Idaho Governor Brad Little received a dose of the COVID-19 vaccine on January 25. “I received the first dose of the COVID-19 vaccine, safe and effective! I’m feeling great and back in the office, working hard for the people of Idaho, ”said Little in a tweet.
BOISE (Idaho statesman) – The term “cautious optimist” is rarely more appropriate than when Idaho leaders talk about coronavirus cases in the state in 2021.
From local public health experts to the governor, the people responsible for the battle against the COVID-19 pandemic in Idaho see a light at the end of the tunnel.
All Idaho COVID-19 numbers are looking better than they did months ago.
Daily cases for Idaho are a fraction of the fall peak – dropping from a high of 2,298 on December 9 to 314 on Friday, according to statistics from the Idaho Department of Health and Welfare. Hospitalizations for people with COVID-19 stubbornly remained above 140 people a day, but are now at levels never seen since the end of September. The same is true for people who need ICU care for coronavirus complications – about a third of Idaho hospital ICU admissions reported in December.
“We are very pleased,” Idaho Governor Brad Little said in an interview on Friday.
“People need to continue to be careful,” he said. “We are currently in a race to bring the vaccine to as many weapons as possible.”
BUT WHY ARE IDAHO’S CORONAVIRUS CASES FALLING?
The Statesman spoke to public health experts and Little about what they are hearing – and their theories about what is making the situation better in Idaho and across the country. They said it is probably a mix of some factors.
They also emphasized that, while it is worth celebrating, it is not a cue to throw off your mask and have fun in crowded bars.
There are wildcards in the future. Students and teachers are returning to face-to-face classrooms with entire classes. A public health council on Friday withdrew the mask authorization for Ada County. (The Boise mask mandate remains.) And this week, one of the most worrying variants of the coronavirus has been confirmed in the Treasury Valley, while two other variants were found in the wastewater in the Boise area.
“People think we are on the final stretch – reducing cases, reducing hospitalizations, launching vaccines”, says the coronavirus working group member Dr. David Pate said on Twitter. “They have no idea what’s coming, and now our school councils and (the Central Health District council) are reinforcing those beliefs with their actions. I’m trying to sound the alarm, but apparently nobody is within earshot. “
ARE PEOPLE BETTER WITH COVID-19 PROTOCOLS?
Idaho saw two major outbreaks of COVID-19. The worst started in October and peaked in early December. Public health officials pleaded with people not to travel or organize large gatherings over the Christmas and New Year holidays, fearing the worst.
But a third wave never materialized. The opposite happened. Cases fell.
“Everyone, from the CDC to almost every expert, did not get it right, because there are a myriad of things” involved in the pandemic, Little said. “Obviously one of them is the behavior. Part of that, we believe, is the awareness that we did through ONE Idaho (COVID-19 prevention campaign), but we also thought … over time, (more Idahoans) we met someone who was really sick ”or who died of COVID-19 .
Two public health experts think this may be part of the calculation that has put the Idaho case on the decline. But how much? They are not sure.
“We’ve been living with COVID for about a year,” said Kimberly Link, manager of communicable disease control at Central District Health in Boise. There are “more permanent changes in the way we interact with each other, both in our homes and in public, which are safe practices. … Masking and physical detachment have become part of the way we live and this will impact the way the disease is transmitted. “
Little said the Idahoans sacrificed themselves during the pandemic – staying at home, postponing trips, not visiting loved ones, losing a business or job because of the economic price of COVID-19. Thousands of Idahoans have also lost loved ones to COVID-19.
People whose sacrifices prevented more deaths and helped to slow the spread of the virus “are part of the reason we are where we are” with better control of outbreaks, Little said.
COVID-19 hit Idaho in waves since the first case was announced on March 13, 2020. The fall brought the worst increase in the state, with hospitals and clinics across the state overloaded by sick employees and hospitalized patients. New infections fell dramatically in December. There was a much milder post-holiday peak than anticipated in January, followed by a steady decline.
LESS TEST = LESS CASES?
Dr. Sky Blue, an epidemiologist and infectious disease specialist in the Treasury Valley, says that some people have spread this theory. Do not handle it.
A lower positivity rate means that a community’s infection rate is low enough that it can catch many of its infections by testing people. When cases are out of control, the rate of positivity increases – because there are so many people catching and spreading the virus, the health professionals and laboratories that do the tests are unable to meet the demand.
The percentage of Idaho COVID-19 tests that are positive is now approaching 5% – the upper limit recommended by the World Health Organization. Three months ago, Idaho’s positivity rate was almost 20%.
“Basically, we are reaching a point where the amount of testing being done is appropriate to the amount of disease in the community, because the amount of disease in the community has decreased,” said Link.
AND THE VACCINES? DESERVE CREDIT?
