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Time	Subject
00:28	Introduction
01:00	How has the latest surge affected 911 and EMS service?
05:31	Keeping schools open and safe
09:34	What does the county's COVID dashboard show about the current surge?
17:26	How the surge is impacting hospitals, schools and unvaccinated children
22:35	Changes to masking guidelines and how to keep your friends and family safe

Theresa Freed 00:00

Johnson County is seeing a sudden spike in COVID-19 cases. On this episode, hear from our medical and public health officials about the rise in cases the impact on hospitals and schools and learn how you can help slow the spread.

Announcer 00:14

Whether you live in or just love Johnson County Kansas, JoCo on the Go has everything Johnson County. Here's what's happening and what's coming up in the community you call home.

Theresa Freed 00:28

Thanks for joining us for JoCo on the Go. I'm your host, Theresa Freed a Johnson County resident and employee of Johnson County government. Community risk of COVID-19 transmission is high with a percent positivity right around 30%. This week, we have updates from Johnson County Public Health and Medical experts who are offering the latest on spread in the community and ways we can lessen the strain on our healthcare systems and schools facing some serious impacts. We begin with Johnson County EMS Medical Director, Dr. Ryan Jacobson.

Ryan Jacobsen 01:00

Your emergency departments and EMS system right now are incredibly busy. We have staffing shortages, we have increased volume of 911 calls for the ambulance, we also have testing is challenging. And so we really don't want people to go to the emergency department or use 911 Unless they're having an emergency, or a really urgent condition that prevents them from getting there some other means. So we don't want to discourage it. But we also want people to be judicious with it. We have extensive waiting times in all the area emergency departments, we have a staffing shortages with both EMS and in hospital. And so trying not to burden the healthcare system with asymptomatic or very mild illness is just another thing that the public can do to help us out, we are seeing a number of people in emergency departments who say they've been exposed to COVID. And they're coming to the ED because they don't have access to a test. And they want to know if they've got it. And so it's basically kind of a fear-based visit to the ED. They have no symptoms, they're otherwise healthy and they're coming to the emergency department to get a test because they're concerned. So I think we do need to address the fear factor. And I think it's reasonable to say that most people aren't going to die from COVID. Most people aren't going to be hospitalized. And so having an exposure to COVID heightens your awareness to look for symptoms, and to keep yourself safe. But at the same time, you don't need to go to the emergency department if you're asymptomatic, and just looking for testing out of concern. So I would seek testing elsewhere at the other sites throughout the county and in the region that offer testing. And again, the asymptomatic nature of it. We just really don't want to burden the emergency departments with folks who are looking for testing and are just concerned that they might have it. We really want to conserve our resources for the heart attacks, the strokes, the traumas, so we can keep those resources intact for the sick folks, we really encourage people to call 911 and to use the 911 system judiciously. We never want to discourage someone from calling 911. Asymptomatic folks who know they're positive and don't have symptoms don't need to seek care and emergency department or call 911.Mild symptoms can be treated at home frequently. So oftentimes ibuprofen, Tylenol, salt water gargles, throat lozenges, over the counter medicines just to help treat the symptoms are very reasonable for much of the population if they have COVID. The common symptoms of COVID are similar to other upper respiratory tract infections. One of the most common things is fever, headache, body aches, chills, sore throat, scratchy throat, cough, some people get nausea, vomiting or diarrhea. It depends. So there are some GI symptoms. And some folks, people frequently lose their taste and also their sense of smell. But depending on the variant, sometimes they have different symptoms, but most of them fever, body aches, cough, sore throat, those are pretty ubiquitous. And everybody kind of seems to have those symptoms if you have risk factors. And by risk factors, I mean, morbid obesity, high blood pressure, heart disease, lung disease, organ transplants, on chemotherapy, cancer patients, kidney disease, people on dialysis, those are the highest risk groups for severe illness and death and COVID. And those folks need to be a little bit more cautious when we're talking about seeking out medical care. But for large majority of the patients who are in not at extremes of age who don't have underlying risk factors, like we talked about, you can manage these symptoms very well at home by staying hydrated, doing your things like ibuprofen, Tylenol, over the counter remedies to just make yourself feel better while you get better. And so I think it's reasonable to give that a college effort if you will, to try to avoid overburdening the emergency departments with unnecessary visits for mild disease. If you have access to primary care, calling your primary care physician is one of the first steps. Second, there are many urgent care and other alternative care sites around the county and in the community that aren't the emergency department. So those are some quick things that you can do.If you have access to the internet, Googling WebMD, MEDLINE, all these kinds of resources that can help you navigate mild symptoms and signs and symptoms of when to call 911 or when to go to the emergency department. So I would seek out those resources before just running into the emergency department because you have a positive test for instance.

