Delta variant is a ‘game changer,’ as healthcare officials battle pandemic

COVID booster shots a possibility Clark County Public Health Director Dr. Alan Melnick is preparing for 

Clark County Public Health Director Dr. Alan Melnick and three other physicians held a press conference Friday to update area residents on the COVID-19 pandemic in Clark County and Southwest Washington. Doctors from PeaceHealth, Legacy and the Vancouver Clinic shared their observations and experiences in battling the virus.

“The Delta variant is a game changer,” said Dr. Melnick. “It’s accounting for 98 percent of current cases in the state, and is more transmissible than the original version of the virus.”

Dr. Melnick began the briefing by sharing current statistics. “Our case rates and our hospitalization rates are higher than they’ve been at any time during the entire pandemic.”

Last week, the county averaged 225 COVID-19 cases a day. Two months ago, there were 21 daily cases. The case rate per 100,000 population over 14 days is 523 cases. At the peak of the pandemic last winter, it was 475. About 23 percent of hospital beds are occupied with COVID-19 patients.

“These case increases are occurring in all age groups, with the highest rate among young adults 20 to 39 years of age,” Melnick said.

“It’s extremely transmissible,” said Dr. Lawrence Neville of PeaceHealth. He indicated it is 10 times more transmissible than the original virus. He said his message was “a somber one.”

“The Delta variant has about 1000 times the number of virus particles being emitted,” he said. “It is extremely contagious.”

At both the Longview and Vancouver hospitals, PeaceHealth has had to put up temporary “auxiliary” ICUs. At the Vancouver facility, 20 of the 75 COVID-19 patients are in the ICU. In Longview, it’s 17 of the 62 COVID patients.

They have put all elective surgeries on pause at PeaceHealth.

“Vaccination is still by far the best way to protect yourself,” Nelville said. He admitted that the hospital is seeing some vaccinated patients coming down with COVID, specifically mentioning nursing home patients vaccinated early in the pandemic. 

“Because we believe so strongly in vaccination, I’m proud to announce that PeaceHealth is to my knowledge the first local area health system where all the bedside providers clinicians, nurses are vaccinated,” he said. “If you have the misfortune of being hospitalized, you will be taken care of by vaccinated caregivers and health care workers.”

Dr. Kelley Pratt, an emergency room physician at Legacy Salmon Creek echoed Neville. He shared that they too have had to re-allocate staff to care for COVID patients. They do have the staff available to handle other surgeries and emergencies.

“This is largely a pandemic of the unvaccinated, particularly for those who are seriously ill,” Dr. Pratt said. “There are some breakthrough cases that are occurring as well. Patients who have complex medical history that put them at higher risk for COVID, even when they’re vaccinated.”

Dr. Devon Ebbing is a pediatrician with the Vancouver Clinic. She is glad to see children going back to school in person. “We have learned over the last 18 months that kids do learn better in person.” 

Dr. Ebbing stressed it needs to be done safely with a multi layered approach because not any one approach is going to be foolproof. “We have seen an uptick in regular viruses and we’ve also seen an uptick in viruses we don’t traditionally see this time of year,” she said.

She and her colleagues are seeing more positive COVID-tests in children too young to be vaccinated, as well as those 12 and above. 

She spoke about vaccine hesitancy. “Pfizer is the only one approved for under emergency use for 12 and up, and it has been one of the most scrutinized vaccines in terms of looking at safety,” she said. “I tell parents, ‘yes, it’s okay to be worried.’” 

Keeping children at home when they are sick is very important, she stressed. She also said masking is okay for children.

Dr. Ebbing also addressed mental health concerns. “We’ve seen a lot of school failure over the last year just from being unable to attend the virtual or remote schooling, which has led to a lot of depression.”

Dr. Neville was asked what happened to the PeaceHealth employees who were not vaccinated. 

They fall into two categories. If they have a medical or religious exemption, they are using their PTO for their leave of absence. If they did not follow our policy, they are on an unpaid leave of absence.

 “We felt we had no choice but to take this hard stance and really proud of the way we did it,” he said. “We did it with a great deal of compassion, a great deal of due process and thoughtfulness.”

The hospital brought in extra staff and moved staff around. “We’ve offered lots of incentives to current staff to keep the right folks at the bedside and behind the bedside doing the important work,” Neville said. “We’re actually really proud to announce that we don’t have any staffing issues.”

Dr. Melnick was asked about King County implementing an outdoor mask mandate. He’s not ready to implement one here in Clark County. He did mention “pandemic fatigue” and is concerned people won’t be as safe as they have been in the past. There are still 40 percent of eligible Clark County residents not vaccinated.

“I just still want to point out that the most compelling reason to get vaccinated is to avoid serious illness, hospitalization and death,” Melnick said. “Vaccines are still effective at preventing transmission as well.”

“There is increasing evidence that the vaccine efficacy may wane over time and may decrease over time,” said Neville. “We still think it’s highly effective. Our data suggests it’s still highly effective, but our national experts and scientists are really looking to see if we all will need boosters.”

Melnick shared that the vaccines are effective against the Delta variant.  He’s not recommending a Delta variant specific vaccine at this time. 

Neville was asked about their decision to protect patients (keeping unvaccinated staff away) and whether or not they followed someone else’s example or if they were the first. 

“I’m proud of the fact that we were one of the first to really take the stance,” he said. “I think the senior leadership of PeaceHealth really deserves a lot of credit for their ethical discernment and bravery around that fact.” He mentioned the governors of Oregon and Washington issuing their mandates as evidence PeaceHealth made the right decision.

Neville was unaware of how many employees are on the leave of absence, other than the 5 percent figure.

He closed by encouraging people not to play the blame game. “This is not about blame, or shame. There are people out there, who have anaphylactic reactions to vaccines, things like that, that are good reasons not to get vaccinated.” These people are few in number.

Neville shared “this is really like World War II — people are off at war. We are asking for a sacrifice.” He strongly believes people are willing to sacrifice for each other.

He also addressed booster shots. He suspects sometime this month the CDC will be issuing guidance about whether folks should consider booster vaccinations. It wouldn’t surprise him if the CDC makes that recommendation. 

“Based on what we’re seeing in our hospitals and what some of the national data and data of Israel shows about vulnerable populations losing immunity over time,” he said. ”We just want to make sure people stay protected.”

Melnick said his staff are already planning for that possibility. “If it’s approved by the CDC, the earliest patients would probably begin (getting boosters is) late September based on eight months since their previous dose.”