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‘We’ll just keep changing with the virus’: Casper’s front line keeps offering care, vaccines as Omicron wave hits Wyoming

Wyoming Medical Center hospitalist Dr. Andy Dunn, Casper-Natrona County Health Department spokesperson Hailey Bloom, and C-NCHD executive director Anna Kinder finish paperwork before transporting part of the first shipment to WMC at the C-NCHD building in central Casper on Wednesday, Dec. 16, 2020. (Dan Cepeda, Oil City File)

CASPER, Wyo. — Along with a new year comes a new surge in COVID-19 cases in Wyoming — this time associated with the Omicron variant that is sweeping the country. Health officials in Natrona County said Monday that despite fatigue from two years of COVID, COVID and more COVID, caregivers on the front line are prepared to continue giving care needed in the community.

“I’m definitely proud of our hospital,” Banner Wyoming Medical Center Chief of Staff Dr. Andy Dunn said during a press conference held at the Casper-Natrona County Health Department (CNCHD). “I’m proud of the providers, the nurses, the CNAs, the techs, the housekeepers. Everyone is really coming together.

“It’s like a mission to be called to help people, so we’re hoping that this is the rally cry that gets us through the finale of this whole thing.”

Dunn and CNCHD Executive Director Anna Kinder spoke Monday about the changing COVID-19 situation and what people can do to protect themselves and loved ones as the omicron variant makes its presence known in the Casper area community.

Wyoming has been adding 511.7 new confirmed COVID-19 cases per day over the last 14 days, according to Wyoming Department of Health data from Monday. That is a sharp increase from the average of 75 new confirmed cases per day the state reported as recently as December 19, 2021.

“As of this morning, basically the state health officer has advised that almost everything that we’re dealing with at this point is Omicron,” Kinder said.

In addition to a surge in cases, Dunn said that Wyoming is likely to see a rise in hospitalizations due to the sheer number of new cases associated with the Omicron wave.

“It’s three times more likely you will get Omicron from a household contact than it was with the Delta variant and the Delta variant was twofold more infectious than the Alpha variant,” he said. “So this is incredibly infectious.”

Unlike previous variants of the virus, the Omicron variant is leading to more hospitalizations among the pediatric population.

“We’re seeing a tremendous increase in the pediatric population being hospitalized over the last two weeks, more so than any time previous,” Dunn said.

Dunn added that studies out of Hong Kong indicate that the Omicron variant affects the lungs in a different manner than the Delta variant and that this may explain why Omicron is leading to more hospitalizations among children.

“The Delta variant basically goes through our lung tubes and settles in the alvioli, the sacks where gases are exchanged from the lung tissue to the blood, and that’s where that’s where havoc happens,” Dunn explained. “That’s where we get that pneumonia and we get what’s called the ‘cytokine storm’ and we hear all this about people requiring lots of oxygen and being ventilated.”

“That’s the Delta variant. It gets really down into your lungs where the gas exchange occurs.”

Dunn said that Omicron is structurally different from the Delta variant and that the study suggests Omicron affects the upper lungs more.

“The study came out indicating [Omicron is] 70 times more efficacious in infecting the upper airway tubes, the bronchioles, the brush cell lining of the air tubes than the Delta variant,” Dunn said, “meaning Omicron stays up top.”

“It doesn’t get down into the alvioli sacks. It doesn’t get to where gas exchange occurs. It gets into bronchial tubes, causing inflammation, bronchitis, or in kids, especially under the age of four, RSV-type symptoms.”

Dunn said that the Omicron variant affecting the upper lungs leads to secretions in the upper airways.

“Kids have a hard time with RSV and different types of bronchitis because it’s hard for young kids to manage those secretions and cough out those secretions successfully,” Dunn said.

Omicron leading to RSV-type symptoms in children likely helps explain why more children are being hospitalized due to Omicron than due to previous variants of the virus that cause COVID-19, according to Dunn.

“They’re having a hard time managing their secretions, much like RSV, and we we don’t vaccinate for COVID-19 for the 0-4 years of age group,” Dunn added. “And so we’re seeing again a doubling effect in hospitalizations in that age group.”

While vaccinations are not available for very young children, vaccines and/or booster shots are available for other age groups.

Kinder said that the CNCHD is seeing people come in to get vaccines for the first time and coming in to get booster shots. She said that the health department tends to see big rushes from time to time in the number of people coming in for vaccines.

“It’s typically families that are coming in with their children, parents, etc.,” Kinder said, “but we are seeing an increase.”

In Natrona County, the Wyoming Department of Health reported that 43.74% of the population had been fully vaccinated against COVID-19 as of Monday, January 10. The vaccination rate by age group in Natrona County breaks down as follows:

  • Seniors 65 years of age and up: 75.4% fully vaccinated
  • Adults 18 years of age and up: 53.41% fully vaccinated
  • Adolescents 12-17 years old: 30.23% fully vaccinated
  • Children 5-11 years old: 7.17% fully vaccinated

Kinder said it is not surprising that the vaccination rate among children is relatively low since it hasn’t been available to kids for a long time. The Centers for Disease Control and Prevention officially started recommending Pfizer vaccines for kids 5-11 on November 2, 2021.

