“We do know it’s a dangerous disease,” Dr. Terrence Reidy emphasized. “There are many bad outcomes with COVID-19 and we can’t expect the vaccine to end it quickly.” Reidy, the Health Officer for the Health Departments of the three counties in West Virginia’s Eastern Panhandle, is following the numbers more closely than most. He says he monitors the seven day rolling average of the infection rate. At mid-December, the infection rate in all three counties was high, well above the range where the color-coding system adopted a few months ago provides a useful tool for guiding activity (see maps below). At this point, Dr. Reidy says he “asks emergency practitioners how many patients they have with COVID-19 symptoms, how many in the ICU, how many on ventilators?” He also noted that at the current levels of new cases reported each week, “the Health Department is not able to contact and trace all positive tests.” Dr. Reidy hoped he might be seeing a plateau in the new cases reported when we spoke, but the numbers continued upward on the days following our interview.
In this situation, the advice is simple, he says, and most people seem to recognize the need to cover their faces and social distance. Dr. Reidy also stressed, “If you are infected [or think you might be] keep away from others. We know how this spreads, it’s primarily respiratory and it takes interaction of a certain kind. Large gatherings are not appropriate. Places where we see spreading are birthday parties, weddings, large dinners, bowling, bingo, places where people are talking loudly. We see it in government agencies where people have lunch together. All you need is one person actively shedding.” Dr. Reidy gave the example of glitter — “if you have seven people at a table working on a holiday project and one is using glitter, how many projects have glitter? All of them.”
Dr. Reidy said that he does see cases in clusters, particularly in nursing homes. In the Eastern Panhandle, he indicated half of the reported COVID-19 deaths were of nursing home residents. He also noted that while he sees small clusters (of 2 or 3) in school settings, he has not seen evidence of in-school transmission. “We see employees who get it outside of school, and children who get it outside of the school, but for the most part they are not passing it on inside the school.” Looking at the numbers, Dr. Reidy also noted that given the current high infection rate outside of the schools and lower transmission incidence inside, that attending school is “no more dangerous than being in the community and at least they could be getting an education.” Looking at the experience of the fall, he continued, “there are many students who don’t participate as well outside of the classroom, and certainly they are missing out on the socialization aspects of school. We’ll struggle with finding a different solution, but there is nothing wrong with changing our approach and getting more kids back if we can maintain a controlled environment.”
“One thing that complicates the school environment is the activities” Dr. Reidy observed. “It’s an important part of development [for many kids], but it’s the spectators that create the risk. If ten basketball players and their families are exposed, that can be contained. But 2,000 people watching a game is not a cohort. That’s a community risk. It’s our nature and these are social and community events and people will crowd together.”
What comes next? “Most of us are in between the extremes and want to hear the evidence. We can expect at least another six months of restrictions.” Even with the vaccinations starting now, “it will be the end of January or early February before we’ll have specific guidance on how the vaccine will be available for the high risk groups in the general population (see featured images above). 2021 will be closer to normal, but the vaccine will not provide complete protection for everyone, so we’ll need to continue the habits of wearing masks, maintaining distance, and avoiding crowds — it’s about lowering risk and making it less likely to transmit the virus.”Staff Contributor