Indiana health officials concerned as COVID-19 cases, hospitalizations trend in wrong direction

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INDIANAPOLIS – Indiana will remain in Stage 5 of its re-opening plan for now and the face covering mandate is still in effect, according to Governor Eric Holcomb during a weekly press briefing.

It comes as the state sees an increase in COVID-19 cases, positivity rate and hospitalizations. Chief Physician Executive Dr. Ram Yeleti at Community Health Network believes Indiana is seeing the start of a surge.

“Stage 5 is not the stage the checkered flag comes out,” said Governor Holcomb. “Stage 5 is not an excuse for indifference.”

It’s been nearly three weeks since the state began the final stage of its reopening plan. In Stage 5, size limitations are removed for social gatherings and meetings. Organizers of events that will have more than 500 people are required to submit a written plan to their local health department.

On September 16, before Stage 5, the state’s 7-day positivity rate was 3.9 percent. The state’s county metrics map on its COVID-19 dashboard was largely showing counties in blue, meaning there was low community spread in those areas.

On October 7, the state’s 7-day positivity rate jumped to 5.3 percent. Dr. Lindsay Weaver, Chief Medical Officer for the Indiana State Department of Health, said these rates do not account for the large increase of cases Indiana has seen over the last few days so it’s possible the rate could change again in the coming days.

Dr. Weaver noted a number of counties have seen an increase in COVID-19 activity. Last week, 39 counties were highlighted in blue, 8 counties were in orange and one was in red.

This week, Indiana has 24 counties in blue, 21 in orange and one in red.

“People are gathering in large groups without masks. They are not social distancing and essentially, they have pandemic fatigue,” she said.

1,357 Hoosiers were in the hospital for COVID-19 on Tuesday. That is the highest number the state has seen since May 13. Dr. Weaver said some hospitals are facing significant staffing challenges and hospitals in several districts are experiencing critical ICU bed shortages.

“This is especially concerning because we have not begun to see the typical increase in ICU bed usage from influenza,” Dr. Weaver said.

As of Wednesday, 50 percent of ICU beds in use statewide are for non-COVID-19 patients. Hospitals do feel more prepared to handle these cases but health officials are concerned about what may happen once more people are forced inside when the temperature gets cooler.

“Several of our hospitals late last week were at full capacity. We had no ICU beds available,” said Dr. Ram Yeleti, Chief Physician Executive at Community Health Network.

Dr. Yeleti said his network has more COVID-19 patients now than they have had in the last three months and there are also more patients in the ICU. He said ICU beds are filling up with COVID-19 and non-COVID-19 patients.

“Now we are starting to see the demographic gradually shift from the lower age category to the higher age category. And because of the gradual shift we are seeing more hospitalizations,” he said. “What is going to happen a few weeks later is those hospitalizations are going to go to more ICU.”

The Regenstrief Institute is noticing a change in the age demographic too. Their Director of Public Health Informatics is calling this moment a “second major wave.”

“We saw in the summer the number of cases were predominantly among younger adults and what we are actually seeing right now, at the beginning of the second wave, so towards the beginning and middle of September, that was still the case,” explained Brian Dixon. “What we are starting to see now is the age of the population getting the virus is getting a bit older.”

Dixon explained patients are staying in the hospital a little bit shorter than before because the hospital systems are more prepared than in the first wave.

Regenstrief’s COVID-19 dashboard also shows 11 percent of all COVID-19 cases in Indiana have been hospitalized and more than 80 percent of COVID-19 cases have recovered.

During his Wednesday briefing, Governor Holcomb said he does see Hoosiers making wise decisions by wearing masks and socially distancing themselves. He said there if proof that folks are operating responsibly in Stage 5 and he believes the shutting down approach is missing the point.

“This ultimately comes down to our personal actions or inaction,” said Holcomb.

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