State medical officer: COVID cases rising rapidly

Acting State Medical Officer Dr. Maggie Cook-Shimanek said Tuesday that COVID-19 cases in the state are rising rapidly with more than 6,300 reported cases during the week ending Jan. 7, an increase of 136 percent from the previous week.

Cook-Shimanek made the comment during a press conference sponsored by the Montana Medical Association with medical professionals from around the state discussing the impending omicron variant-driven surge in Montana, providing updates on the state's COVID-19 trends and what to expect in the near future.

Cook-Shimanek said hospitalizations rose 17 percent from the previous week.

She said 57 percent of the eligible population over the age of 17 in Montana is fully vaccinated, but that number drops to 53 percent when factoring in the rest of the eligible population.

She said 84 percent of COVID-19 specimens sequenced at the state lab were of the omicron variant, up from 70 percent from the previous week, and it does appear to have become the dominant strain in Montana.

The surge to come

The current surge of COVID-19 in the U.S. is being primarily driven by the omicron variant, said Billings Clinic Infectious Disease Specialist Dr. Neil Ku.

Ku said the three holidays in the last few months have certainly contributed, and the fact that so many in Montana are still unvaccinated has also contributed, but omicron is estimated to be three times as transmissible as the delta variant, itself almost three times as transmissible as the original strain of COVID-19.

He said cases caused by the omicron variant do tend to be less severe than the delta or alpha variants, but the sheer number of people being infected means hospitalizations and deaths could easily match or surpass what was seen during last year's delta-driven surge.

He said despite the tendency of omicron to cause less serious illness, people are still getting very sick and deaths are still happening, and the unvaccinated and severely immune-compromised are at especially high risk.

Ku said people who catch the omicron variant of the virus have been found to have much greater viral load in their respiratory systems as well, meaning they can spread it to more people, and the new variant's incubation period is shorter than delta as well, being about three days as opposed to five.

He also said omicron is also more resistant to the most commonly used monoclonal antibody treatments and is better at evading immunity developed in the wake of catching the virus previously, leading to a rise in reinfections.

Like everyone else at the conference, and the larger medical community worldwide, Ku said the answer to this is still vaccination, which is safe and effective.

"Vaccination remains the most important and effective strategy against severe illness, hospitalization and death," he said.

He said vaccines are widely available to the vast majority of Montanans and immunocompromised children 5 to 11 years old are now authorized to get another dose of the vaccine 28 days after their second dose.

He said children 12-17 have also been authorized to receive a booster and the amount of time between their last does and the booster has been lowered from six to five months.

Ku also said while monoclonal antibody treatments are useful for fighting COVID, they are absolutely not a replacement for vaccination.

Wearing high-quality face masks, physical distancing and avoiding gatherings, especially indoors, will also provide more protection, he said, and the more methods people use the safer they will be.

Ku also went over the current quarantine and isolation guidelines at the national level, which recommend different procedure depending on someone's vaccination status.

He said those exposed to the virus who are vaccinated and boosted are not required to quarantine at all as long as they don't develop symptoms.

Those not up to date on their vaccination must remain in quarantine for 10 full days, and need to watch for symptoms and test on Day 5.

Isolation for people diagnosed with the disease is for five days for most people, as long as they have no symptoms or their symptoms are improving and they are fever-free without the use of fever suppressing medication or they have been without symptoms.

Rising hospitalizations

The effects the impending surge will have on the health care system was one of the biggest subjects at the meeting and the predictions were not good.

Ku said hospitalizations across the U.S. have significantly increased and are surpassing previously set records during the pandemic.

Montana, which tends to lag behind most of the U.S. in terms of when surges happen, has seen hospitalizations slowly trend upwards, but they are likely to rise significantly in the coming days.

Montana Hospital Association President and CEO Rich Rasmussen said the hospitals in Montana are already getting full and facing staffing shortages and the bulk of the surge hasn't even started yet.

"This wave is different and it has the potential to tax our hospitals more than any pervious wave," Rasmussen said.

He said last fall's surge had hospitals at or above capacity for 10 consecutive weeks with COVID patients, the vast majority of them the unvaccinated, filling intensive-care units.

"The whole fall was a surge for us," he said.

Beyond the difficult position this puts hospitals in, he said, this will negatively affect patient care as hospitals will increasingly need to consider implementing crisis standards or contingencies to address the surge, meaning elective procedures may once again need to be postponed.

Rasmussen said just because these procedures are non-emergency doesn't mean they're not important, a fact made all the more obvious after the first wave of COVID-19 saw procedures delayed.

He asked for everyone to get vaccinated, including the young who are becoming a more-and-more common sight in the hospitals due to COVID-19.

"It's difficult for our care givers to see so many young people suffer from a disease which is preventable with a safe and effective vaccine," he said.

Rasumssen also talked about the effect the pandemic is having on long-term care facilities which have been plagued by a huge amount of staffing issues as a result of the pandemic.

Despite the situation, he said, there is some good news on the staffing front, with the Gianforte administration's new initiative to find foreign nurses to bolster staff.

He said the effort has drawn a great deal of interest and his organization is very pleased with this new development.

Hospitalizations among children

The U.S. is seeing a massive surge in hospitalizations among young children 4 and younger, who are not yet eligible for the vaccine, and while the surge isn't in full force in Montana just yet, pediatric hospitals are already seeing a lot of children coming in with COVID-19.

American Academy of Pediatrics Montana Chapter President Dr. John Cole said pediatric hospitals in the U.S. are being overwhelmed, and while deaths among children from COVID-19 are rare, they still do happen and long-term impacts are also a possibility.

Beyond the direct effects of having COVID-19, the pandemic has hurt countless children in the U.S. Cole said, indulging the 175,000 children in the country who have lost a care giver or become orphaned by the disease.

He said the pandemic has also had an effect on children's educations as so much time has been lost due to quarantine, on top of the general stress of living through the pandemic.

Cole said until the variant is under control measures like mask wearing, preferably with a three-layered cloth or N-95 mask, and physical distancing should be used to keep children in school.

He also talked about a vaccination and education campaign being run by 10 large health care associations in Montana called "Your Best Shot MT" to help answer parents' vaccine questions and increase COVID-19 vaccination rates in Montana.

He encouraged people to talk to their doctors about the vaccine if they have questions or concerns.

Tools for fighting COVID

Montana Medical Association President Dr. Carley Robertson of Havre said the pandemic is not over and the situation is serious, but the medical community is better equipped the to deal with COVID-19 than it has been in the past.

"It's important to remember that while the pandemic is not yet in our rear view mirror, we have more tools this year than we did last year," Robertson said.

She thanked everyone for providing their expertise and clarity during a time of such rampant misinformation and disinformation.

She ended the meeting by asking everyone to get vaccinated as soon as possible if they haven't already.