While You Were Sleeping: Coronavirus updates for November 17

Coronavirus

INDIANAPOLIS — There were several developments in the coronavirus pandemic that you may have missed overnight.

Here’s a look:

Waiting game. The demand for COVID-19 testing is increasing rapidly amid the rising coronavirus cases.

Doctors warn people it will likely take longer to receive their results.

“I do think you’ll see longer turn around times for diagnostic testing simply because the volume of tests that are going to be required to be performed are going to increase, potentially dramatically,” said Joe Meyer, senior vice president of system operations at IU Health.

Unfortunately, more testing and therefore longer wait times for results also delays the work of contact tracers for each positive case.

“By the time somebody who was maybe a close contact finds out, ‘hey you were a close contact,’ it’s been a week,” said Dr. Christopher Doehring, vice President for medical affairs at Franciscan Health. “You probably have either manifested symptoms by now or not yourself and so we’re kind of two or three steps behind.”

Doehring advises those who had a high risk exposure, that is the person was within six feet inside of an infected person, not wearing a mask, for at least 15 minutes, to act as if they are COVID positive.

“Personally, a negative test doesn’t really tell me anything in the immediate aftermath of a high risk exposure,” Doehring said. “So personally I would recommend quarantining if the risk is that high and monitor yourself for symptoms.”

IU Health’s labs were turning around test results within one day when we interviewed them late last week. Now, the turnaround time is just under two days. The health system does its own testing using its own labs, and offers these services to some other hospitals and other skilled nursing facilities.

“The demand could far out strip the supply of testing,” Meyer said. “I think we are in a delicate situation as this community spread increases so dramatically.” 

Starting immediately, to alleviate some of the long wait times at the three testing sites for the Marion County Health Department, the agency is requiring people to register for their tests beforehand. To register, visit MarionHealth.org/indycovid or call 317-221-5515.

The Indiana State Health Department can connect you to free COVID-19 testing as well. Visit www.coronavirus.in.gov.

“Breaking point.” The Indiana Hospital Association worries that the healthcare system could be nearing a breaking point as the state endures a record number of COVID-19 hospitalizations.

In the spring, hospitals scrambled to get more personal protective equipment and ventilators. The change in seasons is presenting a new challenge with staffing.

“Fast forward to today, and the supplies of PPE, the ventilators are there,” said Brian Tabor, president of IHA. “Those are stable. We know more about how to treat COVID, but staffing is really challenging right now.”

Tabor is one of many in healthcare concerned about the record number of COVID-19 hospitalizations. On Monday, Indiana hit its highest number of COVID-19 patients in the hospital with 2,768. It is a more than 180% increase compared to hospitalizations on October 1.

He said hospitals for the most part have the equipment for more cases, but the length of this pandemic is taking a toll on the workforce. Hospitals are also losing staff for a variety of reasons, like quarantine or even retirement.

“The fear is that the system essentially gets overrun, and that sounds really scary, and that is why we are ringing the alarm now,” said Tabor.

If the trends continue this way, Tabor believes the breaking point is possibly a few weeks away. He warned hospitalizations lag about two weeks behind the rise in COVID-19 cases.

“It’s about making sure that you protect the system so that if you have a stroke or your loved one has a stroke, you don’t have to worry. You know they are going to get immediately seen by the best care,” he explained.

Schneck Medical Center in Seymour is struggling with staffing shortages too. Their biggest concern is making sure patients are cared for.

“Anytime we do not have the appropriate number of staff or the appropriate number of beds, then we may not be able to keep our patients,” said Amy Pettit, VP of patient care services at Schneck Medical Center.

That is why front-line workers are begging the public to follow the guidance.

“Whether that is down in Kentucky or up in Michigan, Illinois or Ohio, they are busy too. So there are no troops we can call in to staff the hospitals,” said Tabor.

Indiana has established a healthcare reserve workforce, and those volunteers will provide additional support to both hospitals and long-term care facilities. The state is still asking more people to sign up.

