Doctors raise alarm over local virus case surge

COVID questions answered at community forum
Casey S. Elliott
Wednesday, November 18, 2020
Grim situation

Dr. Ron Loge of Dillon led a serious discussion on the area COVID situation at a forum Thrsday evening at the BCHS audtiorium. Dr. Greg Moore of Barrett Hospital and Healthcare, and Dr. Peter Pappas, an infectious disease specialist from Alabama, joined Loge on stage for an event that was also broadcast on the radio and shown via video on Facebook Live. J.P. Plutt photo



Longtime Dillon physician Dr. Ron Loge opened the conversation Thursday with grim statistics.

“Soon – if not already – you will know somebody who has been hospitalized with COVID, and you’ll know someone who has died from COVID...As of now, all states are shattering records for new cases and new deaths. Nationwide, we are hitting 10 million cases, we are hitting one-quarter of a million deaths. Yesterday, 2,000 of your fellow Americans died from COVID-related disease,” Loge told community members. “Beaverhead County has over 400 cases so far...last week we had 40 active cases, this week, it’s more than doubled. We’ve had three deaths in our county – two in the last week. Over 50 percent of our tests are positive. That’s a frightening rate of positivity.

“This is a public health crisis like none other. Certainly, it’s not a hoax. It is real, it is serious. We are going to be a lot worse off if we continue doing things the way we are doing them now,” he added.

Loge served as the moderator at a community COVID-19 conversation, which was livestreamed through Facebook. Though he set the tone, Loge left questions largely to community members.

Healthcare experts answered questions as clearly and informatively as possible regarding COVID-19, highlighting both the local and national situation.

Barrett Hospital and Healthcare Chief Medical Officer and Emergency Department Medical Director Dr. Greg Moore detailed the strain on local healthcare facilities and staff, adding though there are beds available for hospitalized residents, there are not enough healthcare workers to tend to them.

If hospital beds fill up, and other regional medical centers are in the same boat, patients may not get proper or rapid care, Moore said. Patient beds may end up in hallways, and nonessential care (elective surgeries and preventive care) will be postponed. Barrett Hospital has advertised for more staff for weeks, he added, and no applications have been received so far.

“There is no available staffing...the nursing staff is very slim, the medical assistant staffing is almost nonexistent,” Moore said. “We will have to work on this with our own staff here, and we have to protect our own staff so they aren’t working through their fatigue and getting infected.”

Montana’s hospitals are in the same boat. State officials outlined the surge filling many of the region’s hospitals and highlighted the healthcare personnel shortage at a Thursday press conference.

Dr. Peter Pappas, an infectious disease specialist and University of Alabama-Birmingham professor, told attendees that surge affects hospitals nationwide.

“We don’t see this kind of stressing of the healthcare administration and personnel in even a bad influenza epidemic,” he said. “Maybe for a week or two, but not for months and months like this.”

Data indicates COVID-19 is more contagious and more deadly than the worst flu seasons, Pappas said. He told attendees that in the worst flu seasons he has seen, the University of Alabama hospital admits three people a week, and sees an estimated three to five individuals die throughout the season. But so far during the coronavirus pandemic, the hospital admits 10-20 COVID-positive patients daily, and tallies three- to four deaths each day.

“Some people are not afraid of (COVID) because they had it and survived it. It can be misleading when you look at the numbers – only about 2 percent of people die, that’s two out of 100 people, or maybe three, depending on where you are regionally and your access to care. Compare that to influenza – perhaps one in 1,000 people die. It is orders of magnitude more severe in terms of mortality.”

Community members asked about test availability and estimates on when a vaccine may be available. University of Montana Western athletic trainer Russ Richardson asked about the high percentage of positive tests in the county, noting only people with symptoms are tested at this time. He asked if testing non-symptomatic community members would drop that percentage.

Pappas said it remains difficult for everyone to get tested. Only communities with a lot of resources are able to provide screening tests for those with no symptoms. He agreed testing people without symptoms would likely lower the positivity rate.

“Fifty percent positivity is astronomical – that’s the highest I’ve heard,” he said. “You have to assume everyone you come in contact with may be positive.”

Pappas said though initial data on vaccine candidates are promising, it will be quite some time before an approved vaccine is widely available.

“The vaccine would go first to the frontline healthcare workers, then maybe extremely vulnerable individuals such as those in nursing homes. Down the line, eventually, maybe next fall there will be enough vaccines available for the general public,” he said.

Masks and their effectiveness were also discussed, with Moore and Pappas expressing frustration about ongoing battle over mask usage.

“Initially when the masking controversy came out, the results were inconclusive. It created a lot of differences of opinion. Now we know that masks are quite effective. Even dual masking – when you wear it and the other person does, too – the studies are pretty conclusive. It prevents up to 80 percent of viral transmission,” Moore said, referencing recent studies published in respected medical journals.

Pappas noted as long as people have a piece of fabric blocking the air they breathe, face coverings (the thicker the better) are effective.

“This is an act of love. Whether you are a Christian, a Muslim, a Jew, a nonbeliever. All of these faiths argue you look after your brother, not just yourself. It’s personal responsibility and an act of love. It’s a no brainer,” Pappas added. “We know it works. There’s no controversy. It’s something we should do. It doesn’t make you less of a man, less of a woman. It shows you care about protecting yourself and protecting others.”