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Will third surge of COVID-19 find us better prepared?

STORY BY MICHELLE GENZ (Week of December 3, 2020)

Three surges into the COVID-19 pandemic, Indian River County would appear to be hoping that this round is the most survivable.

But have we learned from the prior two surges? How much better supplied are our hospitals and nursing homes with gowns, gloves and masks? And most important, how willing are we to hole up in our homes again, forgoing socialization and starving businesses of customers, all for the sake of the vulnerable?

Today, as the third surge takes hold and Florida’s total cases pass the 1 million mark, Indian River County saw total cases since the start of the pandemic top 5,000. Hospitalizations here doubled over the weekend to 21, a frightening jump though well below the numbers in the summer surge.

But with vaccines likely unavailable to the general public here until at least spring, the anxiety, isolation and boredom are bound to continue. Increasing demands for community-wide self-discipline are met with resistance by many.

So far, testing supplies here appear to be adequate.

“We are constantly monitoring supply levels,” said Cleveland Clinic Indian River Hospital’s president, Dr. Greg Rosencrance, adding that testing has remained steady in recent weeks.

Rosencrance said the hospital also has ample Dexamethasone, a corticosteroid that has shown significant improvement in survival rates in hospitalized COVID-19 patients. Another drug, Remdesivir, is also readily available.

The hospital is not using the latest drug, Bamlanivimab, a monoclonal antibody employed in the early stages of the disease that recently received Emergency Use Authorization from the FDA.

“We are working with state health officials to provide the vaccine as soon as available,” Rosencrance added. Healthcare workers are slated to be among the first to get the vaccine, as well as first responders, Rosencrance confirmed.

State and federal officials are hoping that initial batches may be distributed to states sometime this month.

As hospitals, first responders, community clinics and nursing homes wait for the seemingly inevitable post-Thanksgiving spike in cases, health officials are looking three weeks down the road, when the fallout of a spike could turn to increases in hospitalization and deaths by Christmas.

To frontline healthcare workers, this prospect is daunting. The county’s health department has around the same staffing as in the second surge over the summer, according to spokesperson Stacy Brock.

“Staff levels are similar to what we had in July,” said Brock.

Regarding contact tracing, Brock said the department is reaching “100 percent of positive cases.

“Contact tracing has always been and continues to be an essential function of the Florida Department of Health, and every county health department has staff who continue to perform contact tracing daily. There are no plans to stop contact tracing,” Brock said.

As for frontline workers at Cleveland Clinic Indian River, Rosencrance says staffing levels are adequate for now.

“We are currently using nurses from agencies to supplement staffing in a few clinical areas,” he said, adding that there are fewer agency nurses in recent months because positions have been filled.

“We have not seen levels of attrition that differ significantly from previous years,” he said. “However, caregiver fatigue is something healthcare providers across the country are focused on and we continue to do everything possible to assist our caregivers.”

Last week, Cleveland Clinic in Ohio made news when an official said 1,000 employees were out due to COVID-19. At the Vero hospital, as of last week, there were 15 caregivers out as a result of COVID-19 or under quarantine while awaiting test results, he said.

Public schools are another arena that has so far kept COVID-19 mostly at bay. Monday, the school system got word the state will continue remote learning through another semester, though in-person learning must also continue as currently required by the state.

In this third surge, though, parents will get a warning if their children show signs of struggling, and the student will have to return to in-person school unless the parents specifically opt out. Also, school districts are now required to have a plan to make up for the academic gaps turning up in remote learning.

Since schools here reopened, normalcy has roared back, so far, at a pace ahead of the coronavirus.

Unemployment is down to around 6 percent after hitting a high of 14 percent in the first surge. A county mortgage and rent assistance program cut off applications this week, though FPL is still offering breaks on electric bills.

The county’s small business grant program is taking applications through Dec. 8. But along with nearly all businesses and offices – apart from those that never reopened after the lockdown – libraries are open, parks are open, tennis courts are open for singles play only, and pools are open for laps.

Whether the holidays trigger a major outbreak here will soon be clear: the coronavirus takes 2 to 14 days to infect its victim. As of last weekend, Florida’s daily cases are steadily going up but at a rate half the national average, 27 per 100,000 compared to 46 per 100,000.

Rosencrance seems to accept that the third surge has both more advantages and more hurdles than the first two: advantages in terms of better tools for treatment and prevention; and hurdles in terms of mitigation. “The pandemic has evolved since it began and it will continue to do so, particularly once a vaccine is introduced on a large scale,” he said.

Until then, he continues to promote mask-wearing and social distancing, saying “it will be essential to limit social gatherings” this holiday season.

“We implore the community to continue their efforts with social distancing, hand washing and wearing masks,” said Rosencrance.

“We have seen increases in cases after holidays and events where large gatherings of people take place and people let their guards down. We understand that during this holiday season, it will be difficult to change long-held traditions with family and friends. We ask that the community help us with decreasing the spread of COVID-19 by limiting their activities.”