Here & Now

Noon Wednesday: A Chronic Covid Condition

Marisa Wojcik:

Welcome to “Noon Wednesday,” I’m Marisa Wojcik multimedia journalist with “Here & Now” from PBS Wisconsin, and today is December 8. As we close in on the end of 2021 and the second year of this pandemic, we’ve gone from introducing warp speed vaccines and thinking we were heading toward a reprieve in the pandemic to an even worse surge from delta. The first big variant to take hold, and now in the last few weeks, we learned about the next variant of concern, omicron. Here to help us unpack how this looks is PBS Wisconsin reporter, Will Cushman, who writes the weekly Covid Condition, and, will, thank you so much for joining.

Will Cushman:

Hey, Marisa.

Marisa Wojcik:

So how many cases of delta is Wisconsin averaging right now?

Will Cushman:

Yeah. It’s been a little hard to track down in recent days, but state health department has been dealing with some data issues after performing some sort of upgrade to its disease reporting system over the weekend, and so we don’t really have detailed data since last Friday, but I did get some kind of high level stats from the Wisconsin Department of Health Services this morning, and right now, we are averaging about 3100 or so confirmed cases every day. That’s down a little bit from the end of last week when the average was about 3500, and we’re also averaging around 500 to 600 probable cases every day as well, and I want to note that the number of probably cases that we’re seeing lately has been really high. In fact, kind of at its highest levels throughout the whole pandemic, and we think that’s because probably cases are determined usually via rapid at-home antigen tests versus confirmed cases which are determined via a PCR test. So, if you go to the local health department or doctor to test, it is probably via PCR test and takes a few days to get the results versus rapid at-home tests. We are seeing — it seems there are a fewer people getting the PCR tests compared to the big surge last fall, but there are definitely, it appears, more people taking advantage of the rapid at-home antigen tests, and I should also note that the number of probable cases that we are seeing on average every day right now, about 500 or 600, is very likely a significant undercount because there are likely quite a few people who are getting positive results from their at-home tests not reporting to the local health department so it is not fed into the state data system.

Marisa Wojcik:

Very interesting. So likely an underreporting all around, and testing overall is very different from last year. Something that we do know more concretely is hospital capacity. What does that look like statewide?

Will Cushman:

Yeah. So as of yesterday, there were more than 1600 people hospitalized around the state for covid, including more than 400 people who were in intensive care units, so in ICU beds. That is up significantly even over a week ago, about 15% higher than just one week ago, and the Wisconsin Hospital Association is reporting that there are not very many beds left in the state for anyone, whether you are a covid patient or there for treatment for something else. There are, right now, only a little over 30 ICU beds available across the state, and most of those are located in southeast and south-central Wisconsin, so around the Milwaukee and Madison metro areas. There’s a huge swath of Wisconsin from — along the western border from Richland County in the southwest up to Lake Superior including La Crosse, Eau Claire, Superior, Baron, where there’s zero ICU beds available, at least for yesterday, and then in the Fox Valley, there was one ICU bed available in northeast Wisconsin centered around Green Bay, about a half dozen, and in north central Wisconsin, including North Woods and Wausau there’s only a handful of ICU beds available yesterday.

Marisa Wojcik:

Wow. So very, very limited capacity, it sounds like, all across the state. Hospitals have been saying that sometimes capacity not only is beds, but staff. Covid patients take more staff in order to take care of them, and so not only is capacity tight with physical space to put these patients, but actually staff to take care of them, so what are the major hospitals or just hospitals in general saying about what they are experiencing? What is word on the ground?

Will Cushman:

Yeah. That’s a really good point, that a big part of the problem right now with healthcare capacity is in staffing. Yesterday I listened into a round table with hospital CEOs around the state hosted by Wisconsin Health News, including the CEOs from Marshfield Clinic and Feta Care in northeast Wisconsin, and then the Milwaukee area, and they all said very similar things. Feder said the full at the moment, period and that their ICU is filled — about a third of the ICU is covid patients. The hospital’s CEO or president there, Eric Cunningly said 88% of the patients are unvaccinated and staff holds up everywhere around the state according to the CEOs who spoke yesterday. Marshfield Clinic said 75% of the patients were unvaccinated, and, yes, they all said that this is a major strain for the staffs. It can take up to three times as many resources, including human resources to care for a covid patient opposed to patients coming in if other typical ailments, whether they are in ICU or not. So it is definitely of concern, and I think it was — the consensus was that the current situation is not sustainable from a staffing standpoint, and so hospitals are really looking for some relief in the near future, and we’ll see if that happens.

