Positive coronavirus cases are surging across the state, and local health care officials are urging the public to not take it lightly.
Three area hospitals are still seeing manageable numbers of COVID-19 patients, but most have seen an increase since May, when several hospitals were seeing the lowest numbers since the start of the pandemic in March.
Even mild cases are dangerous
Positive COVID-19 cases are on the rise in Indiana, with daily counts increasing by more than 1,000 a few times in the last week.
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Despite the upward trend, there are fewer deaths and severely ill patients than when the pandemic started in March, which is likely due to an increased number of cases in younger people aged 20 to 29, said Dr. Christopher Doehring, vice president of medical affairs at Franciscan Health on the southside of Indianapolis.
"The virus is still around. It’s still very much around," Doehring said. "What is true is the spread seems to be more among younger people … We’ve gone from a low of four patients in the hospital, back to the upper 20s last week, and now we’re back down to the teens. It’s still significantly increased as far as sick patients in the hospital."
Young people, on average, display mild or no symptoms of COVID-19, Doehring said. But asymptomatic people who receive positive COVID-19 tests are still highly contagious even though they don’t feel sick at all, and they can infect others who may get very sick, he said.
In the last week alone, Franciscan is reporting 10 patients have died from COVID-19. The hospital had previously gone more than six weeks with four deaths, Doehring said.
"So, to suggest that somehow people are less sick only to the extent that more of the illness is in young people is not true … we’re still seeing vulnerable people get the virus and die from it," he said.
The Indiana State Department of Health is not recording how many of the state’s total positive cases are asymptomatic people, spokesperson Megan Wade-Taxter said. But based on a controlled study conducted by the IU Richard M. Fairbanks School of Public Health, 44% of people who tested positive for COVID-19 reported no symptoms during the two weeks before testing.
Franciscan Health has tested more than 13,000 people since March, and of those who tested positive, the health care network found that 1 in every 200 patients show no symptoms, Doehring said.
Dr. Robin Ledyard, chief medical officer and Indianapolis region physician executive at Community Health Network, reiterated that there is still a risk even with more people getting milder cases of the disease, because they can still spread the virus quickly. She also added people with no symptoms could get sick later.
"We do not know who will get sick. I’ve seen a few people who aren’t sick — people who had very mild cases — who have had very serious after effects. It can affect the heart; it can affect blood flow. Even though you have an asymptomatic case, you might get sick later," Ledyard said.
Johnson County is not seeing a significant surge in positive COVID-19 cases, but local cases are on an upward trend. The county’s daily reported positives were to single digits in May and June. Now, those numbers are up to 10 to 20 new cases reported per day.
Johnson Memorial Hospital had two positive patients in its COVID-19 unit Thursday, said Dr. David Dunkle, president and CEO of the county’s health network.
Dunkle agrees, the county and state’s increase in cases should be taken seriously, even if many of the newly reported cases are milder, he said.
"Yes, 80% of people infected by the coronavirus have mild to no symptoms, and yes, the majority of people with coronavirus do recover from it," Dunkle said. "That doesn’t justify the fact that we have lost over 100,000 lives in this country … We’re going to lose more if people don’t do what they’re supposed to do."
Still too many unknowns
No one knows how they will be affected by COVID-19, which is why people should remain cautious as the number of cases continues to rise, Doerhing said.
He’s seen all ages — from people in their 20s to people in their 50s — get very sick, including some patients who do not fall into high-risk categories.
“No matter how old you are, no matter how healthy you are, if you get this virus, it’s basically a game of Russian roulette as to whether or not it will affect you severely,” Doehring said.
Ledyard understands that people who have not been personally affected by the virus may not want it to change their whole lives, she said. Everyone has to learn to live a new normal while the unknowns about the novel coronavirus remain, she said.
"There is no doubt that we have a new source of death," Ledyard said. "We know so little about this disease, truly, it’s only been five months. We know so little about who’s going to get sick. We have no treatment. We have no vaccine … Even if you’ve felt that the virus is conspiracy, that doesn’t even matter because it’s here and we have to protect ourselves."
