Hospitalization rates have also begun increasing, though no new deaths were reported
CLARK COUNTY — After switching to a new system that delayed reporting, Clark County Public Health confirmed 45 new cases of COVID-19 on Tuesday, and 37 more Wednesday, bringing the outbreak total to 1,090.
The county has not recorded a new death due to COVID-19 since June 22, with the total remaining at 29.
One potentially concerning statistic involves hospitalizations, which increased to 22 confirmed cases on Tuesday, with 4.9 percent of beds occupied by someone with a confirmed or suspected infection. That was up from 3.7 percent on Monday, and just 1.8 percent last week.
PeaceHealth Southwest has been receiving new COVID-19 cases from its St. John’s location in Longview since June 15, though it’s unclear how much that has contributed to the rise in Clark County.
Dr. Alan Melnick, the county’s public health officer and health director told the Board of Public Health on Wednesday that hospital capacity remains good, with sufficient supplies of protective equipment and ventilators on hand.
“Right now the hospital situation is looking good,” Melnick said, “but I’m concerned over the next few weeks and months, if cases keep going up, we’re going to see stress on our hospital systems.”
The most recent increase in cases has pushed the county to a metric of 52 per 100,000 residents in the past 14 days, dating from July 3. To meet the goal of no more than 25 cases per 100,000 the county would have to see nine or fewer new cases per day. In the past week, the average has been over 20 per day.
Melnick also noted that the average number of tests being done per week has increased from just over 3,100 at the start of June, to nearly 4,700 at the end of the month.
“But you can see the positivity is going up,” Melnick noted. “And that positivity is a measure of COVID-19 activity in the community.”
During the week ending June 13, only 1.18 percent of tests were coming back positive for COVID-19. That number is now nearing four percent and rising, according to Melnick.
One area of concern has been the rate at which the county has been able to contact people who have a positive test. On June 26, when the county applied to move to Phase 3, 63 percent of confirmed cases were being contacted within 24 hours. Right now, that number has fallen to just eight percent.
“That … is not a typo,” Melnick told the board. “That is the actual number. And it is a dismal number.”
Melnick noted the county has been working to bring nursing staff on board to do case investigations, but facing difficulty in getting them trained up quickly enough to handle the recent spike.
“I gotta tell you, I have an even deeper appreciation for the work that long term public health nurses do,” said Melnick, “because transitioning from more of a clinical role to doing this kind of Public Health work takes some training.”
Melnick said the county currently has 20 contracted nurses and a nurse program manager on board, and is working with The Public Health Institute to bring in another contact notification team, bringing the total to 48 people working on that side of the outbreak.
During the measles outbreak in 2018, the county was able to draw on help from the state Department of Health to bring in case investigators who were already trained. With the virus spread across the entire country, there is no outside help to bring in.
“We’re kind of in a race against the virus here,” admitted Melnick, “where we’re bringing on staff who had never done this type of case investigation.”
Clark County Chair Eileen Quiring also wondered whether public health might transition to emphasizing hospitalization rates and deaths over total case numbers in demonstrating to the public the true picture about the outbreak.
“The thing about the case count is it gives you a little bit of lead time in terms of planning,” Melnick responded. “Because if you wait until the hospital numbers start going up, you’re already behind the curve.”
Melnick noted that some places in Texas and Florida, which saw case counts start rising weeks before Clark County, have begun to experience alarming increases in hospitalizations as the virus spreads into older populations.
“Those case count increases are going to occur a couple of weeks, maybe even a several weeks before the hospital numbers go up,” Melnick warned, “but they will go up.”
As of Tuesday, businesses statewide are being told they must refuse to serve anyone who isn’t wearing a mask, though they are also being asked to find ways to accomodate people who can’t wear one for medical reasons.
“If somebody still refuses but does not have a medical condition, the business should politely tell them that they can’t serve them and that they need to leave,” said Melnick, quoting the advice given out by the state health department. “If the individual still refuses to leave (the business) should follow whatever procedures they normally follow when they’re asking somebody to leave for other reasons, which might include contacting law enforcement.”
Melnick said the state is not requesting that businesses block people from entering if they’re not wearing a mask, or physically remove them from the location.
“They can’t ask them what the medical exemption is, and cannot ask for proof or documentation,” Melnick noted. “Basically, they can ask if they have a medical condition or disability, but not what it actually is.”