NEW HANOVER COUNTY — It’s a conversation that keeps trending nationwide: Has the latest wave of Covid-19 peaked? Will we head into another surge as cooler months approach and more people gather indoors?
As of Sept. 17, a spokesperson for public health wasn’t putting New Hanover County quite in the clear, telling Port City Daily it was too soon to determine if local numbers had peaked. However, with last week’s metrics moving slightly downward, health director David Howard said he remains cautiously optimistic.
“Due to the diligent work of so many residents, visitors, and establishments across New Hanover County becoming vaccinated and using helpful precautions, such as wearing face coverings indoors, we are seeing improving numbers for several of the metrics we track,” Howard wrote to Port City Daily Monday. “The percentage of community tests coming back positive has decreased, as well as our running average of new cases per day, hospitalizations are lower, and the figures out of UNCW and the school system are also encouraging.”
The county’s percent positivity fell to 9.5 last week — lower than a high 14% from the beginning of August, as well as 11.8% and 13.9% from the previous two weeks. Though still almost double, the trend is inching closer to health officials’ goal to reach 5%.
The highest one-day spike over the last few months happened Aug. 31 with 159 new cases. The Covid-19 count then began a bit of a decline, though spiked again Friday, Sept. 17, with 139 new cases. Over the last 10 days, numbers have remained below triple digits daily.
The county also looks at deaths from Covid to determine its severity within the community. Cumulatively, the number has ballooned to 259 individuals since March 2020. Two weeks ago, the county experienced its most deaths — 37 — in one week since the pandemic began. Last week, it was down to 14.
“Unfortunately, we have seen a lot of deaths from COVID patients,” Novant’s New Hanover Regional Medical Center chief clinical officer Dr. West Paul said, “which reduce our [Covid-19] numbers but not in a way we want.”
According to Paul, New Hanover County is in a fourth wave of Covid-19 spikes. Each looked differently, he said, though this current one has been the worst over the last 19 months because of the highly contagious delta variant. He said the hospital has “far exceeded” winter 2021 metrics — “which we thought was pretty bad at the time,” he added.
“The last surge peaked and came down relatively quickly,” Paul said. “For this surge, we’ve peaked, and we are very slowly declining, which, again, puts a lot of tactical resources as we go forward.”
While the last few days of August into the first of September saw NHRMC admit on average 132-134 patients a day — again, the most to date — last week the hospital had on average 76 a day. This wave has had more people in their mid-40s and pediatric cases admitted (Paul confirmed no Covid pediatric cases are in the hospital currently). Admission numbers overall have declined by 40% since last month.
Delta’s sharp infectivity, paired with the timing of summer and Covid-19 mandates being loosened, helped amplify rates and duration, according to Paul: “It was kind of a perfect storm of a virus going up.”
Also, vaccinations weren’t trending upward as quickly as they were eight months ago. Paul said NHRMC has seen only a 4% increase in vaccination rates among the general public over the surge.
The New Hanover County Health Department reported a slow-down in inoculations as well. So far, it has listed the most vaccinations during the first part of the year (numbers do not include NHRMC or other county providers), but have fallen drastically in the second half:
- January – March: 37,487
- April – June: 20,462
- July – September: 4,277
Is another spike on the way?
Paul confirmed he is worried about a possible fall and winter surge when more people are closed indoors together, especially through the holidays.
“You have to realize, in fact, as the chief clinical officer, I get paid to worry,” he clarified, “to try to predict worst-case scenarios.”
Delta’s infectivity, and even another mutation of Covid revealing itself, remain top-of-mind. While early in the pandemic, health officials were looking at 70% as a base number for herd immunity — which Paul calls a “theoretical construct — delta’s steep viral load could increase that benchmark. Paul said percentages change based on how contagious a virus can be; he used measles as an example.
“It’s one of the most infectious viruses we have to achieve herd immunity — 95% would either had to have had the disease or be vaccinated,” Paul said. “Now, these days, 95% is what we require of vaccinations in school. So that’s very high.”
To put it into perspective, for the alpha variant — the B.1.1.7 strain, which came onto the scene 12 months ago in England — Paul said its infectivity is lower than delta.
“So as [Covid-19] mutated, as viruses do, it’s probably greater, 80%-85%, to achieve with delta — so the more infectious the virus becomes, the higher that number actually ends up being to accomplish herd immunity,” he explained.
The county health department does not base herd immunity on anything other than vaccinations. Health officials said science hasn’t shown conclusively how long antibodies last in Covid-19 patients — it varies on a case-by-case basis.
“The CDC is still evaluating data from clinical trials to determine the length of time antibodies stay in your system after infection,” a spokesperson for public health said. “So we rely on the county’s overall vaccination numbers to tell us where we are on the path to herd immunity.”
In New Hanover County, 62% have been inoculated with at least one dose of a Covid-19 vaccine, while 58% have received full immunization.
Even as case counts are presently on a decline, the opening of concerts, athletic events and other large indoor gatherings, such as school starting back, present greater possibilities of community spread, Paul said. He admitted a fifth surge seems inevitable.
“Fingers crossed it won’t be as high as what we just saw,” he said.
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