but is likely impossible to achieve. This form of immunity implies that a large enough section of the population has contracted the virus and is resistant. Herd immunity is not a reliable strategy for combating COVID-19. It is due to a lack of important data about transmission frequency after infection. We do not know how long it takes from initial infection for a person to be vulnerable again.

The race for a vaccine

At this time, five vaccines are being tested. These vaccines are being tested by:

  • AstraZeneca
  • Janssen
  • Moderna
  • Novavax
  • Pfizer

AHA, AMA, ANA seeks safe COVID-19 vaccine

Recently, the American Health Association, the American Medical Association, and the American Nurses Association addressed the American people about the status of the COVID-19 vaccine. They have given their full support to the creation of a safe vaccine. All three groups consider it to be the best option for safeguarding communities around the world. They cited the importance of scientific testing, safe distribution and total transparency about the vaccine within the address. They collectively want people to know the benefits and risks associated with the vaccine.

Become informed

The rate of vaccine production might seem like a cause for concern, but it is not. The same level of quality control used in the past is present with the manufacturing of these vaccines. The creation of these vaccines is the combination of good science and a unified need for relief.

For more information about how Tri-County Health Care and how it has been combating COVID-19, visit TCHC.org/coronavirus.


COVID-19 Requires Unified Response

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We have reached a serious and critical point in our efforts to battle COVID-19. COVID-19 requires a unified response now. This virus is not only affecting those overseas or in densely populated areas; it has made its way to rural central Minnesota and is currently spreading quickly right here in our own backyard. Cases of COVID-19 have surged in recent weeks. The trajectory of these cases is predicted to increase throughout the holiday season.Tri-County Health Care COVID Todd County Wadena County Health Partners Germs Hand Hygiene

Healthcare facilities and their respective staff have watched as larger regional hospitals within the state have been overrun. Bed space has been depleted; there is no more room. That means COVID-positive individuals that may have otherwise been transferred to a larger hospital must seek care locally, increasing the strain on our local hospitals which are also near capacity. If this trend continues, this crisis will quickly increase and affect our ability to provide care to those who need it. People who could have been saved may succumb to COVID-19.

As the holidays draw near, healthcare leaders in the area have come together to plead that you celebrate responsibly this holiday season. These gatherings can be a significant source of spread and risk the lives of family members and friends. It may not be easy, but we ask you please try to find safe alternatives to these gatherings. Stay home. Call your loved ones or use video chat to communicate.

Fighting this virus requires a unified front, not just from hospitals but from every single individual. Everyone needs to practice physical distancing, wash your hands regularly, only leave home when absolutely necessary and wear a mask when in public.

COVID-19 is not a hoax or conspiracy. It is a very real virus affecting us all. The recent COVID-19 surge requires unified response. Please take this message seriously. For us to return to normal life as soon as possible, it must be earned with great effort and genuine care for others.

Thank you and stay well,

Daniel J Swenson
Administrator, CentraCare – Long Prairie

Joel Beiswenger
President & CEO, Tri-County Health Care

Tim Rice
President & CEO, Lakewood Health System

Jackie Och
Director, Todd County Health & Human Services

Cindy Pederson
Director, Wadena County Public Health


The Coronavirus: Flattening The Curve

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As viruses spread, they tend to infect increasing numbers of people at high rates. The initial side of the curve over time, or rate of new infections, will naturally increase rapidly as more and more people are infected. If left unchecked, the total number people requiring health care will quickly rise well above the capacity of our US health care system.

By taking certain steps – canceling large public gatherings, for instance, and encouraging some people to restrict their contact with others – governments have a shot at stamping out new person-to-person transmissions, while also trying to mitigate the damage of the spread that isn’t under control.

The epidemic curve, a statistical chart used to visualize when and at what speed new cases are reported, could be flattened, rather than being allowed to rise exponentially. “If you look at the curves of outbreaks, they go into big peaks, and then come down. What we need to do is flatten that down,” stated Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. “That would have less people infected. That would ultimately have less deaths. You do that by trying to interfere with the natural flow of the outbreak.”

Stop the spread of coronavirus by flattening the curve

The notion that the curve of this outbreak could be flattened began to gain credence after China took the extraordinary step of locking down tens of millions of people days in advance of the Lunar New Year, to prevent the virus from spreading around the country from Wuhan, the city where the outbreak appears to have started.

The quarantines, unprecedented in modern times, appear to have prevented explosive outbreaks from occurring in cities outside of Hubei province, where Wuhan is located.

Since then, spread of the virus in China has slowed to a trickle; the country reported only 19 cases on March 9th. And South Korea, which has had the third largest outbreak outside of China, also appears to be beating back transmission through aggressive actions. But other places, notably Italy and Iran, are struggling.

On any normal day, health systems in the United States typically run close to capacity. If a hospital is overwhelmed by Covid-19 cases, patients will have a lower chance of surviving than they would if they became ill when the hospital’s patient load was more manageable. People in car crashes, people with cancer, pregnant women who have complications during delivery – all those people risk getting a lesser caliber of care when a hospital is trying to cope with the chaos of an outbreak.

“I think the whole notion of flattening the curve is to slow things down so that this doesn’t hit us like a brick wall,” said Michael Mina, associate medical director of clinical microbiology at Boston’s Brigham and Women’s Hospital.