Yes, but it will take weeks or months before Idaho sees the full effect of vaccines on controlling the spread of coronavirus.
Many public health experts see vaccination as the clearest path to something that comes close to the “herd immunity” of the COVID-19 virus.
People begin to develop immunity against COVID-19 after the first dose of the vaccine. But getting 90% or more protection requires a second dose three or four weeks later (for modern vaccines from Moderna and Pfizer), plus a few weeks for the body to form immune cells.
The first vaccinated frontline health workers in Idaho, residents and employees of long-term care facilities have only reached this point in recent weeks. As more people get vaccines, the “herd” grows.
A recent decline in outbreaks at long-term care facilities in Idaho highlights this moment, said Link.
“This is an area where the vaccine has definitely had an impact,” she said. “If we see 70% to 80% of residents being vaccinated,” this could prevent vulnerable Idahoans from becoming infected and, in some cases, dying.
More vaccines are on the way. The federal government is accelerating the launch of the vaccine, sending more vials to Idaho and to retail pharmacies, including Idaho Walmart and Albertsons stores.
These factors – in addition to the recovery of doses that were not used in a special federal program – gave Idaho a boost. The state ranked 18th in the United States in vaccine administration, said the chairman of the Coronavirus Vaccine Advisory Committee on Friday.
Little is optimistic about vaccines. He said a hospital leader in Cascade had just reported vaccinating 500 people – nearly 5% of the population across the county – in one day.
IS THE CORONAVIRUS CHANGING?
Little said his public health team had always told him, “Viruses do what viruses do and they change.”
These changes are a normal part of the evolution of a virus. It mutates when making copies of itself inside a person’s body.
Some mutations can make the virus more infectious – as scientists believe it happened with some “worrying variants”, like variant B.1.1.7 first discovered in England.
Little said these variants are under the world microscope now, “but we think that perhaps the existing coronavirus (which dominated in Idaho) may be becoming less infectious,” he said.
IS IT SEASONAL? THE FLU COMES AND GOES, OK?
It might be. Maybe not.
“We saw these waves or spikes of disease happen,” said Link. “There is some nature of coming and going and what causes it is, I think, a little speculated, but it’s not uncommon.”
But epidemiologists have their doubts about COVID-19 diminishing because it is coming out of the season. That’s because the other classic seasonal virus – the flu – usually arrives in Idaho in the fall. And it usually peaks now.
THE VIRUS LEFT IDAHOANS TO INFECT?
Magic Valley can be a case study of what makes a virus increase and decrease.
Twin Falls saw a big increase in October. The regional hospital was so overwhelmed that it had to send patients to the Treasury Valley. This went on for weeks.
Local authorities have refused to restrict activity while the virus spreads. They voted against the mask mandates.
And then, in mid-November, something changed. Cases fell. Hospital beds opened up. The positivity rate has improved.
Was it because people responded to the call for personal responsibility, wearing masks and keeping their distance?
“If you’ve ever been anywhere in Canyon County or Twin Falls, you know it’s not true,” said Blue.
What he and others suspect – noting that this is all speculation – is a strange type of isolated collective immunity.
“We have some people who have been so diligent about masking and isolation that they are probably not being exposed,” said Blue. This group self-selected outside the herd.
“So you have the others who wouldn’t put on a mask if their lives depended on it,” he said. This group is the free passage of COVID-19 to the herd.
Last year, these groups did not mix as they did before the pandemic, Blue said.
While the first group stays at home, the virus spreads to the second group. Most people in the second group recover with some immunity. Eventually, the virus runs out of new bodies to infect.
“So you don’t see it taking off like a forest fire for a while,” said Blue.
But those who haven’t been infected cannot stay home forever. And those who have recovered from COVID-19 will not be immune forever.
Idaho cannot achieve true “herd immunity” without many more people dying and being hospitalized.
That’s why Blue and others expect the Idahoans to get the vaccine.
Blue believes that the virus will become “endemic”, bouncing forever like the flu. Vaccines and post-infection immunity are likely to make the disease less severe over time, he said.
CAN IDAHOANS RELAX ABOUT COVID-19 NOW?
This question generated a few seconds of silence on the other end of the line during the interviews.
While the board that governs his agency voted on Friday to suspend the Ada County mask mandate, Link said the importance of public health guidance for continuing to wear masks has not changed.
“Masking and physical detachment, I really think these are – above all – the things that will really help us get over it,” she said. “These are the first things that came on board and should be the last to leave.”
If the virus starts to spread uncontrollably again, it could go from 500 cases in Ada County this week to 2,000 cases a week in March, she noted. This is what happened in previous waves.
Your advice to everyone? Be careful.
“I think that whenever someone leaves the house and spends time with people they don’t live with, masking and physical distance should be the cornerstone,” she said.