Nearly four years after the COVID-19 outbreak, a high rate of global immunity, vaccinations, home testing, and other tools have helped to dramatically reduce the number of positive cases.
The federal COVID-19 Public Health Emergency ended on May 11, 2023.
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The Florida Department of Health, which only tracks cases reported through the healthcare system, reflects the decline in the past year.
As of Sunday evening, the four counties of Northwest Florida showed just over 17,000 (17,311) reported cases, down about 80% from nearly 88,000 (86,692) at the end of 2022.
But, thanks in part to the holidays, the expected winter spike in cases is now underway.
WUWF’s Sandra Averhart recently spoke to Dr. Susan Laenger, who has been tracking the COVID-19 situation locally. Laenger is an internal medicine physician, who also serves as medical director of primary care services for Sacred Heart Medical Group.
Sandra Averhart: What have your doctors been seeing? What have you been seeing? What have your doctors been seeing locally in recent weeks?
Susan Laenger: I'm actually in a good position to assess the current status in our community because my office has an urgent care embedded. And so I end up speaking with our urgent care clinicians on a regular basis. And we are seeing a definite uptick in COVID-19 these days, is also a definite uptick in flu, for that matter. But across our urgent care system, we have three different ones. It's about ten cases a day of COVID-19 the flu volume is actually even greater.
Averhart: So how does this compare, in your opinion, at least? Maybe we're just getting started with our winter spike. Does this compare to the summer spike?
Laenger: I think it's a bit more than the summer spike. I believe with the sources that I've looked at, that it is now kind of becoming two spikes a year that we are seeing year after year. One is about the August/September time frame, and the other starts in December, right after people have gathered for Thanksgiving, and then goes right through January. So I do think that the winter spike tends to be a little bit higher than what the late summer fall one tends to be.
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Averhart: Now, what are you seeing in terms of severity of symptoms, and what do you know about the need for hospitalization in our area?
Laenger: Well, the great news is that hospital admission rates are low. It is definitely being seen more in the outpatient setting. I have had several of my patients call up and tell me that they home-tested and were positive. As a result, we do a virtual visit and I get to see them mainly having symptoms of just kind of achiness, certainly fever, some of them fever of 103. Very much, a lot of cold-like symptoms, sinus congestion, some headache. One of my patients told me that he felt like Typhoid Mary because he went on a lovely vacation with his wife and another couple, and he thought that they were allergy symptoms. It never occurred to him that he might have COVID until his wife insisted that he take a test. And honestly, by that time, all four of them had come down with COVID. And so I think that it does behoove people that if they have any symptoms to go ahead and test, and then obviously if you test positive we would want you to isolate and contact your primary care physician.
Averhart: A couple of things that I want to ask you about. First, I want to ask you about reporting. What do you know about requirements for reporting to the state?
Laenger: COVID-19 is a reportable disease in Florida, which means that when someone gets tested through the healthcare system, that positive result does get routed to the Florida Department of Health. However, since the advent of home testing, most cases go unreported.
Averhart: So when we look at the numbers, I mean, we're only really getting a fraction of the real story.
Laenger: I agree with that completely. Also, just because somebody tests on a given day, even at a healthcare facility, it might be a negative test, depending upon how early in the course they are with regard to their symptoms. And they may certainly become positive later in that same course of symptoms. So it can definitely fool us.
Averhart: I want to talk now about vaccines. I've had the main shot, the two boosters, the Florida Department of Health, of course, their most recent advisory recommends vaccines only for people 65 and up. What is your position on the vaccinations and whether people should get them?
Laenger: Well, I do suggest vaccination to lower the likelihood of becoming seriously ill. There is a new shot. It came out in September. The FDA is calling the new shots “updated vaccines” and not really boosters in anticipation of needing to provide updated formulas annually, similar to the flu shot, which changes each year. This updated vaccine is recommended for people ages 12 and up. It has been specifically formulated for the variants that are most common in 2023. It came out in September. I've already actually gotten mine. My question to those who are hesitant is, ‘why not get it?’ It lowers the risk of hospitalization, and even if you aren't really worried about needing to be hospitalized, it lowers the risk of long COVID. I actually had a patient come in recently, and he was experiencing symptoms that definitely started right after COVID and were quite severe, even though his COVID infection hadn't been all that severe. He was having just terrible fatigue, almost limiting him from being able to work, but certainly causing him to sleep 12-14 hours a day. He had severe GI symptoms and his quality of life at that point was really horrible. This was about two months after his bout with COVID. So, I feel like with regard to reducing the risk of hospitalization and reducing the risk of long COVID, it's definitely worth getting the most recent updated vaccine.
Averhart: And the one thing that I forgot to ask you about, because it's kind of in the news, lately, these new variants, particularly JN1, are you keeping up to date on all the new variants that are out? And do you have a level of confidence that our current vaccine will deal with that?
Laenger: Great question. And I was just reading an article that did point to the fact that they feel like, yes, there are those brand new variants out, but that they've done a good job of, for the most part, providing protection with the newest vaccination. So I do think that it's so far a reasonable match, which is what we always are hoping for when we have a vaccine — that they are changing the formula on trying to anticipate what is going to be the most common thing that people are coming up against.
Averhart: Do you still have signs, are there signs in your offices regarding preventative measures? Are you still saying to be proactive here?
Laenger: There are definitely signs up with regard to being proactive against any upper respiratory. Right? That it's always good to cover your cough, that it's always good to practice hand washing, that we should all be very thoughtful about trying to prevent any spread of any upper respiratory to anybody else around us who might be more vulnerable, and to stay away from gatherings or at a minimum, just really be exceedingly careful, perhaps even wearing a mask if you have upper respiratory symptoms in order to try to protect all those people around us.
Averhart: Do you think we can still carry on for our holiday gatherings? Because this is another time for the spike, you say, starting with Thanksgiving.
Laenger: Well, holiday gatherings are precious, and we certainly want to protect those that we love. So I just kind of generally feel that it's a good idea to wash your hands, get tested if you have symptoms, and then once you test and you know that you're negative, bask in the glow of knowing that you've done everything that you can to protect those that you love from harm.
Averhart: I think that's it. Is there any nugget of wisdom that you would want to leave us with as we close? Anything that I didn't ask that you really think we should know?
Laenger: Just that if people do have symptoms and test positive, I really would urge anyone to call their primary care physician because we've got some excellent treatment. Either of the two main medications that are available now for COVID-19 paxlovid and lagevrio, and maybe just see if you're a candidate for one of these. Certainly, if somebody were to test positive, stay hydrated, get rest, and, obviously if the more severe symptoms show up — something like really bad shortness of breath or chest pain, or you just can't keep fluids down, go immediately to the emergency department. If people can get the vaccine and just be careful about their exposures we should have a wonderful holiday season. I really look forward to getting together with the ones I love, and I hope everybody else can do so very safely.
