Factors beyond numbers influence COVID spread

Thursday will be six months since first case reported in the United States

Thursday marks a haunting semi-anniversary, a date no one in America will celebrate but one that nonetheless suggests how the coronavirus crisis will one day end.

A woman in her 60s flew from China to her hometown of Chicago after spending nearly three weeks visiting relatives who’d come down with a strange respiratory illness. She reportedly flew into O’Hare International Airport, where she was greeted by her husband — also in his 60s — before heading to their suburban home. She soon fell ill with similar symptoms as those of her relatives back in the Chinese city of Wuhan. Not long after, her husband fell sick.

The woman tested positive on Jan. 24 for a new disease called the coronavirus. Her husband tested positive Jan. 30 — six months ago this Thursday — marking the first case in the United States of person-to-person transmission. At the time, that case struck fear into many residents in Illinois, Idaho and the rest of America. Today, with 58,631 Americans testing positive on Sunday alone, the idea of having only one person test positive in a day sounds like a fantasy.

Idaho’s first case didn’t come until March 13, after a woman visiting New York City — then a burgeoning COVID-19 hotspot — flew home through Boise Airport. That one case turned into five the next day. Within a week, it reached 40, including 10 in Kootenai County. By the end of March, 524 Idahoans had contracted COVID-19. Now, four-and-a-half months in, 18,694 state residents have tested positive for the disease.

As the numbers have risen in near-exponential rates, so, too, has concern among local health leaders.

“The role and responsibilities of public health have never been more important,” Kootenai Health CEO Jon Ness said on July 24 in addressing the Panhandle Health District board, “nor have they been more challenging than they are today.”

Ness added that the World Health Organization noted the unique nature of the disease, not only in terms of numbers (approximately 118,000 cases at the time, mostly in China and Europe), but in terms of its dangerous novelty.

“The comments at that time were, ‘Never before have we seen a pandemic sparked by a coronavirus,’ Ness said. “Let that sink in. Their other comment was, ‘We have never before seen a pandemic be controlled until a proven vaccine is universally available.’”

Ness summized the pandemic with as diplomatic an answer as he could muster.

“We have a problem,” he said.

That problem, Ness said, could easily be seen from his office at Kootenai Health, not only through the long-range telescope of a four-month window, but with a much more narrow, recent and relevant view of the past three weeks.

“On July 6,” Ness said, “Kootenai Health had three hospitalized patients and 420 positive test results from our drive-through testing center. One week later, Kootenai Health had eight hospitalized, with 718 positive test results. One week after that, we had 19 patients and 1,022 positive test results. (On July 23), we have 26 hospitalizations and four deaths. You can see where this is going.”

Ness said that the high number of vulnerable seniors, the shrinking calendar days before schools open and even the nature of North Idahoans could turn the area into a COVID-19 hotspot.

“Why has our situation worsened so quickly?” he asked the board. “What happened? One of the cultural attributes of North Idaho is a sense of independence and even pride in our individual rights of freedom and personal choice. Some might say we value independence and freedom above all else, that that is the most important thing to all of us.”

Katherine Hoyer of Panhandle Health District said one factor that should be considered when examining the recent surge in local cases involves more than just the mathematics behind a pandemic. It also has to do with the untrackable but still palpable X factors: in this case, she speculated, the time of the year.

“I think people want to enjoy their summers,” Hoyer said. “They want to get together with friends and families. It’s been a long year so far, and because people are not necessarily seeing their own friends and families get sick, or they’re seeing friends and family test positive but not necessarily seeing any symptoms. Because of that, I think that’s spawning the thought that, ‘Hey, we can have these get-togethers, and we don’t have to practice social distancing, and we don’t have to wear masks.’ And that’s helping spread the disease.”

Hoyer added that the key is not only continuing to provide the community with data, science and research to better educate the population, but also to encourage best practices.

“I think we know a lot more about what we can do to keep us safe,” she said. “That guidance and education is out there. Now we just need to do it. We know those things work to stop and slow the spread of the virus. Now we need to do those things.”

Andrea Nagel of Kootenai Health reiterated the best practices and education health officials have stressed since the beginning of the pandemic.

“Until we have a vaccination available, the best way to limit the spread of COVID-19 and protect yourself and others is to stay diligent in your prevention methods,” she said. “Wash your hands frequently, follow our county’s masking guidelines, clean surfaces in your home and workspace often, distance yourself 6 feet from others when possible, and stay home when you’re feeling ill.”

Ness stressed that just as the health protocols for battling the coronavirus remain the same as they did when the virus first spread from an Illinois woman to her husband six months ago, the focus of the community is unchanged, as well.

“All of these attributes are making the risk of COVID-19 spread difficult to manage and they make the responsibilities of public health a real challenge,” he said. “Plus, it appears likely we are going to be in this situation for at least six months, if not over a year. Based upon the current situation, our collective efforts need to be on slowing the spread of COVID-19, to protect each other and to ensure we have the health care capacity to treat all patients, not just COVID-19 patients.”