The Perfect Enemy | This COVID wave is worse than we know. But the peak may be here.
July 6, 2022

This COVID wave is worse than we know. But the peak may be here.

This COVID wave is worse than we know. But the peak may be here.  St. Louis Post-DispatchView Full Coverage on Google News

Read Time:5 Minute

ST. LOUIS — The St. Louis region is in the midst of another COVID-19 surge. And doctors and health officials say the numbers are likely far worse than records show.

But, due in large part to a build up of immunity, this wave is not making as many residents as sick as did previous waves.

The surge, in terms of infection rates, is as bad as any, said Dr. Charles Crecelius, medical director for two area nursing homes and an elder care specialist for BJC Medical Group.

“But thank goodness, milder,” he said. “If it were as severe as other ones, we’d be in another disaster, with hospitals very full.”

A full understanding of this surge is hampered by a new obstacle: Residents have come to rely heavily on at-home tests, which often are not tallied in official counts.

Experts laud their availability — a crucial, once-rare tool for residents to quickly and easily self-screen for the virus, and if positive, isolate and prevent further spread. But many don’t take the extra step of reporting positive results to health departments.

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“We don’t have a complete picture,” said St. Louis County Acting Health Director Dr. Faisal Khan. “We can only project, or estimate.”

The rate of known cases is elevated. St. Louis city had a seven-day average of 93 new daily cases, as of Tuesday, up from nine in March.

“We have to assume that the reported numbers are the tip of the iceberg,” Dr. Stephen Liang, an associate professor of medicine at Washington University and an infectious diseases and emergency medicine physician at Barnes-Jewish Hospital, said in an email.

Other measures of virus spread also reflect an increase, though not to the levels seen during the overwhelming winter surge. Wastewater testing shows elevated levels in some local sewersheds. Missouri nursing homes are reporting an uptick in cases among residents. And pharmacies are reporting more sales of cough and flu-related medications, Khan said.

Fortunately, doctors say they are seeing more mild cases of the disease, with patients more often able to recover at home. Though hospitalizations are high, they have not risen as far or as fast as they did during the winter surge.

The St. Louis Metropolitan Pandemic Task Force on Monday reported a seven-day average of 51 new COVID-19 patients admitted to hospitals in the area. That is up from 16 in early April, but well below the peak of 219 seen in mid-January.

Dr. Hilary Babcock, a Washington University infectious disease specialist at BJC HealthCare, said hospitalizations will likely continue to increase for at least a couple more weeks.

“All the data we have, which is likely an undercounting of real cases, definitely supports that we have very high numbers of cases in our community,” Babcock said. “So far, while our hospitals are tight, and our staffing is short, we have been able to manage.”

Dr. Mimi Vo, of Vo Medical Clinic in south St. Louis, said only one of her COVID-19 patients was hospitalized in the past six months. The vaccines have made a tremendous difference, she said, as well as the antiviral drug Paxlovid, which has been available in the U.S. since December.

Since winter, U.S. COVID-19 cases have mainly been caused by the omicron variant of the virus, and sublineages of it. In May, the omicron subvariant known as BA.2.12.1 became dominant in the U.S., and in recent weeks, the newer BA.4 and BA.5 strains have gained ground.

When new strains emerge, health experts typically look at three factors: How easily the new strain spreads between people, whether it makes patients more seriously ill, and whether it proves better at overcoming the defenses people’s immune systems have built up through vaccines and previous exposures.

Khan, the county health director, said that early data suggests that BA.4 and BA.5 are more contagious than previous variants.

But the city may have already reached the peak of this wave, said Suzanne Alexander, bureau chief for communicable disease at the St. Louis Department of Health. Cases in the Northeast, the first region in the U.S. to feel the effects of the latest surge, have begun to decline.

If that holds true here, hospitalizations may begin to decline in a couple of weeks, Babcock said.

Health experts say vaccines and boosters are still crucial to protect the community from any more dangerous variants that may arise in the future. Many adults are eligible for second booster doses, and children younger than 5 may soon become eligible for their first doses of the vaccines.

“There’s always that risk of some strain coming out and being pretty deadly again,” said Crecelius, the elder care specialist. “Which is the argument for vaccination.”

To report the result of an at-home test in St. Louis County, visit the health department website and select “Report At-Home Test.”

To report the result of an at-home test in St. Louis city, call the health department hotline at 314-657-1499, or send an email to health@stlouis-mo.gov.

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