Vaccine distribution. With two pharmaceutical companies announcing in the last week that their COVID-19 vaccines in development are at least 90% effective, the federal government is preparing to get the shots out and people to buy in.

“There is light at the end of the tunnel,” Dr. Moncef Slaoui, the chief advisor of the Operation Warp Speed program to develop and distribute COVID-19 vaccines, said.

Pfizer announced last week its vaccine is about 90% effective and Moderna said Monday its is nearly 95% effective, which Slaoui called “really exciting.”

Slaoui said with his team ready to move as soon as the U.S. Food and Drug Administration starts issuing emergency approvals, it’s possible the entire U.S. population could be vaccinated by as early as June.

“We may be able to immunize up to 20 million people with two shots of the vaccine in December and then going forward from there, about 25 million every month,” he explained. “(Each) state will decide and tell us where to deliver those vaccines — for instance, into elderly nursing homes or into pharmacies.”

Millions of doses of the Pfizer and Moderna vaccines are already stockpiled, and Slaoui said he expects two additional vaccines in the pipeline will also be approved.

“Some may be best suited for frail, elderly people. Some may be best suited for babies. Some may be best suited for health care workers,” he said. “It’s by adding all these vaccines over time that we feel confident.”

The question now is whether Americans feel confident in getting the vaccines.

“We now have to convince people” that the science is solid, said Dr. Anthony Fauci, the nation’s top expert on infectious diseases.

“We’ve already crossed the line of efficacy. We’re there,” Fauci continued. “We’ve got to get people to be vaccinated.”

Slaoui agreed and said transparency will be key in getting people on board.

“We will make every data available,” Slaoui said. “We will explain to everyone how we went fast.”

Iowa governor’s mask reversal. With Iowa hospitals filling up, Republican Gov. Kim Reynolds dropped her longtime opposition to a statewide mask mandate and enacted a limited version of one on Monday.

Reynolds signed a proclamation requiring that everyone 2 or older must wear masks when in indoor public spaces. The mandate applies only when people are within six feet of others for 15 minutes and they aren’t members of their households.

Reynolds also limited gatherings for social, community, business and leisure purposes to no more than 15 people indoors and 30 outdoors, saying the restriction applies to family events. Routine office and factory work and spiritual gatherings were exempted, although she urged employers and churches to take precautions.

Reynolds rejected calls to close bars and restaurants for in-person service and instead ordered that they cannot stay open past 10 p.m. She suspended youth and adult sports and recreational activities, except for high school, college and professional sports.

Reynolds announced the steps in a rare evening televised speech. She said they would not be easy or popular, but that they were necessary to fight a virus that was threatening to overwhelm the state’s health care system.

“If Iowans don’t buy into this, we lose,” she said. “Businesses will close once again. More schools will be forced to go online. Our health care system will fail and the cost in human life will be high. So now is the time to come together for the greater good.”

She said her new restrictions weren’t “about mandates” or government, saying there wasn’t enough law enforcement in the country to enforce the mask requirements or business restrictions.

Critics said they were too little, too late after the governor rejected calls for stronger action for months while attending campaign rallies that flouted public health guidance.

“These guidelines are long overdue and fall far short of what Iowans need to aggressively flatten the curve and relieve the stress on our overwhelmed hospitals and frontline workers,” Iowa Democratic Party Chairman Mark Smith said.

The speech marked a change of tone and policy for Reynolds, who weeks ago was joining President Donald Trump and other Republicans at crowded rallies where many people did not wear masks. The governor said the outcome of the election in which Republicans dominated state races validated her small government approach.

Since then, the pandemic’s toll has rapidly worsened. One in every 100 state residents received a COVID-19 diagnosis in the week that ended Sunday, even as others reported delays in getting tests or were awaiting results. That was the third-worst diagnosis rate in the nation, according to data from Johns Hopkins University.

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