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After nursing home vaccinations, Kansas has fewer COVID clusters and hospitalizations

Wichita Eagle - 2/25/2021

Feb. 25—Health officials are crediting vaccination clinics at nursing homes and lower levels of community spread with much of the reduced coronavirus pressure on Kansas hospitals.

"We have had a dramatic drop-off in the number of cases, hospitalizations and deaths," Dr. Lee Norman, secretary of the Kansas Department of Health and Environment, said during a Tuesday media briefing hosted by the University of Kansas Health System.

Hospitalization COVID-19 statistics have improved so significantly that the KDHE and Kansas Hospital Association last week discontinued their weekly regional hospital reports and teleconferences.

Dr. Steve Stites, KU's chief medical officer, gave nursing home vaccinations much of the credit for the reduced impact on hospitals. He said that current hospitalizations at the Kansas City hospital have dropped about 70% from what the patient counts were three months ago.

"The reality is, when our hospital census has dropped ... that just means there's less COVID in the community," Stites said. "Part of that is because we don't see it in nursing homes, part of that is a lot of people have had it, part of that is 10-14% of the population is now vaccinated."

Norman said about 88% of nursing home residents statewide have been vaccinated, though some are still waiting for a second dose, while the rest opted out. About 65% of staff in long-term care facilities have also been vaccinated, and officials are looking for strategies to increase that number.

"It's been a very successful program," Norman said.

Over the course of the pandemic, Kansas has reported 642 total COVID-19 outbreaks at long-term care facilities, accounting for 14,611 cases, 1,212 hospitalizations and 1,817 deaths. About 38% of all COVID-19 deaths in Kansas were connected to a nursing home cluster.

Sedgwick County has had 86 of those care home clusters, according to the local health department.

The state has experienced a large drop in the number of active coronavirus clusters at nursing homes. On Wednesday, the KDHE reported 59 active clusters at long-term care facilities statewide. The state's cluster list named just three of the long-term care facilities.

The number of active clusters peaked in the KDHE's Dec. 23 report, which showed 215 facilities had ongoing outbreaks. The cluster list identified 51 of the locations statewide, including six in Sedgwick County.

In the past week, Kansas had three new outbreaks at care facilities. The state also had 56 newly-reported deaths connected to nursing home clusters, though it is unclear when those patients died.

The American Health Care Association and National Center for Assisted Living, in a statement issued last week, said COVID-19 vaccines are making a difference in long-term care facilities.

"For nearly a year, long term care facilities have been at the epicenter of the pandemic," the group's statement said. "Now, residents and staff have a reason for hope. There is still a long road ahead, but if we continue to make vulnerable seniors and heroic caregivers a priority for the vaccines and essential resources, we can continue to save lives."

Research by the organization, using December data, "found that COVID-19 cases decreased at a faster rate among both residents and staff associated with nursing homes that had completed their first clinic, compared to those nursing homes that had not yet administered the vaccine."

New COVID data and vaccinations

As of Wednesday, Kansas has now had pandemic totals of 292,837 confirmed and probable cases, 9,189 hospitalizations, 2,482 ICU admissions and 4,724 deaths. The increase from Monday to Wednesday was 1,122 new cases, 86 new hospitalizations, 16 new ICU admissions and 81 new deaths.

Sedgwick County, according to the KDHE, has now had 53,429 cases, 1,402 hospitalizations, 403 ICU admissions and 695 deaths. Wednesday's report contained 194 new cases, 31 new hospitalizations, six new ICU admissions and 15 new deaths.

The state's weekly cluster report showed 17 new outbreaks statewide. That included four schools, three nursing homes, three business and three private events, among others.

The Sedgwick County Health Department reported three new school clusters, one new business cluster and one new nursing home cluster in the past week.

As of Wednesday, Kansas has received 694,720 doses of vaccines, which is an increase of 112,745 doses in the past week. The KDHE allocated Sedgwick County 10,530 doses this week.

There have been 350,989 total first shots reported as administered, or about 12% of the population. There have been 155,412 second shots reported as administered, or about 5.3% of the population.

