Friday, May 20, there was a large and happy crowd out to experience the first White Street Art Walk after two years of the popular event being cancelled due to Covid. Few people were wearing masks and many were seeing and hugging friends they hadn’t seen since the pandemic began in 2020.
While the respite from Covid-19 has been welcome, there is an underlying concern about the increase in new Covid cases being seen across the country. Arkansas still ranks as having one of the lowest rates of new Covid cases per population, coming in 47th in the country. But two more Carroll County deaths from Covid were reported in the past two weeks ending May 23, bringing the total Covid-19 deaths to 104, according to the Arkansas Department of Health. ADH put the number of new cases in the past two weeks Carroll County at only 23 while active cases increased from 13 to 23.
There is concern that the number of new Covid cases could be undercounted because many people may have mild cases or no symptoms at all, and others are using home test kits whose results are not being recorded by health authorities.
Eureka Springs Hospital CEO Angie Shaw said the hospital went about 30-45 days without a case.
“Now it is trickling up,” Shaw said. “We are seeing some positives. I think last week we had four. Some days we don’t have any. It seems the positives we do have come in twos. I don’t know if they are relations, or what. We have been doing tests for people who are going to be traveling. Those are the ones who are negative. Those who come in with symptoms are more likely to be positive. I haven’t really seen an increase in demand for testing as of yet. We are probably still doing three or four tests a day.”
Dr. Dan Bell, co-founder of the ECHO Clinic, said we are clearly in a slow-motion surge with a gradual increase in cases.
“It is probably underestimated because a lot of people aren’t getting tested,” Bell said. “We are still at a fairly low level of Covid activity, but it is steadily increasing. They are doing this nationwide wastewater surveillance for Covid antigens. It shows there is already a surge, and that testing of people is understating the activity. Wastewater spiked with Covid antigens is the canary in a cage. It happens sooner than we see it in patient testing.”
Bell said people are still getting sick, and some are still ending up in hospital. He recommends that if you get Covid, if you have significant symptoms, get treated with Paxlovid, the Pfizer drug that can be effective in preventing hospitalizations and deaths.
“People need to take the whole course of it,” Bell said. “Paxlovid should be considered if you are over 50 or have a chronic illness that makes you more susceptible to Covid. Even if you are vaccinated and boosted, if you are seeing significant symptoms, your immune system probably needs some help.”
Studies have shown that only a small percentage of people are getting the second booster shots recommended for adults over 50 years old or with underlying health conditions whose previous vaccination was at least four months ago. Bell said there is vaccination fatigue.
“People are sort of tired of the whole process,” Bell said. “They say, ‘I’ve had my series. I’ve had one booster. Why should I get another one?’ There is fatigue not just with vaccinations, but with all the other precautions like masking and avoiding crowds. People have lost their drive.”
Currently the federal government is warning there could be a rationing of vaccines in the fall – at a time when immunity from prior infections and vaccinations will be waning in millions of people – unless Congress approves more funding for vaccines. The Biden administration has warned that perhaps 100 million Americans will catch Covid later in the year when people spend more time indoors, possibly leading to another surge in hospitalizations and deaths.
Bell said if you are due for a second booster, you should get it now because it is going to be months before fall when a new version of the vaccine targeting the omicron variants is expected to be available. He said there is a distinct chance there will be a vaccine shortage and rationing next fall.
Some people, even those with initial mild infections, are getting long Covid. Bell said that can cover a myriad number of different symptoms that leave people struggling to function. He suggests keeping up with vaccinations as the best bet to avoid long Covid.
Shaw agrees that long Covid is a real problem. “It definitely takes it out of them, and they continue to have odd symptoms,” Shaw said. “Just stay safe. If you are in large crowds, it might be a good idea to wear a mask. Just watch out for yourself. Cruise ships are requiring everyone to have Covid vaccinations before they can travel. It is probably a good idea for other types of travel, too, such as in airplanes.”
The hospital has been getting more calls from people requesting booster shots, and will hold a vaccine clinic Friday, May 27, from 10 a.m. – 1 p.m. at the clinic across from the main hospital entrance. Both Pfizer and Moderna shots are available.
“You can mix and match the shots,” Shaw said. “For example, if you had Moderna earlier, you can have the Pfizer booster. If you had Johnson & Johnson shot initially, you can get another J&J, but we don’t have J&J. If you have had Moderna or Pfizer shots earlier, you should not get a J&J.”
Katy Turnbaugh, a retired science educator, said one bright spot in the picture is that it looks like the omicron variants may cause less long Covid.
“And they are finding that those who have been vaccinated have less long Covid,” Turnbaugh said. “For people with long Covid, it is a life changing event for them.”
She finds another type of Covid surveillance fascinating. In New York City, there are online thermometer checks people are using. “On a normal day, the online thermometer folks see about 1.5 percent of the population will have a fever,” Turnbaugh said. “As of this past Friday, that was up to four percent. That combined with wastewater surveillance at numerous locations across the country shows many areas have a yet unregistered substantial increase of Covid.”
Arkansas does not have a current wastewater surveillance program, but ADH spokeswoman Katie White said they are working on securing funding to expand their capacity.
Turnbaugh said she wishes there were more ways to judge the risk.
“I look at community spread and base how much I need to mitigate my behavior by how transmissible the variants are, and community spread,” she said. “Now I don’t think we have clear information about community spread.”