Theresa Freed 05:15

Next, in a recent Facebook Live event with Johnson County mayors, Johnson County Department of Health and Environment director, Dr. Sanmi Areola, Deputy Director Charlie Hunt, and Epidemiology Director Elizabeth Holzschuh, offered additional information about what we're seeing with COVID-19 spread,

Dr. Sanmi Areola 05:31

it does not take being an expert in public health to know that things are pretty bad. And if you listen to the chief medical officers, in the recent weeks, they have been very consistent and ask that you watch their language. The first few months of this pandemic, they were very careful about what to say. But you can see coming from them, we're in trouble, we're in a bad place. And that and that, and that's the picture. It's not about fear-mongering, it's about painting the appropriate picture for you. We have the past few weeks now, infections have been driven by omicron. We were dealing with delta mostly. And because hospital metrics tend to lag infections by three to four weeks. And the next few weeks, we're going to begin to see some of the consequences of the high number of new COVID infections that we have. And nationally, if you track pediatric data through the American Academy of Pediatrics, you will see increases in hospitalizations in children that's increasing profoundly across the country. If you look at local data from Children’s Mercy Hospital, they are saying the same thing they are trying out not just because of the workload, but because of staffing shortages, also, because of omicron. So that's why, again, we have consistently worked with decision makers. And that's why I'm very appreciative of this opportunity, I would point out that I'm particularly very happy to see a few of our cities take the lead, and the absence of a countywide mandate to take the lead every little bit of those steps. I am very happy that Board of County Commissioners continued with the public health order that will allow us to keep our school safe. Because I've said publicly several times, I just don't see how you can keep our schools open with our mask. And we are seeing the consequences now. So our job is to see can we take enough consequential steps now, to ensure that this doesn't spread, you know, when people point to things are flooding in New York, need to be very careful, New York did take mitigation steps to reduce the spread. And they're still doing that. And flattening at a very high peak is not where we want to be. So just want to make sure that we understand that we have updated our mask guidance, we recommended my masking KN95. We're working with our emergency management, to address equity issues to ensure that masks are more readily available in the county and I know that there's a similar action at the federal level to do that. We are making testing more available. And and that's that's an example of when people talk about do we have enough, just, if you go to our website, if you hover on those graphs on the testing numbers, you will see the number of tests from PCR tests alone for the past seven days at that time was over 36,000. So when you add antigen tests, or your, your rapid tests, we have a lot of testing in the community. But when you have this level of infection, just like hospital capacity has been overwhelmed. Our testing capacity has been overwhelmed. And several that capacity size has been overwhelmed. Our job at all times is to create conditions where our resident, every single one of them have optimal opportunity to be at the best health that they can be. And that job is even more important now given what we're facing. But I'll let Elizabeth share the screen. I'll take you through some of those numbers.

