Nov 14, 2021 —
The number of new COVID-19 cases across the North has remained stubbornly high this fall. Public health officials fear the holiday season will spark another wave.
St. Lawrence County, like others in the region, has a dangerous combination: a high percentage of positive tests and a vaccination coverage that is below the state average.
dr. Andrew Williams is the chairman of the St. Lawrence County Board of Health. He told David Sommerstein that public health leaders have spent a year and a half strengthening the region’s hospital system, but it is showing tension. Their conversation has been lightly edited for clarity.
Dr ANDREW WILLIAMS: We are talking about caring for both patients with COVID, but also patients who have non-COVID-related reasons for being hospitalized. However, because the number of cases has remained high for so long, it puts a lot of pressure on our local hospital systems.
DAVID SOMMERSTEIN: So are we seeing patients being turned away or ambulances having to travel longer distances to other hospitals?
WILLEMS: At this time, we never reject patients who come to the emergency room. But one of the challenges for us is to have a bed available for them within the hospital. For patients who need a higher level of care and a transfer to one of the larger regional hospitals, because those hospitals are so full, there is often a delay in the transfer or difficulty getting them there. Our transport system is also partly under considerable pressure due to the volumes.
SUMMERSTEIN: And the staff shortages in all those categories exacerbate it all.
WILLEMS: I think, as in other industries, in hospital systems we definitely see the impact of staff shortages on how we can care for our patients and deliver care.
SUMMERSTEIN: What can the province do to try, as we said at the beginning of the pandemic, to flatten the curve, or bend the curve back down and make lowercase letters?
WILLEMS: Interestingly, even as the pandemic continues, we’ll still fall back on what we call the “pillars of community response.” So it’s actually six things. It used to be five pillars, but now we’ve added vaccination.
The six pillars of the community’s response to flatten the curve are vaccination; wearing masks when people are indoors; physical distance; wash hands; stay at home in case of illness; and stay local. So those strategies really haven’t changed.
We continue to work on isolation and quarantine at the county health department level so that we can identify cases and reduce the spread in the community by isolating people with COVID and then quarantining those at high risk as well.
SUMMERSTEIN: And then there’s the sixth you mentioned, which is getting more people vaccinated, which is still a really big problem. St. Lawrence County has a lower vaccination rate than other places.
WILLEMS: If you look at St. Lawrence County, despite the best efforts of the medical and public health community, we currently have 55% fully vaccinated St. Lawrence County residents. New York State has an overall average of 67% fully vaccinated. And there are some provinces where more than 75% of the population has been vaccinated. So unfortunately we are a relatively low vaccination community.
In particular, what we are seeing is that the demographic age of our unvaccinated population is our younger residents, and in particular people who are employed, who may be parents of young children who attend school or go to daycare .
SUMMERSTEIN: As a patient you come into contact with all kinds of people. How do you talk to people who might be wary of getting vaccinated? How do you approach them?
WILLEMS: It’s a great question. Whenever someone has not been vaccinated and is interested in discussing vaccination, I talk about the risks and benefits of vaccination, just like any other therapy or intervention I could recommend.
I really point out that we have vaccinated millions of people in this country. A lot of research has been done on the development of vaccines. There is now a really excellent safety record for the vaccinations. And we also know that the vaccines remain highly effective in preventing people from becoming seriously ill and hospitalized or dying.
I also explained to them that while they may be concerned about vaccination, the biggest risk is getting the COVID-19 infection, and if you compare the risk of the infection with the risk, or perceived risk, of vaccination , vaccination a much better choice.
SUMMERSTEIN: What are you most concerned about right now?
WILLEMS: My concern is that we have this consistently high number of cases that we have been seeing for several months now and that we are about to enter the winter season. We are about to enter the holiday season where many of our families gather. And I’m really concerned that we won’t see a drop in the number of cases, and in fact we might see another increase on top of the current increase.
When I talk to patients about the importance of vaccination, I emphasize that it is important, safe and effective for them as individuals, but the benefit of vaccination really goes beyond protecting them as individuals. It’s the best way to protect our families and our community.