From Deputy Health Officer Dr. Robert Wack, January, 2023
It’s another year with covid, and as usual, there’s good news and bad. The good news is that, even though we’re talking about another surge, we have ample testing, effective vaccines, and good knowledge about how to limit the spread of the new variants.
The bad news is nature is still cranking out new variants, we still have too many people who are under- or unimmunized, the hospital is swamped, ambulances are overtaxed, and there is still a lot of disinformation leading people to bad decisions.
Forget about all the strings of numbers and letters or fanciful names: new variants are racing through the community like a prairie fire. Along with the seasonal surges of influenza and RSV, the people sickened by covid and other respiratory viruses are once again maxing out the capacity of our health system. Carroll Hospital Emergency Department (ED) is routinely overfilled, hospital beds are full, and Carroll County EMS providers are often waiting to unload patients because of a lack of space. In addition to delaying care for the people in the ambulance, this also makes that vehicle unavailable to transport someone else having an emergency. A car crash, a fall off a ladder, a heart attack: all may have delayed care if an ambulance is tied up inappropriately
New variants can develop new capabilities in at least three different directions: contagiousness (how easily it spreads), immune escape (whether our immune system recognizes it), and virulence (how sick an infection makes you). The direction (better or worse) is random, so you can have a variant that is less contagious, more easily recognized, or makes you less sick. Those variants wouldn’t spread very far, so we don’t hear much about them, and they likely wouldn’t persist as long. The opposite can also happen: a variant that is more contagious, less recognizable, and makes you sicker.
Here’s the most important thing: the more infections there are, the more chances for a new mutation to arise giving birth to yet another variant. This is why we have to do everything possible to decrease all infections, even ones where people don’t get that sick, because each one is an opportunity for a new variant, with unknown and possibly more harmful capabilities.
The new variants we are currently dealing with are more contagious, but fortunately not more virulent, and are still at least partially recognized by the vaccinated immune systems, which prevents most serious disease and death.
Most of the hospitalizations and deaths in Carroll County from covid are unvaccinated elderly members of our community. But it’s not just covid: influenza and RSV are also complicating things in the hospital.
We have to be smart about using the precious resources of our EMS system. If people use the ED or call 911 inappropriately, you may need to be transported to an out of area hospital such as Hanover, Gettysburg, Frederick, or Baltimore due to the temporary shutdown of Carroll Hospital to ambulance referrals. You may realize a significant delay getting into a room at the ED due to the volume of patients and limited resources.
You should call 911 for true emergencies such as breathing difficulty, chest pain, traumatic injuries, overdose/poisoning, or severe allergic reactions. If there will be a delay for an ambulance, then fire units may arrive first. They carry emergency equipment as well as EMTs or Paramedics to provide stabilizing care.
To get through this winter, get vaccinated, get boosted, and be smart about protecting the vulnerable. Stay vigilant about your exposures, wear masks when necessary, be aware of your situation, and test if you feel sick or have a known or suspected exposure. Test kits are widely available through the library, drug stores, and most retail outlets.
We can get through this. Summer isn’t too far off!