“It’s really all borne out of the risk of our health care infrastructure pulling apart at the seams if the virus spreads too quickly and too many people start showing up at the emergency room at any given time.”

The U.S. has about 2.8 hospital beds per 1,000 people (South Korea and Japan, two countries that have seemingly thwarted the exponential case growth trajectory, have more than 12 hospital beds per 1,000 people; even China has 4.3 per 1,000). With a population of 330 million, this is about 1 million hospital beds. At any given time, about 68% of them are occupied. That leaves about 300,000 beds available nationwide.

Most people with Covid-19 can be managed at home. But among 44,000 cases in China, about 15% required hospitalization and 5% ended up in critical care. In Italy, the statistics so far are even more dismal: More than half of infected individuals require hospitalization and about 10% need treatment in the ICU. As cases spiked, Italian hospitals quickly couldn’t keep up with the patients coming in.

Countries and regions that have been badly hit by the virus report hospitals that are utterly swamped by the influx of sick people struggling to breathe.

Alessandro Vespignani, director of the Network Science Institute at Northeastern University, is gravely worried about what he’s hearing from contacts in Italy, where people initially played down the outbreak as “a kind of flu”. Hospitals in the north of the country, which the virus first took root, are filled beyond capacity, he said.

By limiting exposure to others, also known as “social distancing“, epidemiologists believe the curve could be meaningfully flattened. Social distancing means avoiding contact with others. This is crucial from a global health perspective. Limiting coronavirus cases not only has the obvious benefit of keeping the elderly and vulnerable safe, but it lessens the single biggest public health issue: overwhelmed hospitals.


Why should you get the flu vaccine?

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By Ben Hess, M.D., Chief Medical Officer

 

As we look ahead to peak influenza season in Minnesota, now is a good time to consider getting your annual flu vaccine. The vaccine is absolutely safe and can protect you from contracting the virus and suffering severe symptoms that can put you down and out for one to two weeks.

 

Cold and Flu Season Street SignAbout this year’s vaccine

This year’s vaccine contains four strains of influenza, including H1N1 or swine flu. The strains included in the vaccine change every year based on extensive research and well-documented flu migration patterns in other parts of the world.

On average, about once every seven years, there is a bad match or the virus changes from the time of production to when flu season actually arrives. This is why the vaccine is not very effective some years.

In the U.S., the peak flu season is approximately November to February. However, in Minnesota, the peak is from January to February. The virus typically affects coastal states and large metro areas first, which is why I recommend that snowbirds and those who travel get their vaccinations early.

Check out this map that shows the steady progression of the virus.

 

Feeling sick after getting the vaccine?

One argument I commonly hear for why people opt out of the flu vaccine is they are worried they will get the flu from the vaccine. Here are some important things to consider:

Dead virus. The flu vaccine that we give here at TCHC is a dead virus. You would never get the flu from this vaccine.

Delayed effect. The vaccine takes about two weeks to become fully effective. It is possible to contract the flu in this time period, which is why it’s important to get the vaccine early.Sick woman sneezing to tissue. Medicine, hot beverage and dirty paper towels in front. Girl caught cold. Cough syrup and handkerchiefs on table. Very ill person feeling bad and having fever.

Specific strains. The vaccine contains specific strains of the flu that researchers believe will be most prevalent during the current season. It is possible to contract a strain that is not included in the vaccine.

No response. A certain percentage of people simply don’t respond to the vaccine. The reasons are unclear, and because the vaccine changes every year, it is hard to research.

Already infected. The flu has an incubation period of up to four days. If you were already infected with the flu before you get the vaccine, then the vaccine will be ineffective.

Immune response. It is possible to have an immune response to the vaccine, which can give you muscle aches and pains or a mild fever for two to three days. This is reassuring because it means your immune system is responding to the vaccine and you are likely more protected from the flu.

 

Influenza – a serious illness

Influenza is extremely contagious and is spread through droplets when people talk, sneeze or cough. Typical symptoms last about one week and include high fever, muscle aches, upper respiratory infection and fatigue. Most people will experience weakness and fatigue for another one to two weeks after the actual illness.

Those most at risk are the elderly, people with weakened immune systems and children, especially infants younger than 6 months old because they can’t be vaccinated.

Flu vaccine calendar noteTo a certain extent, the younger you are, the more severe your reaction will be. Most symptoms that come from the flu are caused by your immune system, so the healthier your immune system, the potentially more severe your symptoms will be.

If you come down with the flu, your best course of action is to stay home from work or school, drink plenty of fluids, get lots of rest, and take anti-inflammatory medications such as Ibuprofen or Aleve.

The flu is also a fairly significant cause of mortality in the U.S. From the 1976-1977 season to 2006-2007 season, flu-associated deaths ranged from as low as 3,000 to as high as 49,000 annually, according to the CDC’s Morbidity and Mortality Weekly Report.

Because the severity of the virus is unpredictable, I highly recommend getting the vaccine as soon as is convenient for you. By doing so, you potentially avoid illness for yourself while ultimately preventing the spread to vulnerable individuals.

 

For additional information about influenza, visit www.cdc.gov.

 

About the Author: A board-certified family practitioner and Chief Medical Officer at Tri-County Health Care, Ben Hess, M.D., was inspired to study medicine because he wanted to make a difference in people’s lives every day. While not at work, Hess enjoys hunting, fishing, bowling and listening to public radio. He and his wife have three daughters and make their home in Verndale.Dr. Hess