ODH director says unvaccinated driving hospitalizations

By CALLAN PUGH 

City editor 

COLUMBUS — Ohio Department of Health Director Dr. Bruce Vanderhoff addressed the media in a press conference Wednesday regarding the ongoing struggles with the delta variant in Ohio and to once again discuss vaccines and mask usage. 

Case rates like February 

Vanderhoff said Ohio is continuing to see troubling increases in COVID-19 cases state-wide, with more than 32,000 new cases reported Tuesday — the highest number reported in a single day since February.  According to the Ohio Hospital Association, one in 13 patients in the hospital are there with COVID and one of seven in the ICU is battling COVID. 

“This continues to be the unvaccinated who are driving these hospitalizations,” Vanderhoff said. “Although we still have hospital beds and ventilators available for patients as well as those facing other illnesses, the rapid spread of the threatening Delta variant state-wide, especially in the context of our hospitals being very busy, caring for patients with other serious conditions brings heightened concern as reports continue to reach us from other states that hospitals there are beginning to turn away elective procedures and are even seeking to move patients to beds out of state.” 

Get the vaccine

Vanderhoff touched on booster doses for the M-RNA Moderna and Pfizer vaccines for adults 18 and older, eight months after they completed their second dose of the vaccine. This would start Sept. 20 with the older Ohioans and those in long term care facilities who were the first eligible for the vaccines in the winter. Vanderhoff said the plan was still subject to the FDA’s independent evaluation and determination of the safety and effectiveness of a booster dose as well as the CDC’s advisory committee on immunization practices issuing booster dose recommendations. ODH is also reviewing and awaiting scientific determinations from those two groups, Vanderhoff said. 

According to Vanderhoff, U.S. Health and Human Services reaffirmed that the COVID vaccines authorized for use in the United States continue to be “remarkably effective at reducing the risk of severe disease, hospitalization and death even against the widely circulating delta variant.” 

“We need to remember that protection against severe illness and death, which the vaccines continue to offer very robustly, was in fact the original goal of these vaccines,” he said. 

Vanderhoff explained that vaccines against respiratory viruses rarely protect against mild to moderate infections as well as they protect against severe illness. This is because the vaccines are better at inducing immunity in the lungs rather than in the nasal cavity, where respiratory viruses first infect the body. He said immune systems also are complex and, in addition to antibodies, also include special cells known as B-Cells and T-Cells which offer protection. 

“Doctors generally expect levels of antibodies to most respiratory viruses to decline over time — even for vaccinated people, that happens against most bugs,” Vanderhoff explained. “But in most people, the vaccines against COVID also created reserves of B-Cells and T-Cells. Reserves that recognize the virus and lie in wait even after our antibodies wane. This means that while immunity against more moderate infection may indeed begin to wane, our protection against severe illness and death is much more likely to endure.”

Vanderhoff noted that medical professionals were blown away by how effective the vaccines were initially at preventing even moderate infection. He said people began to take it for granted that the vaccine provided such protection, even though it wasn’t the initial goal of the vaccine. 

Back to school 

Vanderhoff said the state is additionally worried as students start to go back to school about the impact it will have on state COVID trends. 

Vanderhoff noted that Brevard County Schools in Florida reported starting schools with optional masks and one week later reported more than 1,000 students and staff in quarantine, with an additional 470 actual cases among students and teachers. In South Carolina’s Pickens County, it took just nine days for the COVID cases to spread exponentially, Vanderhoff said, with 168 students testing positive for COVID-19 and another 568 students and staff landing in quarantine, causing a temporary shift to virtual learning. 

“We don’t want that to happen here in Ohio,” he said. “Our goal is to keep our K through 12 students in school, in person, five days a week.” 

Vanderhoff said in-person learning can be conducted safely amid COVID-19 when schools are able to employ layered prevention strategies including masking, social distancing, good ventilation, and good hygiene practices in addition to vaccination of eligible people. 

“Last spring, these practices created a very safe environment in our schools,” Vanderhoff said. “When school districts implement these same layered prevention strategies across the state, we’re confident it will enable uninterrupted academic experiences as well as extracurricular activities for Ohio’s students.” 