Marisa Wojcik:

Very, very alarming. So how does this compare to last winter when we saw a surge, but we didn’t even have vaccines at that point? I recall we kind of hit peaks towards the end of December, early January. How does this year and what we’re experiencing right now compare to where we were at this time last year?

Will Cushman:

Yeah. The — at least in terms of hospitalizations, the current number of people who were hospitalized, a little over 1600, about 70% of the peak number of hospitalizations that we saw during our worst surge last late fall and early winter, and that tracks with what hospitals are seeing on the ground as well. Marshfield Clinic’s CEO said they, right now, are seeing about 75% of the number of covid patients they were seeing a year ago during the worst phase of the pandemic for them, so it’s approaching those — it’s clearly at crisis levels and approaching the basically unprecedented levels. It is approaching what we saw in the worst peak last winter.

Marisa Wojcik:

And you touched on how many people were vaccinated and percentages in some of these areas across the state where we are reaching capacity levels. NPR recently looked at counties’ political affiliations against the impacts of covid and found that areas that went for Trump are experiencing more deaths caused by covid-19. Does this have to do with vaccination rates and taking precautions like distancing and masking, and is this what is happening in Wisconsin?

Will Cushman:

Yeah, that does seem to be the case. The NPR report you are referencing, I believe it was looking at death rates since May, so, basically, since vaccines have been pretty widely available, and, yeah, there does, indeed, seem — or there is a pattern that we’re seeing, including in Wisconsin that was with NPR that has a little infographic that you can enter in county names and look at death rates since May along with the vote tallies from the 2020 election, and you can see a pretty clear pattern that places that, yes, went for Trump have had higher death rates since May, including in Wisconsin, and we know there’s definitely political component to the willingness to get vaccinated. We know, actually, that NPR report included an interesting stat that Republicans and Republican leaning voters now make up the majority of those who are unvaccinated in the US, and so that’s a pattern we’re seeing all across the US, including in Wisconsin.

Marisa Wojcik:

And so now we have another concerning variant circulating. How many cases are omicron are in Wisconsin that we know of?

Will Cushman:

Yeah. So, I heard from the state health department just this morning that they are still only aware of the one case of omicron detected in an individual in Milwaukee County last week, actually, over last weekend. That individual had recently traveled to South Africa where the variant was first detected and where it really is blowing up first. And in addition to that, we are also aware of several pieces associated with omicron and people in California who had attended a wedding in Milwaukee County just after Thanksgiving and are believed to have possibly been infected there, but so far, there’s just that one case that the DHS is aware of in Wisconsin, but even last week before the first case of omicron was confirmed in Wisconsin, Dr. Ryan Westergaard, the State Epidemiologist for Communicable Diseases, told reporters it is probably safe to assume that omicron is spreading around Wisconsin as it is likely spreading around most of the world at this point.

Marisa Wojcik:

So what do we know about omicron? What are public health officials saying about it? Should we be concerned at this point as we are in the midst of a huge surge of delta?

Will Cushman:

Yeah. That’s — last week, there was definitely quite a bit of emphasis on the fact that, yes, omicron is concerning, but being in Wisconsin and the upper Midwest generally are in the midst of a really bad surge caused by another variant, delta. So, health officials were very clear we should not lose sight of the fact that the present situation is not good as it is even without this other concerning variant, and state health officials have said that they are concerned about the potential increased transmissibility of the omicron variant, but it is still early, in terms of the scientific understanding of the variant, and scientists still have to pin down exactly how transmissible it is, possibly more transmissible than delta, but there are a lot of questions of its ability to evade prior immunity whether through natural infection, vaccination, or a combination of the two. We know that what made omicron so concerning in the outset was the large number of mutations, especially mutations that affect the spike protein which is how we know the coronavirus, Sars-Cov-2, which is covid, affects people, and so there is worry all mutations might make the omicron variant better at infecting people, and there does seem to be some pretty limited lab-based data so far that the omicron variant is potentially better at evading both prior infection and the two-dose regimen of Pfizer, at least, at least some form of vaccination than previous mutations were, but that’s lab based evidence, not real world evidence were able to assess yet. But, it is of concern and there’s a rapid rise of cases in South Africa where the variant was first identified along with now a rise in hospitalizations, and whether or not omicron is responsible for milder disease than delta or other variants is an open question. There’s still a lot of open questions related to the variant, and we’re going to be finding out a lot more in the next couple of weeks.