COVID-19 is not the flu
One argument that has circulated, garnering mainstream attention, is that COVID-19 is just as bad as the flu.
Unless people are referring to the 1918 Spanish influenza pandemic that killed about 625,000 people in the U.S., that is not the case, Dunkle said.
"(The) coronavirus has killed more people in the United States this year than the flu," he said.
More than 167,000 people in the U.S. have died from COVID-19. Last year, about 34,000 people in the U.S. died from the flu, according to the Centers for Disease Control and Prevention.
The main difference between the COVID-19 and the flu is the spread of the flu is more preventable because it has been studied for years, Doehring said. There also are effective treatments and vaccines available to treat and prevent the flu, which is not the case with COVID-19.
"The way the human body seems to react to this novel coronavirus is way more lethal. Once we have this full experience with the coronavirus, it could be 10 to 50 times more lethal than the flu," Doehring said.
As traditional flu season approaches this fall, Ledyard said people should be aware of the differences in symptoms.
"COVID-19 tends to come on at a very slow onset; you may be sick on Friday, but then you won’t feel sick again until Wednesday. The flu hits you like a ton of bricks. You are sick within hours with the flu," she said.
Also, the flu is known to be isolated to the respiratory system, also different that COVID-19, which has similar affects on the respiratory system, but is also know to impact several organs and cause blood clotting, Ledyard said.
Yes, masks work
Duke University released a study this month in which researchers tested 14 different types of masks. Each face covering was tested 10 times. Those wearing the masks were asked to repeat a certain phrase into a box. Inside the box, the particles passed through a sheet of light created by a laser hitting the lens, and produced flashes which were recorded by a phone camera.
The study concluded that an N95 mask, which is worn by most health care workers, released almost no particles when tested. Regular, three-layer cloth masks and standard medical masks were also dubbed highly effective.
The study found that masks with respirators, neck gaiters and bandannas are not effective at all in preventing the spread of particles.
Gov. Eric Holcomb issued a statewide mask order at the beginning of the month.
Ledyard said wearing a mask, as well as practicing social distancing and good hygiene are simple and effective methods of defense against the virus.
"We know that the virus lives in our saliva, in our nose droppings. Wearing a mask — anything that keeps that saliva from spreading when you’re talking — is going to prevent that from happening," she said. "I know for some people it seems as if we’re infringing on their rights, but this really is a public health issue. To me, it’s about how we take care of each other."
It is frustrating for health care officials to see members of the public disobeying safety guidelines, Dunkle said.
"For a lot of people in the medical profession, we’ve seen the lost lives, we’ve seen really sick people. It’s difficult for us to see how people think the coronavirus isn’t bad, and they don’t want to wear a mask," Dunkle said.
Wanting to return to normal
Health care workers are getting bogged down, too, they said.
"Even in health care, people so badly want to go back to pre-COVID-19, but I’m so hesitant to do that," Ledyard said. "I do worry about post-traumatic stress. I think that it’s stressful … (But) we are not going to be able to go back to the way it was before for quite a while."
Others may be able to take a break from hearing about the pandemic or seeing people sick with COVID-19, but health care works don’t get that, Dunkle said.
"Overall, our morale is decent. But like a lot of the country, people are worn out from it," he said. "They don’t get a break from it. We still have very sick people suffering from COVID-19."
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Here is a look at the highest and lowest reported daily positive COVID-19 cases in Indiana from May to August, as well as the moving average of tests at the end of those months:
May
Highest: 831 cases
Lowest: 281 cases
Avg. tests: 5,142
June
Highest: 549 cases
Lowest: 233 cases
Avg. tests: 7,776
July
Highest: 997 cases
Lowest: 300 cases
Avg. tests: 9,257
August
Highest: 1,249 cases
Lowest: 574 cases
Avg. tests (to date): 9,170
Source: Indiana State Department of Health
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