Idaho government Brad Little received a dose of COVID-19 vaccine on Jan. 25. “I received the first dose of the safe and effective COVID-19 vaccine! I feel great and back in the office, working hard for the people of Idaho, ”Little said in a tweet.
BOISE (Idaho Statesman) – Rarely has the term “ cautiously optimistic ” been more appropriate than when Idaho leaders talked about the 2021 coronavirus cases.
From local public health experts to the governor, the people responsible for Idaho’s COVID-19 pandemic struggle see a light at the end of the tunnel.
All COVID-19 numbers in Idaho look better than in months.
The daily cases for Idaho are a fraction of their fall peak – according to statistics from the Idaho Department of Health and Welfare, it drops from a maximum of 2,298 on December 9 to 314 on Friday. Hospital admissions of people with COVID-19 have stubbornly stayed above 140 people per day, but they are now at levels unseen since late September. The same is true for people who need intensive care for coronavirus complications – about one-third of ICU admissions in Idaho hospitals reported in December.
“We are delighted,” Idaho Gov. Brad Little said in an interview Friday.
“People just have to be careful,” he said. “At the moment we are in a race to get the vaccine into as many arms as possible.”
BUT WHY DO IDAHO’S CORONAVIRUS CASES FALL?
The Statesman spoke to public health experts and Little about what they heard – and their theories about what is improving the situation in Idaho and across the country. They said it is likely a combination of a few factors.
They also stressed that while it’s worth celebrating, it’s not a cue to throw out your mask and hang out in crowded bars.
There are wild cards in the future. Students and teachers return to face-to-face classrooms with full lessons. A public health council lifted the mask mandate for Ada County on Friday. (Boise’s mask mandate continues.) And this week, one of the most worrisome variants of the coronavirus was confirmed in the Treasure Valley, while two other variants were found in wastewater from Boise and the surrounding area.
“People think we’re at home – fallen off, hospital admissions off, vaccines rolled out,” state member of the coronavirus working group Dr. David Pate said on Twitter“They have no idea what’s to come, and now our school boards and (Central District Health’s board) are reinforcing those beliefs through their actions. I’m trying to sound the alarm, but apparently no one is within earshot. “
DO PEOPLE GET BETTER WITH COVID-19 PROTOCOLS?
Idaho has seen two major peaks of COVID-19. The worst started in October and peaked in early December. Public health officials implored people not to travel or organize large gatherings for the Christmas and New Year holidays, for fear of the worst.
But a third wave never came about. The opposite happened. Cases have gone down.
“Everyone, from the CDC to almost all of the experts, has not gotten everything right because there are a lot of things involved,” Little said. “One of them is clear behavior. Part of that is, in our opinion, awareness we have done through ONE Idaho (COVID-19 prevention campaign), but we also think … as time went on, (more Idahoans) knew someone who was really sick ‘or who died of COVID-19.
Two public health experts think this may be part of the calculus that puts Idaho’s case on a downward slope. But how much? They are not sure.
“We’ve been living with COVID for about a year now,” said Kimberly Link, manager of communicable disease control at Central District Health in Boise. There are “more permanent changes in the way we interact with each other, both at home and in public, that are safe practices. … Masking and physical distance have become part of our way of life, and it will affect the way the disease is transmitted. “
Little said Idahoans sacrificed themselves during the pandemic – staying home, delaying travel, not visiting loved ones, a business, or losing their jobs due to the economic toll of COVID-19. Thousands of Idahoans also lost loved ones to COVID-19.
People whose sacrifices have prevented more deaths and helped slow the spread of the virus “are part of why we are where we are” with better control of outbreaks, Little said.
COVID-19 has hit Idaho in waves since the first case was announced on March 13, 2020. The fall set off the state’s worst wave, with hospitals and clinics across the state being overwhelmed with sick workers and hospital patients. New infections fell sharply in December. January saw a much milder than expected post-holiday peak, followed by a steady decline.
LESS TESTING = LESS CASES?
Dr. Sky Blue, an epidemiologist and infectious disease specialist in the Treasure Valley, says some people have advanced this theory. It doesn’t stop.
A lower positivity rate means that a community’s infection rate is low enough to catch many of its infections by testing humans. When cases get out of control, the positivity rate goes up – because there are so many people catching and spreading the virus, the health workers and labs running the tests can’t keep up with the demand.
The percentage of COVID-19 tests in Idaho that now returns positive is nearing 5% – the upper limit recommended by the World Health Organization. Three months ago, the positivity rate in Idaho was nearly 20%.
“Essentially, we’re getting to that point where the amount of testing being done is sufficient for the amount of disease in the community, because the amount of disease in the community is declining,” Link said.
WHAT ABOUT VACCINES? DO THEY DESERVE CREDIT?
