Carney COVID hospitalizations 1-25-22

A major focus for Director for the Division of Public Health Dr. Karyl Rattay during the latest update on Delaware's fight against COVID-19 Tuesday was making sure, as the state's infection numbers seemed to be trending in the right direction, that all eligible children were receiving their full vaccinations. 

That is not to say the state's lowering COVID-19 statistics are in a good spot. On a seven-day moving average, the state was still looking at 1,643 new cases a day, and a 23.8% positivity rate. Those hospitalized still remained at 550, with 59 critical--a decrease from the January 2022 peak of 759 and "heading in the right direction," said Gov. John Carney, but still significantly higher than January 2021's peak of 474.

In Delaware alone, 2,480 people remained dead from the virus. 

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"It slowed down a little bit the last couple of days," Carney said. "As we send in the [Certified Nursing Assistant]-trained National Guardsmen and women to provide relief for our long-term care facilities, it will enable the hospitals to release more patients who don't need hospital care to the long-term care facilities. So we're expecting and hoping that number, 550, will be reduced again over the next weeks."

Hospitalizations have always been Carney's benchmark to truly represent the position the state is in, as it's what he calls a "discrete" number that doesn't care how many tests or vaccinations have been issued in a week, only showing how many Delawareans are so severely ill at the moment that they need to be in the hospital. 

He did respond to criticisms that the state hadn't initially been differentiating between how many of those hospitalized were hospitalized because of COVID, versus how many were hospitalized due to some other mitigating factor and later were discovered to have COVID. He said it was a fair criticism. 

"We watch the data every day, and we try to use the data to make various decisions and understand what's happening out in the world, so to speak," Carney said. "One of the things that I had noticed several weeks ago, I guess, as the surge started to hit us, was a disconnect between the increase in the number of people hospitalized that had tested positive for COVID, and the number are admitted." 

While some were admitted with COVID symptoms that required hospitalization for care, there were others who were being admitted for something else and subsequently tested positive during their stay.

"I'm not sure it makes a difference to how we react. The hospitals still have those patients, and we still have been put in a position to support them," Carney said. "They have patients that are patients, workers, hospital workers, that can't come to work because they're testing positive. So the effect is the same. It does give a different context to what's actually happening there."

Agreeing, Rattay said the data points may provide some insight into the seriousness of the strain of COVID a patient is facing--overwhelmingly Omicron at the moment in Delaware--but the effects are the same. 

"It's still very intensive from a resource perspective for the hospitals. They still have to place COVID-positive patients in a separate unit, require extra PPE, extra staffing. So it is more resource intensive, whether you're admitted with the diagnosis for COVID--if COVID is the cause of your admission or not," Rattay said. "The other thing that's very important: whether you're admitted for surgery, whether you're admitted for a heart attack, a stroke, another reason, having COVID certainly complicates the course of your illness, regardless of whether or not that is why you were admitted. So it is a factor."

Because, as Rattay pointed out, despite her current "cautious optimism" and the protestations from some corners that "this is no worse than the flu," the reality is it's far, far worse. 

"Our death rates in the last few days...are a stark reminder that COVID is not just the common cold or even the flu. Prior to Thanksgiving, we shared on a press briefing the sad news that we had lost 2,200 Delawareans to COVID, and since that time, we've lost nearly an additional 300 Delawareans," she said. "When you compare that to our worst flu season in history, where we lost 36 Delawareans, it's clear that we're just not yet to a point where we can say this is endemic, like flu. But we are excited that we are seeing a decrease in these numbers right now."

Just after the Thanksgiving holiday, Rattay said the state began to see significant increases in their pediatric COVID infections due to a Delta surge, followed by just as dramatic an increase around Christmas due to Omicron.  

"Currently in our state, the 5-to-17-year-old age group has the highest case rates in the state. And none of this really is entirely surprising, if you look at the vaccination rates for these age groups, and incorporate what we know about the spread of Omicron," Rattay said. "But it does reinforce how important it is to get our children vaccinated."

Only 27% of children ages 5 to 11 in Delaware have received just one dose of the COVID vaccine, enough to place it 21st out of all states for vaccinating this age group, she said, and compared to 70% overall for the state.

"Given these low vaccination rates in this age group as Omicron began to sweep the state, it's not a surprise that infection wasn't easy to stop in this age group," Rattay said. 

There were also demographic disparities among children receiving the vaccination. While 23% of white children had received a single dose, on 15% of both Black and Hispanic children in that same age group had received a dose. 

Meanwhile, for older children, 62% of the 12-to-17-year-old population had received at least one dose, with almost 55% having received two, but only 8% have received their booster, again placing Delaware 21st nationally for that age group. While Black youth in that range had received fewer vaccinations, Hispanic youth were substantially higher, Rattay said. 

"While vaccination rates are higher among this 12-to-17-year-old population, because their immunity from completing the primary series is starting to wane for those who were on target and getting their vaccine late spring, early summer, it's very important to get this age group boosted as soon as they pass that five month mark," she said. 

Kent and Sussex counties were both areas where youth vaccinations were well below the state average.  

She also stressed that vaccinations, important as they are, have been shown to be scientifically, overwhelmingly safe. Though there have been a wide variety of concerns over vaccines at the beginning, enough have been distributed by now to put even the most worried at ease, she said, and there should be even greater concern for actually catching COVID.

More than 20 million children aged 5 to 17 have received at least one dose, and the safety profile has been "very positive," Rattay said. Serious side effects have been "extremely rare," the doctor said, including the slim chance children may develop myocarditis, which has been shown to be "for the most part...very mild and self-limiting."

"The data show, looking more closely at the 12-to-17-year-old population, that the risk of myocarditis from COVID infection--from getting the infection itself--is much more likely than the risk of myocarditis from vaccination," Rattay said. "We know a lot of parents are concerned about possible developmental side effects, which, there's no evidence of developmental side effects with these vaccines. We also know one of the myths out there that's been perpetuated, is that the vaccine can cause reproductive or fertility issues. I really want to reassure you that no reproductive side effects or fertility issues have been seen...there were reproductive side effects from COVID infection seen for males. So, once again, the infection itself is riskier for reproductive side effects than the vaccine."

The vaccine is supported by professional healthcare associations like the American Academy of Pediatrics, and two years into the COVID-19 pandemic, the number of individuals who've received the vaccine so far and the fact that it was developed on the back of another vaccine developed 10 years prior to combat SARS and MERS have created an overwhelming safe product which is currently saving lives and keeping people out of the hospital, she said. The COVID vaccines have gone through the same approval processes as previous childhood vaccinations, Rattay said. 

Again, she stressed, regardless of what age group into which an individual might fall, they should get fully vaccinated to protect themselves and others. 

"According to the CDC, among adults ages 50 to 64, unvaccinated individuals were 44 times more likely to be hospitalized than their fully vaccinated peers who had also gotten a booster dose; 44 times more likely to be hospitalized if you are unvaccinated compared to if you've received a booster. That's, really, a really astonishing figure," Rattay said. "We encourage everyone who's age 12 and older and eligible, to get your booster--and right now, for the most part, most individuals who are 12 and older are likely to be eligible for their booster, if it has been five months since they have received their second dose of either Pfizer or Moderna. You're eligible for a booster if it's been two months since you have received your single dose of Johnson and Johnson."