Over the weekend, Monroe County’s number of active coronavirus cases, according to the local health department, seemed to have gone down. With Tuesday’s total case count topping 1,000, it is clear that was nothing but false hope.

Monroe County Health Department Administrator John Wagner reported Tuesday there are 1,034 active COVID cases in Monroe County. With St. Louis area hospitals so overwhelmed now, they have not been notifying local health departments of new hospitalizations as quickly as usual.

Wagner is left to estimate how many active cases the county has, and he said the health department “has no idea.” Last he heard last week, this figure was in the 20s.

The 948 active cases reported Monday was down only slightly from Friday’s total of 974, at which point Wagner cautioned this does not mean Monroe County has hit its Omicron surge peak.

“We will have to wait to see if the numbers continue to go down,” Wagner said then.

Other neighboring counties are experiencing high case counts. St. Clair County Board Chairman Mark Kern announced Friday that the St. Clair County Building will be closed to the public effective Jan. 10, citing high positivity rates.

The press release said the courthouse’s essential services will continue, but patrons should contact the proper office first. It also warned that while all offices will remain operational, some employees may be working remotely.

At last Monday’s meeting of the Monroe County Board, Wagner stressed the county is seeing more deaths of individuals under the age 65. He believes some of the recent deaths – especially of those below 60 years of age – may have been prevented had they gone to the hospital sooner.

One local man in his 40s died from the disease just before the new year, bringing Monroe County’s overall COVID-related death toll to 109.

Wagner said those who feel sick and cannot find a test or do not want to brave long testing lines should “just assume that they have COVID and isolate for five days, and then wear a mask for five days (after),” as the most recent CDC guidance states. 

Wagner said based on tests the health department is receiving in which the results are classified by variant, “Omicron is definitely starting to pop up more and more as the week goes on.” 

He estimates that very soon, Monroe County’s COVID case count will be primarily Omicron cases. 

As Dr. Clay Dunagan, chief clinical officer for BJC and an infectious disease specialist with Washington University, said during a recent press briefing by the St. Louis Metropolitan Pandemic Task Force that the “hallmark” of Omicron is it is very contagious although it does not seem to be more severe than other variants. 

Wagner said the Omicron variant is known for causing night sweats and a “scratchy” – not sore – throat. 

On Monday, the St. Louis Metropolitan Pandemic Task Force reported 1,340 hospitalizations due to COVID in St. Louis area hospitals. The task force reports that 70 percent of these individuals are unvaccinated. The daily ICU census for these hospitals was at 216, with 138 ventilators currently being used for COVID patients. Another 47 hospital patients in the St. Louis area are suspected of having COVID, per the task force.

Of the total hospitalizations, the task force reports that 29 are children ages 0-11 and 27 are ages 12-18. There are eight children under age 11 and two children ages 12-18 currently in ICU due to COVID.

The record number of patients on Monday is triple the number seen Dec. 5, when there were 433.

In addition to an increase in COVID-positive patients overwhelming already crowded hospitals, health care workers are facing another problem.

Dunagan spoke during last Wednesday’s St. Louis Metropolitan Pandemic Task Force press briefing. For a video of the entire report, click here.

“On top of (increased hospitalizations), the wave of infection is affecting our workforce pretty dramatically and we have multiple times the number of health care providers who were sick. So, in short … there really are no hospitals that were left untouched. There’s no place for us to go for respite,” Dunagan said.

“We expect the number of COVID patients we are taking care of to continue to climb, and this is really a frightening scenario,” Dr. Alex Garza, chief community health officer for SSM Health, said during a recent task force briefing. “Now, we have staffing challenges because of those high numbers of patients, as well as a number of our staff who are testing positive. Because of this, capacity could actually decrease, and that could mean we have less intensive care capacity when we really need it the most because our workforce is becoming depleted.”

Last week, the St. Louis Post-Dispatch stressed 87 percent of hospital beds that can be manned by staff were taken. For ICU beds, 83 percent were taken. 

Garza explained that while the vast majority of area health care workers are vaccinated, the vaccines protect them from getting seriously ill and they may still catch the disease and have to miss work. 

The BJC HealthCare hospital system has postponed elective procedures until further notice beginning Thursday, stating its workers are “stretched to their limits.”