Elizbeth Holzschuh 09:34

Good morning. And thank you for the opportunity to come and speak to you today. So I'm hopeful that all of you are familiar with our dashboard. But if you're not, you can go to jocogov.org and click the COVID-19 button and then there's a button for our COVID-19 cases in vaccine dashboard. And there's a wealth of information. And on this front page. What we really focused on are the key community metrics as laid out by KDHE or CDC as well as ones that we been tracking throughout this pandemic, as Dr. Areola said, you know, when we were looking in October, and certainly, you can see how low our numbers were. And in this top graph, we're looking at our incidence rate. And we do this per 100,000 population. And really the reason we do that is to be able to compare our numbers with other jurisdictions that may be of different sizes. So obviously, we're looking at how Wyandotte County is doing compared to us, we can't just compare raw numbers because their population is significantly smaller than ours. And you can see that, even though we have continually had to expand how high our axis goes, for the number of cases that we're getting in, it just keeps getting higher and higher. As Dr. Arriola said, you know, at the middle of October, when we had started coming down off of our, our COVID delta wave, early fall, we were sitting out of about 158 per 100,000. And now we're at 1939 per 100,000. population in Johnson County, and it just continues to increase. Very similarly, if you look at our percent positivity, and these are going to be the number of individuals who have tested positive by PCR. Over the last seven days, everybody has been tested in our community, Johnson County residents. And again, numbers that, quite frankly, we just never anticipated seeing. I remember when we were up around 15% Last winter, and that was really stark for us. And you’ll see us now up all the way up nearly 31% It's really a dramatic increase. Wyandotte County is reporting nearly 65% positivity. And really what that means is there's a lot of individuals getting tested and a lot of them testing positive. And usually when we look at really high percent positives, we tend to think that there's not enough testing capacity. But as Dr. Areola said, we had nearly 35 or 40,000 of Johnson County residents get tested last week alone. So certainly there's a lot of testing available. And a big piece of that is our school districts who are continuing to test their students and their staff and their families. And that's been a really big help. And I know that I believe Charlie Hunt will be talking about some of the additional testing capacity. The other piece of data that we look at weekly are vaccinations. And so you can see that vaccination progress up here, where we have 64.6% of eligible population fully vaccinated. And again, those of our children in our community under the age of five are not yet eligible. I’m not going through a lot of the additional data, but I do encourage you to explore it. The Vaccination Progress tab has a number of different data points, including vaccination coverage by zip code, as well as different age groups, and we can look at how we're doing in particularly in that five to 11 age category. The most recent to be eligible for vaccines. Additionally, our case summary tab has some overall numbers. And you can see here that the average number of cases per day is nearly 1700 cases that Johnson County is receiving 1700 individuals who are testing positive each day, getting reported to Johnson County, that is just a really high number. I will say that in July, when we had sort of taken a breath, we're at about 20 per day. And so quite frankly, the number of cases we're getting in is just exceeding all capacity at all levels, from local levels to KDHE. It also talks about deaths on this page and Dr. Arriola mentioned our morgue capacity. I will say that since the beginning of the year, we've lost nearly 30 Johnson County residents to COVID-19, the majority of, the vast majority, of those being unvaccinated individuals. When we see vaccinated individuals unfortunately passing away from this disease, most often they are either not boosted, which we know provides an extra layer of protection against omicron, and they generally also have a number of pre existing conditions. And so unfortunately, even though we have really good vaccination or vaccines to prevent severe illness, we still are losing some of our most vulnerable population due to this disease because there's just so much spread in our community. This page also has information about breakthrough cases as well as our variants from whole genome sequencing. And that's how we know that we are seeing omicron here, which is also supported by just the sheer volume of cases and the exponential growth we're seeing are case counts. The other dashboard that I'd like to bring your attention to one that maybe is not as well known is the MARC COVID hub. So I generally get to it by just Googling MARC COVID hospitalization data, or MARC COVID data and coming here. And why this website is incredibly valuable is from the hospitalization perspective. If you've been paying attention from the beginning of this pandemic, we've constantly been discussing, that our data infrastructure between us and our hospitals is not what it should be. From a public health standpoint. We still rely heavily on faxes and emails, and we don't have automated data that comes directly from our hospitals to us to report patients who are hospitalized from Johnson County. So MARC has gotten access to a national dataset where all of the hospitals must report or should be reporting daily. You can see here in this top right hand corner that we don't have all of our hospitals reporting for this day about 23 out of 27. So these data are incomplete at this moment. But you can still see this dramatic increase in new hospitalizations in recent days, far exceeding what we saw even in our Winter surge last year, as well as in the surge earlier this Fall. You can look at both the MARC region as well as each individual jurisdiction, we can look specifically at Johnson County, I generally take a regional view and we think about hospitalizations because our patients don't just necessarily go to Johnson County hospitals, and very similarly, people from other counties or jurisdictions end up in our hospitals. So I think it's important to take a view on both of those. So you can see in Johnson County, again, our numbers have really skyrocketed in our hospital systems. You can also look at all hospital beds. And this is another really useful graph, this one on the bottom where that green bar is really the availability of hospital beds. And you can see how many are taken up by other patients in the blue shaded area. And then in the red shade is the COVID hospitalizations. And again, you can look at Johnson County. And then finally looking at adult ICU hospital beds, you can see that for Johnson County, we are at a very high level. And this is not again, all of our hospitals reporting, we have one hospital that does not report and we're sitting at about 11% availability in ICU beds. Generally when you get below 10 that's really a crisis. And hospitals tend to be in crisis mode when you have less than 10% of your ICU beds available. And very similarly, our numbers have gone up and down in the metro area. And again, not all hospitals reporting, but we're still hovering right around that 10%. So these are things that we're really keeping an eye on, because this is really what the consequence is going to be. When hospitals are overwhelmed. It's not just about taking care of COVID patients. It's about taking care of those patients who get in car accidents or have a heart attack or have a stroke. It's about being able to get people into beds that need it as well as to have enough staff to take care of them. And we know that staffing as you've heard, both from hospital leaders as well as Dr. Areola this morning is really in a dire state in our hospital systems. So unfortunately, as Dr. Arriola said, we expect these numbers to continue to increase as those numbers for hospitalizations do tend to lag what we see in our case counts. And our case counts just continue to go up. And so with that, I'll hand it over to Mr. Hunt.

