Wilkes County and North Carolina saw record daily increases in COVID-19 cases due to an omicron strain-based surge the first week of 2022, with little relief expected this week.

The increases actually were larger than official numbers show because of people with COVID-19 not getting tested and results of self-tests at home not being reported, said public health officials. North Carolina doesn’t require reporting at-home test results, nor does it have protocol for this.

For Wilkes Emergency Medical Services, the surge meant a daily case load last week 16% larger than the daily average in 2021. Wilkes EMS Director Tim Pennington said that due to COVID-19 cases, Wilkes EMS ambulances averaged almost 39 calls per day last week. Pennington said four Wilkes EMS paramedics, all vaccinated, had to quarantine last week due to testing positive for COVID-19.

He said COVID-19 patients seen by Wilkes EMS last week weren’t as sick as people with the delta variant, but respiratory problems and other issues were severe enough to transport all to hospitals. Pennington noted that every day last week, there were times when Wilkes EMS had to call for ambulances from Watauga, Alleghany, Iredell or Surry counties to be on standby at the county line due to all Wilkes ambulances being tied up.

On Monday, spokesmen for Atrium Heath Wake Forest Baptist, Cone Health and Novant Health said they’re at a critical stage in how effectively patients can be treated due to large patient loads and staff becoming sick. They asked the public to follow vaccination and testing recommendations to help limit the load.

In the week ending Jan. 7 (first week after Christmas break), the Wilkes schools had 78 active COVID-19 cases and 335 people having to quarantine. Both numbers included adults and students. These are the highest totals since August and September, when the delta variant caused a surge.

The N.C. Department of Health and Human Services (DHHS) reported that 20.32% of documented COVID-19 tests of Wilkes residents in the seven days ending Jan. 7 came back positive, up 2.75% from the prior seven-day period.

On Sunday, DHHS reported a COVID-19 case rate of 989 per 100,000 people for Wilkes for the seven days ending Saturday, Jan. 8. That was based on 677 new cases in the seven days.

DHHS reported a case rate of 520.38 per 100,000 people in Wilkes for the seven days ending Jan. 2, based on 356 new cases in that period. This was 140% more than the prior seven-day.

The official number of COVID-19 deaths of Wilkes residents since the pandemic began had been 205 since Dec. 29 until it increased to 206 on Monday and then 207 Tuesday.

Also on Tuesday, DHHS reported that 13,104 Wilkes residents had officially tested positive for COVID-19 since the pandemic began. On Friday, the total was 12,715.

In Wilkes schools

In a 3-2 vote Monday night, the Wilkes school board defeated a motion to make masks optional in Wilkes schools for the next month. As a result, masks remain mandatory for everyone indoors on school property.

School board members Hardin Kennedy, who made the motion to make mask optional, and Chairman Rudy Holbrook voted for the motion. Voting against it were board members Sharron Huffman, Joan Caudill and Kirk Walker. The board was split the same way in votes on Dec. 6, Nov. 6 and Oct. 4 that kept the mask mandate in place.

Holbrook said he voted for the motion because he believes school officials should let parents decide if their children wear masks in schools.

Kennedy said that none of the school districts in counties adjoining Wilkes that made masks optional earlier this year have had to close schools due to COVID-19 since taking this action.

Caudill said some Iredell County schools had to be closed due to COVID-19 cases while masks were optional there in the first half of the school year. She said making masks mandatory in the Wilkes since Aug. 30 helped prevent closure of any Wilkes schools.

Huffman said she voted against Kennedy’s motion because requiring masks is the best way to keep students in schools. Centers for Disease Control guidance includes various situations that prevent a student from having to be quarantined if he or she is wearing a mask when exposed to someone with COVID-19 in a school setting.

One parent spoke against the mask mandate and a retired Wilkes school nurse who is a parent and grandparent spoke for it during the public concerns portion of the meeting.

10 deaths in care facilities

DHHS reports COVID-19 outbreaks in congregate care facilities and COVID-19 clusters in schools online every Tuesday. The Jan. 4 report listed outbreaks in three nursing homes and two residential care facilities in Wilkes, as well as the Wilkes County Jail. It showed clusters in two Wilkes schools.