Vanderhoff said quarantine practices in place state that in schools where everyone, both vaccinated and not vaccinated, are wearing masks correctly and consistently, maintaining at least three feet of distance and utilizing other practices such as good hand hygiene, students are able to forego quarantining if exposed in the classroom. Additionally, schools where such procedures aren’t in place, but the student or teacher is either vaccinated or consistently and properly wearing a mask, quarantining is not required if additional masking and testing recommendations are followed, and symptoms aren’t present. 

“By choosing to be vaccinated, or choosing to wear a mask, even if not required by the school, the student or the teacher benefits and they avoid a constant vicious cycle of quarantining or returning to the classroom over and over again,” Vanderhoff said. “Adopting layered prevention measures in schools now, will help ensure that our students can learn in person as much as possible this year and keep our students participating in extracurricular activities.” 

Vanderhoff said he thinks all Ohioans want to see children having a successful school year and not getting sick or missing out on extracurriculars. 

“But that’s going to be inevitable if we don’t take the lessons that we are seeing from other parts of the country that are ahead of us on this COVID wave and have experienced just that,” Vanderhoff said. “Schools that have begun the school year without much in the way of protection against the delta variant of COVID-19 and delta has spoken very loudly and made it very clear that look, delta uses the unvaccinated like a magnet and it is really just a matter of when someone who’s unvaccinated and unprotected acquires the delta variant and therefore ends up having to miss out on their education.” 

Testing still important

Vanderhoff said testing will look a little different this year but remains important for both schools and the public. He noted that last year testing was one of the few tools in the arsenal last year, but now the most important thing to do to fight the virus is to get vaccinated. However, the number of people who remain unvaccinated, the 12-and-under age group that is not yet eligible and the 65% of Ohioans ages 12 to 17 who aren’t vaccinated continue to have the potential to become infected with and to spread the delta variant. 

“One of the questions people often ask is when should I get tested,” Vanderhoff said.

He advised that those with symptoms should immediately be tested, regardless of vaccination status or previously having COVID-19. Those who are in close contact with someone with COVID-19 also should be tested about 3-5 days after the contact.

Unvaccinated people who take part in high-risk activities such as travel, attending large social or mass gatherings and being in crowded or poorly ventilated settings also should be tested a few days following the activity.

“As a precaution people may also consider being tested before they go to a wedding or large event or before visiting a vulnerable loved one,” Vanderhoff said. “Testing lets you know if you have COVID-19 so you can respond accordingly by isolating to avoid further spread.”

Vanderhoff also touched on at-home tests which locally are available at the Upper Sandusky and Carey libraries. Vanderhoff said libraries, health departments and other ODH community partners along with any school in the state have access to the tests for free. The tests, BinaxNOW, are proctored using telehealth that helps read the results and report them to the state. 

“Until far more Ohioans choose to be vaccinated and the COVID-19 virus is no longer driving waves of hospitalization, testing will remain an important tool,” Vanderhoff said. 

Multisystem Inflammatory System Syndrome in Children

Dr. Michael Forbes, a pediatric intensive care specialist at Akron’s Children Hospital, also joined Vanderhoff on the call.  He said in November, December and January when cases spiked, about four to six weeks later the hospital started seeing children who were previously healthy, with minimal symptoms who about six weeks after getting coronavirus developed the multisystem inflammatory Syndrome. 

“We’ve taken care of about 65 kids so far with MISC (at Akron Children’s) — about 44 were confirmed, 20 were suspected and so overall we’re still seeing the syndrome,” Forbes said. 

He said MISC is like Kawasaki disease, in which the immune system goes haywire causing multiple organ system dysfunction and failure, not because of the bug that triggered it but the patient’s own immune system activating a self-destruct sequence. 

About half of MISC patients end up in the ICU, Forbes said, because it is a new disease and doctors were trying to be very careful because they hadn’t seen it before. He noted that children often presented with cold symptoms, fever, abdominal pain and diarrhea and abdominal pain that rapidly turned into multiple organ system failure due to a hyper inflammatory response to COVID. 

“It’s a new pandemic, it’s different, it’s changed,” Forbes said. “We are now seeing, across the United States, pediatric COVID and deaths due to pediatric COVID. Not only are the unvaccinated adults being frankly taken advantage of by the virus, but now we have mutated the virus to the point where children are also being affected, being harmed, being critically ill and even losing their lives because the virus was given opportunities to propagate and mutate. We need to stop that, and the way you’re going to stop that and get back to school is to get vaccinated if you’re eligible and wear your mask, frankly if you’re around any other person.”