This is not without consequence, however.

“While we talk in terms of elective procedures, even elective procedures have a time frame,” Dunagan previously told the Republic-Times. “So, doing a colon re-section for colon cancer, yes that can be postponed, but the longer you postpone it, the greater the risk that it may spread. It’s not like there’s no consequence to postponing these cases, so I think there’s a real risk that this will start to impair the care of other patients.” 

Another death

The most recent COVID death for Monroe County was a man in his 40s on Dec. 30.

Of the Monroe County deaths that have occurred since COVID vaccines became available, a very large majority were unvaccinated individuals, Wagner said. 

Dunagan said this fact extends across state lines. 

“Even in the present surge, most of the people being hospitalized, most of the people dying, are unvaccinated,” Dunagan said. “Those vaccinated individuals who wind up in the hospital are typically older or have some sort of disease that compromises their ability to combat COVID. So, vaccination remains the single most important thing you can do.”

The Monroe County Health Department is hosting a vaccine clinic this Thursday at Rock City in Valmeyer. This is a Pfizer clinic for ages 12 and up from 1-3 p.m.

On Saturday, Jan. 29, the Illinois Department of Public Health will be administering first, second and booster doses of the Pfizer, Moderna and Johnson & Johnson vaccines, as applicable, from 11 a.m. to 2 p.m. at Morrison-Talbott Library in Waterloo. The Pfizer vaccine for children ages 5-11 will also be available. For more information on the library’s clinic, click here.

The health department will host a pediatric vaccine clinic for those ages 5-11 needing the children’s Pfizer vaccine from 3-6 p.m. Jan. 18 at Rock City in Valmeyer. Students do not need to go to school in-county to get vaccinated at the clinic.

For all clinics, those getting a second or booster dose must present their vaccine card.  

Now, IDPH officially recommends children ages 12-15 receive a booster dose five months after receiving their second Pfizer vaccine. This expands the criteria of individuals who IDPH states should get boosted.

“We know that COVID-19 vaccine booster doses can help provide ongoing protection against the Omicron variant,” said IDPH Director Dr. Ngozi Ezike in a press release. “Following the CDC’s recommendation, booster doses are encouraged for those aged 12-15 years who received their second dose of Pfizer-BioNTech vaccine five months ago.”

As of Friday, 57.61 percent (19,782 residents) of Monroe County’s eligible population is vaccinated. There have been 8,666 booster doses administered to Monroe County residents.

The Centers for Disease Control and Prevention says the greatest risk is among unvaccinated people who are much more likely to get infected and therefore transmit the virus.

“Fully vaccinated people get COVID-19 (known as breakthrough infections) less often than unvaccinated people,” the CDC states on its website.

COVID vaccines approved or authorized in the United States are highly effective at preventing severe disease and death, the CDC says, including against variants.

“But they are not 100 percent effective, and some fully vaccinated people will become infected and experience illness,” the CDC website states. “For all people, the vaccine provides the best protection against serious illness and death.”

This week, the CDC released results of a study showing that COVID vaccines do not add to the risk of pregnant women delivering a baby prematurely or a child born smaller or less developed than expected. As many as two-thirds of pregnant women remain unvaccinated — many out of concern that the vaccine is not safe.

On Thursday, the IDPH announced new COVID-19 antivirals will become available in Illinois later this month. Unlike the vaccine, Paxlovid and Molnupiravir are not preventative measures – they will be prescribed to those who are COVID positive and are “at high risk for becoming severely ill, including hospitalization or death.”

School decisions

With large numbers of staff – ranging from educators to cafeteria workers – positive with COVID or otherwise isolating due to being exposed to the disease, schools across the state are starting the semester remotely. 

Late Wednesday afternoon, Waterloo School Superintendent Brian Charron announced that grades 9-12 would be learning remotely this Thursday and Friday due to a large amount of school employees being absent because of COVID-19 or other illnesses.

Charron explained staff from the high school will be filling the positions of the staff who are absent at the lower grade levels, allowing to keep younger grades in-person for now. He said the decision to have WHS students learn remotely instead of younger grades was influenced by high schoolers being better able to adapt to remote instruction.