Marisa Wojcik:

And I believe even just this morning Pfizer said three doses of their vaccine is a much better 25-fold better protectant over the omicron variant so very much evolving information as we learn more and more. Given that, we have a major holiday that typically involves a lot of travel coming up. Christmas is just around the corner. Typically, this is a time people take off, college students go back home, and people will travel very far to be with family. Should people be modifying their plans? Have there been any mandates put in place? What can we expect, and what is the safest thing to do?

Will Cushman:

Yeah. That’s a really good question. Here in the US, there haven’t been a ton of new mandates or restrictions put in place yet to respond to omicron. Aside from more stringent testing rules for people entering the US from abroad, including US citizens, but, yeah, I sat in on a Q&A for reporters that the Mayo Clinic held with a doctor late last week, and so it was before even understanding what we do now about omicron, so very early omicron, but that doctor, with Mayo was expressing that people should really be cautious over the holidays, especially if you are immunocompromised or elderly or you have immunocompromised people in your life who you plan to spend the holidays with. He suggested taking precautions, of course, first and foremost, fully vaccinated. Now, if you’re an adult, getting a booster shot, as you said, there’s early evidence that at least a booster of the Pfizer vaccine may help protect against infection from the omicron variant, but he also mentioned all of those kind of mitigation strategies that we are really well-familiar with at this point, layers of protection so masks up in public places, especially in indoor settings, traveling in the airport. You have to mask up in the airport and flying right now anyway, but making sure you are vigilant about that. Washing your hands frequently. Distancing when you can. And then, yeah, with your holiday gatherings, think about keeping it on the smaller side, maybe, especially if you are concerned about your health status or that of a loved one or anyone in your life, avoid large crowds and such. I think there’s also — and the doctor from Mayo acknowledged this as well. There’s definitely a hunger people have to spend the holidays this year with their loved ones, especially after the last year when it was even less safe to do so because most people were not vaccinated, so he was definitely not of the opinion that you should cancel your holiday plans necessarily, but you should definitely think about the layers of protection and try to be as vigilant as you can about the holidays.

Marisa Wojcik:

It seems a lot of things have relaxed a bit since last year, and it’s very difficult to bring those regulations back or to reign things back in so people are definitely going to still be seeing family and friends over the holidays. As this continues to evolve and we go into 2022, what are you going to be focusing on most in your reporting? What are you kind of looking at closely as this continues to drag on?

Will Cushman:

Yeah. First and foremost, I am going to be following closely, like a lot of people are, how the omicron variant actually pans out, what its actual real world impact is going to be in Wisconsin and the US. I think that’s definitely what I’m going to be following closely in the near future, but now I’m also going to be following kind of rapid — we are approaching, believe it or not, two years with this virus, and as you said, things have, in terms of restrictions, relaxed quite a bit over the last six to nine months since we had widespread availability of the vaccines, so I’m interested in reporting on how healthcare, in general, is going to be just shifting, maybe on, like, a permanent basis in response to the ongoing threat of covid. This round table with hospital CEOs yesterday that I attended was some of the topics they touched on were pretty interesting. Just the unsustainability of the situation of healthcare workers and for healthcare systems in general, I think, is going to be something that we want to pay really close attention to over the next several months to two years for sure.

Marisa Wojcik:

All right. Will Cushman, thank you very much.

Will Cushman:

Thanks, Marisa.

Marisa Wojcik:

For more from “Here & Now” and PBS Wisconsin, you can visit pbswisconsin.org/news, and thank you so much for joining us on “Noon Wednesday.”