SOUTHERN INDIANA — As the United States surpasses 200,000 deaths from COVID-19, health officials in Southern Indiana are reflecting on what they have learned about patient care and the local pandemic response.
Since the pandemic began, there have been a total of 56 deaths in Clark County and 61 deaths in Floyd County. Health officers in both counties say patient care in local hospitals has significantly improved since the early days of the pandemic, and they are both seeing lower COVID-19 mortality rates.
Clark County Health Officer Dr. Eric Yazel said that as of Thursday morning, the county’s positivity rate of about 7% is the lowest he has seen in several months, and the number of COVID-19 deaths has become more sporadic since the early stages of the pandemic. Yazel also serves as a doctor in the emergency department at Clark Memorial Health in Jeffersonville.
“When it comes down to it, the numbers are pretty simple — the more cases you have, the more deaths you are going to have,” he said. “In March and April, we got to the 40 to 50 number of deaths fast, but that went down, and we didn’t have COVID-19 deaths for six to eight weeks in the summer. We faced a resurgence in July and August, and we saw five to 10 more deaths since then.”
Yazel said when he looks at Clark Memorial intensive care unit admissions for COVID-19 now versus the beginning of the pandemic, the difference is “night and day.” He was aware of two COVID-19 patients in the Clark Memorial ICU as of Thursday, but in early stages of the pandemic, half of the patients in the ICU would be COVID-19 cases.
Floyd County’s positivity rate has also been trending downward for the past three weeks, according to Floyd County Health Officer Dr. Tom Harris, who also works in the emergency department of Baptist Health Floyd. The county’s 7-day positivity rate is at 5.15%.
There have been fewer ICU admissions in the last two months, Harris said, and the mortality rate of those admitted to the ICU for COVID-19 has improved by 30% since the beginning of the pandemic.
In both Clark and Floyd, hospital beds and ventilators availability is not an issue, according to Yazel and Harris.
The Indiana State Department of Health reports the statewide COVID-19 7-day positivity rate for Indiana is 3.9%.
Gov. Eric Holcomb announced Wednesday that Indiana will move into Stage 5 of the state’s reopening starting Saturday. The mask mandate will continue, but limits on group gathering sizes and capacity limits in bars and nightclubs have been lifted. Social distancing of six feet is still required.
There have been significant advances in COVID-19 treatment since the pandemic began in March, and both Harris and Yazel have seen major improvements in Southern Indiana.
For example, a technique called “proning” or a process of positioning patients on their stomach so they are lying face down, is used for improved oxygenation, or breathing. The practice was not commonly used before the pandemic.
“When I get a COVID patient who is short of breath, that’s one of the first things I tell them to do,” Yazel said.
Doctors are looking to creative ways to keep patients off ventilators when possible, he said.
Hospitals are also looking to medications such as steroids and an anti-viral drug called remdesivir for treatment, Harris said, and developments with ventilator supports and ventilator tactics have improved survival rates.
Harris said that the best way to treat COVID-19 is to prevent people from getting it in the first place, and he urges people to continue taking the proper safety precautions as Indiana enters Stage 5.
“Pandemic fatigue” is a concern as people tire of wearing masks and following other safety protocols, he said.
“That’s an ugly trend from the public health perspective,” he said. “We’ll need to be wearing masks probably to the end of the year at best, and probably after that.”
Yazel expressed optimism with the decreasing positivity rates in Clark County, but he emphasizes that people will need to take personal responsibility in following safety precautions.
“One of the concerns is when the weather cools off a lot of outdoor things will move inside,” he said. “Halloween has been a big topic of discussion, since a lot of people have big Halloween parties and things like that. Level five gives some freedom but also puts a lot of responsibility on the individual.”