Yes, but it will be weeks or months for Idaho to see the full effect of vaccines in controlling the spread of the coronavirus.
Many public health experts see vaccination as the clearest path to anything nearing “herd immunity” to the COVID-19 virus.
People start to build up immunity to COVID-19 after their first dose of the vaccine. But to get 90% or better protection, you need a second dose three or four weeks later (for the current Moderna and Pfizer vaccines), plus a few weeks for the body to build immune cells.
Idaho’s first vaccinated primary care health workers, residents of long-term care facilities, and staff have only reached that point in recent weeks. As more people receive vaccines, the “herd” will grow.
A recent decline in outbreaks among long-term care facilities in Idaho underscores that timing, Link said.
“That’s one area where the vaccine has certainly had an impact,” she said. “If we see 70% to 80% of those residents getting vaccinated,” it could prevent vulnerable Idahoans from becoming infected and, in some cases, dying.
More vaccines are on the way. The federal government is speeding up vaccine rollout and shipping more vials to Idaho and to pharmacies, including Idaho Walmart and Albertsons stores.
Those factors – plus reclaiming doses that went unused in a special federal program – have boosted Idaho. The state is ranked 18th in the US for administering its vaccines, the chairman of the Coronavirus Vaccine Advisory Committee said on Friday.
There is little optimistic about vaccines. He said a hospital leader in Cascade just reported vaccinating 500 people – a number equal to nearly 5% of the entire province’s population – in one day.
DOES THE CORONAVIRUS CHANGE?
Little said his public health team has always told him, “Viruses do what viruses do, and they change.”
Those changes are a normal part of the evolution of a virus. It mutates as it makes copies of itself in a person’s body.
Some mutations can make the virus more contagious – as scientists believe this has happened with a few “worrisome variants,” such as the B.1.1.7 variant first discovered in England.
Little said those variants are now under the microscope of the world, “but we think the existing coronavirus (which dominates Idaho) may be becoming less contagious,” he said.
IS THE SEASON? THE FLU COMES AND GOES, RIGHT?
Could be. Maybe not.
“We’ve seen these waves or spikes in disease happen,” said Link. “There is a certain nature of comings and goings and what ultimately causes them, I think, has been a bit of speculation, but it’s not uncommon.”
But epidemiologists have their doubts whether COVID-19 is easing, as it goes off-season. That’s because the other classic seasonal virus – influenza – usually arrives in Idaho in the fall. And it usually peaks about now.
WAS THE VIRUS BROUGHT FROM IDAHOANS TO INFECT?
The Magic Valley could be a case study for what makes a virus rise and recede.
Twin Falls saw a massive rise in October. The regional hospital became so overwhelmed that it had to send patients to the Treasure Valley. That took weeks.
Local officials refused to curtail activities as the virus spread. They voted away mask mandates.
And then, in the middle of November, something changed. Cases fell. Hospital beds opened. The positivity rate got better.
Was it because people responded to calls for personal responsibility, put on masks and kept their distance?
“If you’ve ever walked anywhere in Canyon County or Twin Falls, you know that’s not true,” Blue said.
What he and others suspect – pointing out that this is all speculation – is a strange kind of isolated herd immunity.
“We have a number of people who have been so diligent about masking and isolation that they are unlikely to be exposed,” Blue said. That group has selected itself from the herd.
“Then you have the others who wouldn’t put on masks if their lives depended on it,” he said. That group is COVID-19’s free ticket for the herd.
For the past year, those groups have not mixed like they did before the pandemic, Blue said.
While the first group stays at home, the virus spreads through the second group. Most people in the second group recover with some immunity. Ultimately, the virus has no new bodies to infect.
“So you don’t see that taking off like a bushfire it has been for a while,” Blue said.
But those who are not infected cannot stay at home forever. And those who have recovered from COVID-19 will not be immune forever.
Idaho cannot achieve true “herd immunity” without many more people dying and being hospitalized.
That’s why Blue and others hope Idahoans will take the vaccine.
Blue believes the virus will become “endemic” and bounce around like the flu forever. Vaccines and post-infection immunity would likely make the disease less severe over time, he said.
CAN IDAHOANS RELAX ABOUT COVID-19 NOW?
This question caused a few seconds of silence on the other end of the phone during interviews.
While her agency’s board of directors voted Friday to lift Ada County’s mask mandate, Link said the importance of public health guidelines to continuing to wear masks has not changed.
“Masking and physically distancing myself, I really think these will be – above all else – the things that really get us through this,” she said. “Those are the first things that came on board, and they should be the last.”
If the virus starts spreading out of control again, it could go from 500 cases in Ada County this week to 2,000 cases per week in March, she noted. That’s what happened at previous peaks.
Her advice to everyone? Be careful.
“I think any time someone goes out the door and spends time with people they don’t live with, masking and physical detachment should be a cornerstone,” she said.