“I think anybody that’s out there that has children that haven’t been vaccinated [should] seriously
consider it, especially since they go to school,” Kinder said. “They’re around many more people than we even are around.”

Kinder added that the health department is seeing a “pretty significant number of people” come in to get booster shots, noting that the CDC has updated guidance on who is eligible to receive a booster shot.

Whereas people wanting to get a booster were previously eligible to do so six months after their initial vaccinations, the CDC has shortened the wait time to five months. Booster guidelines from the CDC include:

Dunn said that vaccines and boosters are working in offering protections against serious illness and hospitalization from COVID-19.

“You want to take a look at the hospitalization rate in people who’ve been vaccinated versus those that have not been vaccinated,” Dunn said. “That’s your your tell-tale test sign to see whether the vaccines are working. They are working. The booster is of the utmost importance.”

“It’s the coat of armor that you need to get through this. It’s no joke that you can go from one in five people that are unvaccinated hospitalized to one in 50 with the vaccine [getting] hospitalized.”

Kinder said that there is no shortage of COVID-19 vaccines available in Natrona County. The CNCHD also has some therapeutics and monoclonal antibody treatments to treat COVID-19 available, though Kinder said supplies are limited. Kinder said that the CNCHD has some supply of Plaxovid and molnupiravir, oral antivirals that have been approved by the U.S. Food and Drug Administration for treatment of COVID-19 in some patients.

Kinder said such treatments will be used for high-risk populations. She added that the CNCHD is working with Banner Wyoming Medical Center’s Mesa and Sage clinics to get information out to providers across the county about how to get patients access to therapeutics available through the health department.

Dunn encouraged people to talk to their health care providers or the CNCHD about the therapeutics that are available.

“You’d be surprised how many people meet criteria for many of these treatments,” Dunn said.

The CNCHD also has supplies of Evusheld, a pre-exposure prevention treatment available to immunocompromised patients, those with cancer and those who have had a stem cell solid organ transplant.

“It’s actually an injection that we have that we’re providing here at the health department for anyone that has a script from their provider to come and get,” Kinder said. “It’s every six months they’ll get it, but it’s just an additional help for those individuals that didn’t develop an immune response to the vaccines to begin with.”

While the CNCHD continues to offer COVID-19 testing and has seen a significant number of children come in for testing in the past week, Kinder said that the county, like the state and the country, is seeing a shortage in testing supplies.

She said that that rapid antigen tests are being reserved for at-risk patients. Other testing remains available to anyone with results available in 2-3 days.

“Unfortunately, we will have the testing that takes a couple days longer moving forward and I believe Mesa and Sage have moved to that protocol as well,” Kinder said. “Supplies are just extremely limited. We don’t know when they’re going to come. So we’re trying to really conserve as much as possible.”

Kinder said that the health department anticipates COVID testing lines will be long — as they were on Monday — and that staff appreciate everyone’s patience.

“We know that the lines are going to be incredibly long and we ask for people’s patience,” Kinder said. “Unfortunately, there’s not a lot that we can do. We don’t have additional staff to put to it.”

People don’t need to make an appointment for COVID-19 testing at the CNCHD’s 475 S. Spruce St. clinic. People can come for testing between 8:30 a.m. and 4:30 p.m. Monday-Friday.

Kinder said that the surge in Omicron cases makes it very difficult for the health department’s contact tracing efforts.

“Contact tracing has gone down to a minimum level due to the numbers,” Kinder said. “There’s no way we can keep up with them. So we’re just doing a really risk base and communal living situation for contact tracing.”

“If you’re positive [for COVID-19] you must isolate at home for 10 days, unless you’re willing to wear a mask at which time you can come back after five days and wear masks so that people can get back into work or different things like that.”

The CDC’s latest quarantine and isolation guidance is available online.

Dunn said that public health experts have been discussing what to expect in terms of the Omicron variant since around Thanksgiving. While the variant could bring record-breaking numbers of COVID-19 cases to Wyoming, he said he thinks the Banner Wyoming Medical Center is prepared, adding that staffing shortages were not leading to any extraordinary measures as of Monday.

“There’s a nice calming unity in the hospital that, ‘Okay. Here we go again,'” Dunn said. “We have a variant that’s coming on fast, coming on strong and hopefully it burns out. Hopefully, this is going to be the thing that helps us with our unity, helps us with our vaccine rate.”

Dunn said that he thinks that health care wrokers and planners will find a way through this latest surge of COVID-19: “We’ll just keep changing with the virus.”

Just as caregivers are being asked to stay strong and help fight the pandemic, Dunn asked for the community’s resolve as well: “Get your vaccine and yeah, please, please don’t give up. We’ve got to finish strong the next three, four weeks.”

The Wyoming Department of Health provides COVID-19 case, variant, death, testing, hospital and vaccine data online. The department also shares information about how the data can be interpreted. COVID-19 safety recommendations are available from the CDC.