Two years ago, in early March 2020, West Virginia was the only state in the country without a documented COVID-19 case. Anticipating the virus would soon arrive, Governor Jim Justice issued an order to close all West Virginia schools (pre-K to grade 12) after Friday the 13th of March. At the time there was very limited information about the virus, but the date was an omen of what was to come. Four days later the first case of COVID was diagnosed in Jefferson County. By April, Berkeley, Jefferson and Morgan Counties were determined to be “hot spots” and Governor Justice issued expanded Stay-at-Home orders and additional restrictions for the three Eastern Panhandle counties.
The First Wave
The first COVID-19 wave in the spring of 2020 was, in retrospect, small and the “curve was flattened,” in Jefferson County (see chart). By the summer of 2020, more was learned about the disease, and it became less scary. Difficult economic and social restrictions were greatly relaxed. Still, new cases continued to be reported across the country and it became apparent that this virus was not going to disappear quickly. The number of local cases and hospitalizations remained low but steady through the end of the summer and the early fall of 2020. Then, in October 2020, the story started to change. With cold weather, football games, and holiday gatherings, case numbers and hospitalizations climbed, and hospitals in the Eastern Panhandle and surrounding counties were significantly strained in December and January.
Vaccines Help Turn the Tide
By late December 2020, vaccines for this previously unknown coronavirus became available, one year after the initial identification of the virus. For many weeks West Virginia led the country with the largest percentage of vaccines administered. The state’s rapid vaccinations for vulnerable nursing home residents were widely praised, although the rollout of the vaccine to the general population was much more uneven at first. By February, local clinics were organized to process hundreds of patients a day, relying on the hard work of several hundred civilian and Air National Guard volunteers who assisted the Jefferson County Health Department, West Virginia University Hospitals, Berkeley-Morgan Health Department, and many other organizations to administer tens of thousands of doses of vaccines.
A Slow Summer Turns To A Hot Winter
Cases and hospitalizations decreased, increased, and decreased again through the spring of 2021. By the summer, most public health restrictions were no longer required but many people continued to adjust their social behaviors to avoid infection. By July of 2021 there were very few cases in West Virginia (see chart). The downward trend continued into August until the delta variant arrived. A small spike at first, the delta variant led to increased cases and infection rates.
Locally, the peak of new infections in the fall of 2021 looked similar to the wave that hit in the previous fall. Cases declined by early November, but that declining trend reversed and then in December 2021 surged with the arrival of the omicron variant in the Eastern Panhandle. For three weeks there were more than 100 new cases of COVID-19 identified daily. In Jefferson County, the number of COVID-19 cases in the past 3 months (since mid-November 2021) have equaled the total number in all of the prior months combined.
Vaccines Lower Risk For All
The good news — a substantial number of people in our local community now have some level of immunity to COVID-19. The Eastern Panhandle has a population of about 194,000 and over the past two years there have been 53,000 documented cases of COVID-19. This is a 27% rate of documented infection. Vaccination has also provided some immunity to 61% of Jefferson County residents with 51% of residents completing their initial series.
Additionally, there has been over one year of real-world experience with COVID vaccines. Although vaccinated people can still get COVID and can become seriously ill or die, there is a marked decrease in the chance of severe illness or death. Vaccines may also decrease prolonged symptoms (long COVID) or multi system inflammatory disease.
Particularly if you are over age 50, it’s important to complete the initial vaccinations and keep up with boosters. Most of the serious cases of COVID and deaths are in the elderly. There have been over 440 COVID deaths in the Eastern Panhandle (a death rate of 0.23% of the total population). Of the Jefferson County residents aged 70 or over with COVID, about 8% have died — 32 times the rate of the general population. Vaccination can make a significant difference for the senior population — a direct protection from their own vaccination and a reduced risk of transmission if the younger people around them are vaccinated.
We should not be as terrified of this virus as we were two years ago, but the hospitalizations and deaths continue — and it’s up to all of us to respond as a community to manage this virus that will remain among us for the foreseeable future.
Dr. Reidy is the Health Officer of the Jefferson County Health Department.
By Terrence Reidy, MD, MPH