The report listed seven deaths of residents in the outbreak at Westwood Hills Nursing and Rehabilitation Center in Wilkesboro. This was the most deaths for any congregate care facility statewide in the Jan. 4 report.

The seven Westwood Hills residents who died were among 29 residents with COVID-19 in that outbreak. Ten Westwood Hills staff members tested positive for COVID-19 in the same outbreak.

The Jan. 4 report listed three deaths of residents in the outbreak at Accordius Health at Wilkesboro. It said 20 residents and six staff members at Accordius tested positive for COVID-19 in the outbreak.

According to the Jan. 4 report:

• 13 staff members and four residents tested positive for COVID-19 in an outbreak at Wilkesboro Health and Rehabilitation in North Wilkesboro;

• 12 staff members and seven residents tested positive for COVID-19 in an outbreak at Wilkesboro Assisted Living Center;

• one staff person and two residents tested positive for COVID-19 in an outbreak at Rose Glen Manor in Wilkesboro;

• 16 inmates at the Wilkes County Jail tested positive for COVID-19 in an outbreak there.

The Jan. 4 report also included two clusters: one at North Wilkes Middle School with 15 students testing positive and another at Mountain View Elementary School in Hays with five students testing positive.

An outbreak in a congregate living facility is defined as two or more confirmed COVID-19 cases. A cluster in a school or child care facility is defined as at least five related positive cases within 14 days. An outbreak or cluster is considered over if there is no evidence of continued transmission 28 days after the latest date of onset in a symptomatic person or the first date of specimen collection from the most recent asymptomatic person, whichever is later.

Dr. Christopher Ohl of Atrium Health Wake Forest Baptist in Winston-Salem said in his weekly COVID-19 update on Facebook Live on Jan. 6 that area nursing homes outbreaks are increasing, largely due to infected staff.

Ohl emphasized the importance of nursing home staff not coming to work if they’re sick. He said they should participating in testing programs and get booster shots.

Case numbers are less relevant now because of the many people who think they might have COVID-19 but aren’t getting tested or are self-testing and not reporting results, said Ohl, an infectious disease expert.

The Wilkes County Health Department announced last week that it no longer would report COVID-19 metrics on its website.

Ohl said there will be less emphasis on knowing case totals as COVID moves more into the endemic stage, so next year at this time they likely won’t be counted.

Ohl looks at trends and rates based on available numbers and said he increasingly is gauging conditions by COVID-19 hospitalizations. He said these indicators reflect a surge in cases due to exposure over the holidays, with 80-90% of them resulting from the omicron variant.

He said hospitalizations in the Atrium Health Wake Forest Baptist system, which includes Wilkes Medical Center, are similar to the peak of the delta variant surge in late August and early September. The system’s hospitalization totals are about 30% less than in early January 2020.

“That means that omicron is a less severe infection for vaccinated people and people who were previously infected.” He said it tends to infect the upper respiratory areas rather than lungs so in that sense is less severe.

He said people hospitalized with COVID-19 are mostly the unvaccinated, reflected by the fact that 92% of those with COVID hospitalized in the Atrium Heath Wake Forest system the morning of Jan. 6 were not vaccinated. It’s higher in hospital ICUs. He said immunocompromised people and those over age 70 with underlying health conditions account for most of the rest.

January and February are already the busiest months for hospitals, plus staffing is down because many have “COVID colds.” He said this will continue for at least three more weeks.

He said booster shots should be thought of as the third in a three-shot series, similar to three-shot vaccinations for some other viruses because protection from the first two starts to wane after five to six months.

Ohl said people soon likely won’t be considered fully vaccinated for COVID-19 unless they’ve had three shots. He said the extra protection greatly raises the likelihood of a person not becoming infected with COVID-19 and only having cold symptoms if they do contract the virus. It also reduces transmission of the virus.

“If you are unvaccinated, you will get omicron. No ifs, ands or buts; it’s going to happen,” Ohl said. He said vaccinated people, especially those with boosters, won’t experience any more than a cold if they catch the virus. He expects antibodies to help protect immunocompromised people.

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