CVPH doc expects COVID hospitalizations to decline
Jan. 21—PLATTSBURGH — Dr. Wouter Rietsema expects COVID-19 hospitalizations in the North Country to peak and start declining over the next week or two, lagging behind the downward trajectory the region is currently beginning to see in new positive cases.
New York State as a whole is experiencing a decrease in new hospitalizations, a statistic primarily driven by downstate areas whose pandemic trends tend to be 10 days to two weeks ahead of the North Country's, he explained.
"If I look at the North Country, hospitalizations are still going up a little, and that's because hospitalizations are what we call a lagging indicator," Rietsema said. "Anybody hospitalized today is really representing the new infections that were happening two weeks ago."
COMING OFF OF PEAK
The Plattsburgh Rotary Club hosted Rietsema — the vice president for population health and information services at University of Vermont Health Network, Champlain Valley Physicians Hospital — as its guest speaker for the third time since the pandemic began during the group's virtual Zoom luncheon Wednesday.
In his presentation, the infectious disease physician utilized graphic representations of COVID-related data generated by the state and the North Country COVID Vaccine Hub, of which he serves as coordinator.
State-posted data show that cases took off after Christmas, experiencing a massive peak statewide and rapidly coming off that peak, Rietsema said.
"Clinton County is just starting to come off the peak, in fact, if I ... looked at the graph and didn't have any knowledge of what was going on downstate, I might wonder, 'Are we really coming off or not?'" he continued.
"But we had, certainly, a very explosive outbreak of cases, and so I would expect that we will see the same fairly rapid coming off that peak of omicron."
BY THE NUMBERS
Since Tuesday, the Clinton County Health Department has reported 249 new COVID-19 cases, based on lab-processed results.
Clinton County also saw four COVID-related deaths posted during the same timeframe, bringing the death toll in the county to 69.
Essex County Health Department and Franklin County Public Health's numbers include positive results from at-home antigen tests as well.
ECHD posted 205 new cases over the two-day period, while FCPH shared 246. On Thursday, there were 490 active cases in Franklin County.
The St. Regis Mohawk Tribe has not provided a COVID update since Tuesday.
WHAT MILD MEANS
Rietsema said it is known that the omicron variant is highly infectious, but he has not seen data from local cases supporting the notion that it is milder than its predecessors.
He noted that hospitalizations during the omicron surge did not increase to the same degree that cases did, which suggests an omicron infection is less likely to result in hospitalization.
"It's really confusing to sort out how much of that is vaccination and how much of that is milder omicron," Rietsema added, though he believes New York State will get data on that.
The doctor said he has learned over time that his definition of a mild illness and the general community's definition are different. For him, mild means you're not sick enough to be hospitalized.
"But make no mistake, you're going to feel it," he said, remarking on breakthrough cases among the vaccinated. "I know a lot of people who have felt pretty darn sick."
Still, the doctor, who is vaccinated, has not "hibernated" during the omicron surge. He said his risks of severe disease and hospitalization are very low, and there is no high-risk person in his orbit.
"I'll probably feel pretty lousy for three days to seven days (if I get it), and then I'll move on, and that's generally I think where we are going as a country, but it's a personal decision that everybody makes."
GET VACCINATED, BOOSTED
Regional vaccine hub data show that 60% of all North Country residents have completed their vaccine series, and 25% have been boosted.
Clinton County's numbers are higher, coming in at 68% with a completed series and 30% of the population having received a booster shot.
Rietsema noted that a 100% rate is not currently attainable as children ages zero to four are not eligible for vaccination.
He recommended boosters for those who have not gotten theirs already.
"Every bit of protection we can get — and remember that what we've learned, what omicron has taught us more than anything is the vaccine is to protect us from getting seriously ill, but it does not protect nearly as well against infection as it did for delta and some of the prior variants that we've had."
Rietsema added that both he and fellow CVPH infectious disease physician Dr. Keith Collins say, based on their understanding of the immune system, that those who become infected should wait about four weeks before getting boosted.
"You want to treat your COVID infection like it's a booster and then you boost that with a vaccine and that timing appears to be about four weeks," Rietsema said.
HOSPITALIZATION RISK
The risk of COVID-related hospitalization remains much higher for those who have not been vaccinated against COVID-19.
Though he has not seen what those figures look like specifically for omicron infections, Rietsema said he believes the unvaccinated are at least 10 times more likely to end up in the hospital than those who are vaccinated.
He said he thinks more of the COVID-positive patients currently hospitalized at CVPH are vaccinated, which he attributed to how more people are vaccinated than not, especially older people. That age group both tends to end up in the hospital in general and has a very high vaccination rate.
But observationally, Rietsema has found the vast majority of people in CVPH's intensive care unit who are very sick with COVID are unvaccinated.
"So even the vaccinated people that are hospitalized with COVID symptoms tend not to be as ill."
Information on where to get vaccinated is listed on page A8.
Email Cara Chapman:
Twitter: @PPR_carachapman
