A spike in COVID-19 cases is flooding local doctors’ offices with patients, depleting testing and treatment supplies, and threatening to limit capacity at Hardin County’s only hospital.
“I typically see 20 to 25 patients a day,” said Dr. Thomas Waters, a physician at Iowa Falls Clinic in Hansen Family Hospital. “On Tuesday I think I saw 40. We’re getting kind of overrun . . . For me personally, I saw the most positive cases that I’ve seen.”
According to data released Friday afternoon by Hardin County Public Health, there were 97 new cases of COVID-19 in Hardin County between Sept. 3 and Sept. 10. Of those 97 new cases, 65 are residents of the Iowa Falls ZIP code, 16 live in the Alden ZIP code, and 14 are from the Eldora area. Information about the number of new COVID-19 cases in the county is released twice each week – on Wednesdays by the Iowa Department of Public Health, and on Fridays by Hardin County Public Health.
Waters said this year’s patient surge is different from last year.
“I’ve had the most children positive that I’ve ever seen this last week,” he said, noting that the most common symptoms have been headache and fever. Some also have had a cough and sore throat.
After weeks of minimal virus spread early this summer, Iowa has seen a spike in cases over the last six weeks. Hardin County’s active case count – the number of total cases minus recoveries and deaths – ballooned from 25 on July 27, to 189 on Sept. 7. Three weeks ago, students and staff returned to local schools to start a new academic year. But whereas last year masks were required, this year there is no universal masking. In May the Iowa Legislature passed and Gov. Kim Reynolds signed a bill that prohibits schools from mandating face masks. But local doctors said children – especially those under 12 who are not eligible to receive a COVID-19 vaccine – should be taking steps to protect themselves from the virus.
“My advice for children under 12? I think they should be masked in schools,” Waters said. “I think that even though it apparently cannot be mandated, it makes a lot of sense for children to go to school masked.”
Dr. David Van Gorp, a physician at Ackley Medical Center, said he’s hopeful that the vaccine will be available to children under 12 in the coming months. Until then, other mitigation measures – like masks and social distancing – should be used.
“We have to do what we can with these other mitigation measures,” he said.
Van Gorp said his patient mix in Ackley is predominantly older people, including some geriatric patients, and by and large most of them have been vaccinated against COVID-19. It’s the younger people – middle-aged – who have declined vaccination.
“Certainly in February we all had lots of questions – I had questions,” Van Gorp said of the vaccine. “But those have been put to rest, in my opinion. The vaccine has been around. It is safe. It is protective. It is efficacious 95 percent of the time and adverse events are very rare.
“The adverse events of Pfizer are estimated to be five per million. That’s less adverse events than traffic events on the highway,” he added. “I try to tell my patients if you’re worried about side effects from this vaccine are you driving? If you’re driving you’re taking more risk than you would be if you’re taking this shot.”
A strain on resources
As the number of local cases has increased, so has demand for testing supplies and treatments. Waters and Van Gorp said the monoclonal antibodies infusion, which has been shown to help some COVID-19 patients avoid hospitalization, is in short supply. Last week, the hospital’s stock was depleted to almost zero before another allotment of the medication was delivered.
“That’s going to be an issue if more and more people get sick,” Waters said. “We’re doing everything we can to keep them well and out of the hospital.”
Testing supplies, too, are becoming scarcer. Jill Schafer, the infection control nurse at Hansen Family Hospital, said last week the hospital was in the yellow zone for testing supplies.
“We have a limited amount and we are not getting the requested numbers that we have asked for from the distributors,” she said. “They only allot so many. If we ask for four cases they might give us one. That’s not unique to our facility – that’s nationwide.”
The hospital – like others – is also dealing with staffing shortages.
“The surge has put a strain on staff as far as fatigue in general,” HFH Interim CEO George Von Mock said. “It’s been a little over a year of the pandemic. Folks are tired. There’s a lot of fatigue and they’re working extra hours due to shortages, or due to staff that is out because they were exposed [to COVID-19].
“For smaller hospitals it can be a little more challenging because you don’t have the critical mass that a larger hospital or a larger system has,” Von Mock said. “Our lab has five to six people in it. If you have one or two go down, you’re really strapped.”
While the local hospital has not had to turn patients away or ration care because its facility is full, Waters said that is possible if the current surge continues.
“I’ve not had an issue [finding a bed for a patient], but it’s coming,” he said. “Anything that you would need to be admitted for – pneumonia, heart attack, stroke – those are going to keep happening at their regular rate, and if the hospital is full of COVID people, we won’t have any room.”
Waters said RSV – a respiratory virus that can be serious in young children – is showing up locally, and children have been admitted for treatment. And if the flu returns to pre-pandemic levels this fall and winter, that could further strain resources.
Doctors urge vaccination
Waters said the patients he’s treated for COVID-19 in recent weeks have been both vaccinated and unvaccinated. But where the vaccine has made a difference is in the severity of illness.
“In the last week I’ve had a 20-year-old patient admitted and a 30-year-old patient, both unvaccinated. And one 30-year-old left the hospital and now needs oxygen at home. I’ve not admitted any vaccinated people [to the hospital].”
But what can those people who’ve been vaccinated and don’t have children under 12 do to control spread of the disease and prevent rationing of care at doctors’ offices and hospitals? First, Van Gorp said, if you are eligible to receive a vaccine, get it.
“[Vaccination] is an important step to take and we do need to get a handle on this virus because it’s stretching our resources and costing lots of money across the country,” Van Gorp said. “The vaccine is safe and it’s free.”
Beyond vaccination, Waters said there are things everyone can do to protect themselves, their loved ones and the medical community’s ability to treat patients – whether they need care for COVID-19 or another illness.
“I think your role is to prevent the spread of the disease by continuing to wear your mask out in public and by limiting your social interactions,” he said. “We’re not saying don’t do anything, but you probably shouldn’t go to outdoor sporting events and concerts in large groups.
“It’s here and it’s real,” he added. “I’m worried that this is going to get much worse and I want people to wear masks out in public.”