Between Monday and Wednesday, the KDHE logged 11,799 new first shots given and 11,397 second shots given.

Kansas continues to rank low in the Centers for Disease Control and Prevention's reporting of doses administered per-capita. As of Wednesday, the CDC's statistics had Kansas as the fifth-worst, ahead of Georgia, Mississippi, Alabama and Texas.

On top of weather delays last week hampering the roll-out, Kansas officials say data reporting issues persist.

"We know there's a lot of doses out there that have been put in people's arms that have not been recorded," Norman said.

Last week, Gov. Laura Kelly announced administrative fixes to reduce the reporting lag.

"We want to reconcile for accountability purposes and for the public confidence that the vaccine is being used right," Norman said.

The Sedgwick County Health Department, as of Wednesday, had administered 40,076 total doses. There were 992 first doses and 1,219 second doses administered on Monday and Tuesday.

There are 80 pharmacies and other community partners in Sedgwick County that will help administer vaccines, County Manager Tom Stolz said during a Wednesday media briefing. He said he expects the county will open up vaccinations starting next week for everyone who is 65 year old or older.

The health department had one single dose lost to spoilage early on in the vaccine roll-out, but has not had issues since then, Stolz said.

"That's just part of the deal: don't waste a single dose," he said.

Low COVID numbers and reopening

The improving pandemic trends have been reflected in wastewater surveillance, which Norman said has proved to be a "remarkable" indicator of community spread. In most Kansas communities, sewage tests show coronavirus levels are dropping.

While drops in cases, hospitalizations and deaths are good news, the recent decline in testing is potentially concerning for health officials. While several factors may be at play in the reduced testing, the plummeting positivity rate suggests at least part of it is because there are fewer sick people seeking a diagnosis for their illness.

The statewide positive test rate is down to about 5%, Norman said on Tuesday. On Wednesday, the Sedgwick County Health Department reported a 14-day rolling average below 5% for the first time since September.

Still, testing will remain an important tool in the fight against the coronavirus disease.

"It (testing) is still extremely valuable to us," Norman said. "Obviously for testing symptomatic people who may have it, and then secondly for surveillance — as kids come back, teachers come back, businesses ramp up to their pre-COVID levels — to do asymptomatic persons."

As has been the case throughout the pandemic, there are likely people in the community who have not been tested and are unknowingly spreading the coronavirus.

"We have to assume there is some sort of asymptomatic spread out there," said Dr. Dana Hawkinson, an infectious disease specialist at KU.

While the numbers have shown significant improvement, some indicators for community spread are still high.

In particular, the rate of new cases in Kansas remains in the red zone of the most recent report from the White House COVID-19 Task Force. The death rate is also in the red zone, while the hospitalization rate and the positive test rate are both in the yellow zone.

Stites predicted another surge will happen, citing several factors, including people "getting too comfortable" and taking their masks off.

"I'm willing to bet on another surge coming out as the weather warms up and we don't have enough folks vaccinated," Stites said. "But I'm going to say that by August things are really going to be turning around for the better for the long term."

Hawkinson said that while he is optimistic about reopening and moving toward normalcy, the new variants could potentially lead to further shutdowns and lock-downs.

"I think you also have to understand probably the overwhelming force of people just being tired of doing what they're doing," he said. "Whether that's right or wrong, things may inch back towards normal, even if it's not the right time. People want to get back together."

In Sedgwick County's Wednesday media briefing, commission Chairman Pete Meitzner lauded the community and the order from health officer Dr. Garold Minns.

"It's a great community effort to — for the most part — abide by and respect the health order," Meitzner said. "The spacing, the restaurants, the capacity, obviously the masking."

He suggested it may be time to loosen the restrictions in the county's order.

"All the signs are pointing better for us to, again responsibly, keep opening up," Meitzner said.

Norman said public policy on health restrictions requires wisdom. Tight lock-downs "will likely not be needed and would probably not be tolerated very well. But we don't want to fling the doors open and party like it's 1999."


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