a good way to approach the coming months

How about we discuss COVID today? Neighbor to neighbor. Across the back fence, or on the front porch. Grab a cup of coffee before you start reading. I'll wait.

I want to talk about how COVID is spreading now as opposed to early on in the pandemic, the hospital capacity situation, what's happening with vaccines, and what we should do about the upcoming holidays. I will try to stay on track with this outline

In the spring we heard about "clusters" of infection - in prisons, nursing homes, church services/funerals, and large gatherings. We still see this, but now the numbers are being driven by smaller gatherings in homes and communities - all communities. Small towns in more rural areas who early on had no cases, and did not feel the need to mask/isolate, are now struggling. Right now, Kansas has the fourth highest positivity rate in the country at 43.8% based on data from Johns Hopkins.

The community spread is also increasing the numbers of patients who are hospitalized. Yesterday in our hospital we had a total of 126 COVID patients - 84 actively infectious, 31 of those in the ICU, 12 of those on ventilators. The 126 also includes 42 patients who have "recovered" but are still too sick to leave the hospital. Non-emergent surgeries are being delayed to increase bed capacity for those who need those beds NOW. We are a hospital that routinely accepts critically ill patients from across a multi-state area who need a higher level of care than can be provided in their community. We are now not able to accept some of these patients. Can you imagine trying to decide which of 2 patients needs our care more, when clearly both do? The problem is we can't just put up tents or fixed wall facilities to get more beds. We must have the STAFF to care for the patients. There are over a hundred staff members who are unable to work because of COVID. They either have it, are awaiting test results, or are isolating/quarantining. All across the country hospitals are struggling with this, making it impossible for healthcare workers from one area of the country to travel to another area to help out, as seen previously in natural disasters. We are trying to figure out how we can transfer patients who no longer need our specialized care (but still must be in a hospital) back to their community hospitals to free up beds. Something typically not done. 

Vaccines are in the news. With both Pfizer and Moderna reporting promising results, work is underway to figure out the logistics of distribution and prioritization. Healthcare workers taking care of COVID patients will likely be in the highest category of need, followed by individuals in long term care/skilled nursing facilities, then essential workers, people who are at high risk of serious illness, and lastly the general population. These vaccines will require an initial injection, followed by a second injection several weeks later. The second injection must be the same vaccine as the first; they are NOT interchangeable. This is going to sound silly, but for vaccines to be effective, they must be given. We know some people do not believe in vaccinating themselves or their children. Please be very thoughtful about your decision not only for yourself, but for your household/community. At this time we do not know if these vaccines will need to be given annually (like the influenza vaccine) or perhaps semi-annually. Along those same lines, we know that being infected with COVID likely makes you immune from re-infection for about 90 days. This means that if you've had it you must still follow the same precautions as someone who has not been infected. 

Finally lets talk the holidays. Here are some guidelines for staying safe. Gatherings are best kept small - 4 at the most. Even at that, if you do not normally live under the same roof, you should be masked and maintain some distance especially while you are eating and your masks are off. Individuals coming home from colleges/universities are a worry - even more so if they are flying home. To quote Dr. Lee Norman of the Kansas Department of Health and Environment, we need to "virtually carve the turkey" this year. Chris and I have cancelled our usual holiday extravaganza and will be dining alone. We are hoping to be able to take our usual turkey day hike outside with family in the area. Masks will be required, keep your distance, no hugging allowed, and bring your own thermos of coffee.  

The pillars of good infection prevention remain the same: wear a mask, continue to socially distance, wash your hands. This post is not meant to tell you what to do. Rather, it's what I think is a good way to approach the next months based on what is happening right now. Remember, this is a friend to friend conversation, one neighbor to another. It's based on my understanding of best practices to stay safe. I don't normally do this, but if this resonates with you, pass it on to your family and friends for a read. But only as my opinion, as a regular person, not a scientist, not a politician, just a citizen of the world.

Comments

[Sarah S]

You're not just a citizen, Carol - you're on the front lines! I appreciate your advice, candor etc!

[Susan Bjerke]

Thank you!

[Karen Scudder]

Thank you for this and all you do!

[Linda Watson]

Thank you. And, while it's starting, perhaps, to sound a bit obvious to say it, please stay safe.

[Faith]

Thank you. We are also doing Thanksgiving solo. We had our first known exposure in my department at work the other day and the director finally has backed off the requirement to be in the office at least once a week, because cases are spiking in our county, higher than they have ever been and our local positivity rate is over 10% (which, while nothing compared to the rate in Kansas, is worryingly high). Enjoy your small celebration and your distanced hike and stay safe.

[carol]

I thank YOU all for taking the time to read and share with those you love.

[jeanette sclar]

Bravo! You are a wonderful advocate for living life well, in good times and in challenging times. I sincerely hope you get one of the first rounds of vaccines so that you can feel more confident in being safe at work.

[Jan Jackson]

Thank you for sharing this, Carol.