An email sent to parents said the high school hopes to return to in-person instruction Monday, as the majority of employees infected with the disease over winter break should be off isolation by then. However, this is subject to change as new cases continue to increase daily in Monroe County.

Waterloo High School is to return to in-person instruction on Tuesday, Jan. 11, Charron announced the evening before. As his address to parents states, the district will continue focusing on “minimizing the disruption of the school day” for elementary grades. For junior high and high school classes whose teacher is absent, they will spend the class period in larger spaces. During this time, students can complete work assigned by their absent teacher or otherwise use it as a study hall.

Wagner said Columbia and Valmeyer have also been talking with the health department on how – if it becomes necessary – to best handle school closures and remote learning. They, too, have been seeing a larger number of employees absent than normal.

“Yes, we’re going to have students spread it and students numbers will go up and everything, but there’s a whole lot more students than there are staff. So, we can lose a lot of students to being home sick and still have school in session, but we cannot lose many staff,” Wagner explained. “That will probably be the scenario that makes the schools go remote – if they just lose so much staff that they can’t be able to make it safe for the kids and to be able to provide lunch and transportation for the kids.” 

Charron said the week started as an all-hands-on-deck effort, as Tuesday saw 36 district employees absent and Wednesday saw 43. Paraprofessionals were filling in for absent teachers, teachers who could attend school were subbing for others during planning periods and even administrators were leading classes. 

Other staffers were stepping up to help other departments as well, Charron said. 

Student absences in the district, due to either COVID or quarantine, neared 375 on Wednesday.

Columbia Assistant Superintendent Alyssa Smith said that on Tuesday, Columbia had 12 school personnel absent due to COVID. 

“As of right now, we feel like we can take care of it,” she said, adding that like Waterloo, Columbia is also relying on administration and fellow teachers to substitute in classes, external substitutes and other staff to fill in for non-classroom settings. 

While IDPH has adopted CDC guidance that limits the isolation guidance for individuals who test positive with COVID-19 from 10 days to five, this currently does not apply to Illinois schools. 

If school personnel or students have COVID, they still must isolate for 10 days from their test date or symptom onset, Charron said. 

This leads to staff absences being a longer-term problem, Charron said, yet he is hopeful things will change soon. 

“The state superintendent did send an email to all superintendents on Dec. 31 indicating that they would be working with IDPH to come out with updated guidance for schools,” Charron said. “We’re anxiously awaiting that new guidance and hoping that it will be helpful in getting employees back to work sooner.”

Church going remote

The St. Paul United Church of Christ – Waterloo Consistory met Wednesday night via Zoom for a special meeting regarding the surge in COVID cases and approved a motion to suspend in-person worship and church activities until the end of January.

Martha’s Kitchen/Mary’s Heart will continue serving meals through a drive-through distribution, and will still be hosting the blood drive Jan. 11.

Worship services will be available Sunday mornings on the church YouTube channel, St. Paul UCC Waterloo IL.

Contact tracing clarified

More details are gradually emerging regarding IDPH’s centralized contact tracing efforts. 

As of Dec. 28, all positive COVID cases entered in the state’s data system will receive an automatic text message with a link to isolation instructions and a phone number to call to “opt in” to an interview. 

Those ages 65 and older will receive a phone call if they do not respond to the text. 

Starting Jan. 13, positive cases will be sent to the surge center. The surge center will handle all contact tracing efforts except those that occur in congregate settings, schools and for outbreaks, IDPH Public Information Officer Melaney Arnold said via email. 

As previous coverage detailed, local health departments will continue to oversee these specified areas.

Arnold said that while local health departments will not be responsible for all contact tracing in their area, they will still be able to easily follow COVID metrics. 

“Local health departments will still have access to and see every case in their jurisdiction and can continue to monitor, track and report trends in their communities,” Arnold said.

Wagner said he has not yet received information regarding exactly how this process will work. For example, he is not sure if there will be a database administrators can access that has all the cases the surge center is aware of, or if the surge center will notify each health department of cases directly. 

Centralized contact tracing is an effort to lessen the burden on local health departments. 

“With more than 100,000 cases being identified weekly in Illinois, it is not feasible for local health departments to conduct contact tracing on every case and close contact,” Arnold said.