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MSDH updates guidance, prepares hospitals for ‘challenge unlike any we’ve seen’

In the wake of the tragic death of a Mississippi teenager due to COVID-19 and in the midst of alarmingly rapid transmission of the delta variant throughout the population, the Mississippi State Department of Health held a press conference on Wednesday where officials stressed the magnitude of the ‘fourth wave’ of coronavirus and the importance of vaccination to protect ourselves and our communities.

MSDH has updated their public health recommendations to align with those of the CDC and ordered all hospitals to participate in the COVID-19 emergency care plan to maximize resources in preparation for what data trends project to be a potentially overwhelming influx of patients.

“We are seeing a really phenomenal increase in the number of cases in the state of Mississippi and we are also seeing significant stress on our healthcare system,” State Health Officer Thomas Dobbs said.

New cases in the last two weeks more than doubled the number of cases reported in the first half of the month (credit: MSDH)

The combination of a highly infectious viral strain with low levels of immunity foreshadows immense challenges ahead as we move into a new school year.

“93% of the samples that we’ve looked at recently are the delta variant, and we know the vast majority of transmission is occurring among and from unvaccinated folks,” Dobbs continued.

In a very short period of time, the delta variant has infected tens of thousands of Mississippians (credit: MSDH)

Breakthrough cases are also on the rise, with 18% of recent deaths occurring in fully vaccinated individuals.  Dr. Byers attributed these tragic outcomes, in part, to age and underlying health factors. 

“We have seen some common themes among the breakthrough deaths, for certain, with a median age of 79, so it’s in older folks that we’re seeing the breakthrough deaths,” Byers said. “We have seen breakthrough cases in all age groups, but where we have seen the impact of severity of illness has been, by and large, in those older individuals who are immuno-compromised.”

Vaccinated individuals account for 18% of recent deaths, which officials attribute to high transmission rates causing breakthrough infections, along with age and overall health contributing to the grim outcome (credit: MSDH)

Dr. Dobbs said the spike could indicate that a small subset of people, namely elderly individuals and those will immune deficiencies, should discuss with their doctor the possibility of added protection from a booster vaccination. Ultimately, decisions to receive an extra dose of vaccine are best made between physicians and their patients, based on each individual’s needs and personal health.

Dobbs was clear that the best way to protect those most at risk, though, is to get shots in the arms of those yet to be vaccinated.  Increasing immunity levels within the community is the best protection for everyone; including young children who cannot yet receive a vaccine.

(credit: Johns Hopkins University)

“We’re seeing a massive rise now, and then school is just getting started,” Dobbs said. “If you look at the trajectory of our rise, it’s not a slope, it’s a cliff.”

“I think it is important to understand that as we continue to have high levels of transmission, we may have additional variants that emerge,” Dr. Byers warned. “The more that the virus is out there circulating and causing illness, there’s certainly more chances that we’ll have another variant strain emerge that may be more deadly, may be more transmissible, that may even escape the protection from the vaccine.”

In an effort to slow the spread of the highly contagious virus, MSDH strongly encourages everyone 12-years and older to get vaccinated and recommends that everyone wear a mask in public indoor settings regardless of vaccination status.  Individuals that are over the age of 65 or are otherwise vulnerable should avoid indoor mass gatherings altogether.

(credit: MSDH)

MSDH will also be updating their guidance for K-12 school settings, although the final policies will be determined at the district level.

“We are going to recommend and promote universal masking indoors, because we know that is an important added step that we know is not going to keep our kids safe, but that is gonna keep them in the classroom learning…it is going to be very disruptive, all these outbreaks,” said Dobbs. “We think it’s an important measure.”

As of Tuesday, July 27, ten children were hospitalized with COVID-19 and three were in intensive care units in Mississippi hospitals.  This number does not include children from Mississippi who may have been taken to out-of-state hospitals, as is common in some parts of the state.

“It’s important to reiterate that for children, the vast majority of them do not have severe illness, but there can be severe illness,” Byers said. “If you have a child that is eligible for a vaccine, now is the time to get vaccinated.”

With hospitalizations on a rapid rise and 28 hospitals reporting no ICU bed availability already, all state-licensed hospitals have been ordered to participate with in the Mississippi COVID-19 System of Care Plan, effective Thursday, July 29 through Aug. 15.

“In parts of our state, hospitals are struggling to accommodate the acute clinical demands that they are facing with the increase in hospitalizations,” explained Senior Deputy Jim Craig. “We will enact a COVID-19 rotation to help ensure the assignment of patients to an appropriate hospital.”

Facilities will be classified based on their capabilities to treat COVID-19 patients in accordance with the severity of illness. This process of matching patients with resources offers the best possible opportunities for positive outcomes.  The full plan is available here.

Dr. Dobbs expressed his gratitude and sympathy for Mississippi’s healthcare workers at several points during the talk, noting that nurses and other frontline workers are already experiencing burnout from the sustained pressure of the pandemic as they face the challenge of managing the fourth and most infectious wave of coronavirus sweeping through the population.

“It’s going to be a challenge unlike any we’ve seen,” Dobbs said. “I know that sounds kind of remarkable, but its the truth.”