Charlie Hunt 17:26

Thank you. I guess the other thing, and I actually will make one very brief comment about that the hospitalization admissions that Elizabeth was just talking about. Of course, that availability is one issue to worry about, but also staffing at the hospitals being at critical levels, and it makes it difficult, if there aren't the staff to the care providers to work with those patients, then the available beds may not be able to be utilized. I do want to focus a little bit on schools here. And first just acknowledge our partners in the in the schools throughout the community. schools and children have been a very strong focus of ours, particularly during this school year. And the the work that they have done in the school districts has been it's been incredible. This is very challenging work for them. Everyone from the you know, the administration to the district health coordinators and the school nurses and all the other staff that that that work with us day in and day out on identifying children and staff who are infected, identifying who those close contacts are making sure that people are properly excluded and given the right information, follow up testing and so forth. So I'll talk about that just as Elizabeth and Dr. Areola, who have both alluded to the the change in COVID-19. Over the months, we're now seeing a higher percentage of cases among among children than we did earlier in the pandemic. And this is having a substantial impact on the schools. And that combined with with this most recent way with omicron has really made things difficult. When we started the school year, of course, we have the existing county masks requirement in place for K through six. And most of the school districts in May the private schools also required masks for the upper grade levels. As things had improved a little bit over the over the Fall weeks and months. The district started to remove those requirements at the secondary level. However they they put in triggers or thresholds so that when absenteeism got to a certain level, that would trigger the mask requirement going back into place for the for the secondary schools. And as we've seen over the last couple of weeks now, as indeed what has happened, where we're seeing nearly across the board, those districts that had triggers in place actually going back to masks, so things are very challenging for them. I will say this in recognizing how things are difficult for the schools and how challenging it is to do that contact tracing our emphasis in working with the schools is to ensure that those who are infected or suspected of being infected or excluding many districts had put into place test to stay strategy so that children, students and staff members who had been exposed to a case could remain at work and in school, so long as they test every day or every other day. And unfortunately, with the with the caseload and the volume, it's been difficult for most of them to keep that program going in. So they're not able to test those close contacts, I can tell you that having personal experience with this with a with a family member who, whose child was exposed and was not able to participate in the test to say program because they simply don't have the capacity right now. And so we recognize that is a challenge for them. And, again, we're doing all we can to support them, and to streamline our, our processes here to make sure that we're exchanging information and supporting them the best that we can. With respect to testing, testing capacity has been an issue was, as we talked earlier, 35,000 County residents were tested last week. But we recognized that we that we need to work to increase testing capacity to existing mass testing sites in the community. At Johnson County, Community College and a church of the resurrection are expanding their hours. And I believe they're also moving to an appointment system. For those two sites. We have been working with Kansas Department of Health and Environment, and our Johns County Parks and Recreation District to expand and add a mass testing site. And that's going to be at Shawnee Mission Park. And so that'll provide additional testing capacity. And that will also be by appointment. We also are working on identifying some indoor spaces to do some testing, which will further increase our capacity in the community, and potentially offer the capability to do antigen testing, which has been, again challenging for people to find appointments for there are at least 30 sites in the community that are offering testing right now. And so, there are options for people but but sometimes there can be a little bit of a delay, and so we're doing the best we can to expand that testing.

Theresa Freed 22:28

Finally, here's Johnson County local health officer, Dr. Joseph LeMaster, with details on how you can help slow the spread.

Dr. Joseph LeMaster 22:35

Hi, I'm Dr. Joe LeMaster, local health officer for Johnson County. We again today wanted to come back to you just to re emphasize some of the basic things that we've been saying all along that are even more important now, given the fact that we have the omicron variant. As we've said before, the most important thing that you can do to protect yourself and your family and your colleagues, your loved ones from omicron is get vaccinated get boosted. That is the thing that's making the difference in the things we're seeing in the hospital. Those people who are fully vaccinated and boosted even if they do get omicron. Even if they do get sick enough to be in the hospital, they tend to be much less sick than those people who are unvaccinated and the by far, the majority of people who are hospitalized are unvaccinated. We want to talk a little bit about wearing masks, we still strongly recommend the use of masks in all public places. I wanted to show you today we are going to be re emphasizing the use of masks. But we would like to propose now that people double mask if they only have simple surgical masks or cloth masks, I'm going to show you how to do this. This is a simple surgical mask. So you just this is the way we've said to wear them before and then I've got a cloth mask. And I'm just putting that up over the top and fitting it on. So I've got a double layer. These are double layer masks in the the surgical mask is double or triple layer and these are double layer cloth masks. So that will give you even more protection from shedding the virus or spreading the virus if you happen to be infected and you don't know it. Now, with respect to the masks, the most important thing is that you have a good seal around your face. So you want to have it up over your nose coming around your the sides of your face and under under your chin with not big gaps all around. If you've got a big gap at the side, your breath can go out that way and other things can come in. Remember that asymptomatic infection is even more prominent out in the community now. And the reason partly is that is because omicron Sometimes only produces very mild, cold like symptoms, if any at all. And all Also, there is such a hard time right now for people to be able to get the over the counter tests. Many people aren't coming forward for testing. Remember that we still do have testing clinics at Johnson County. Most of your primary care physicians and doctors offices, and pharmacies still will provide you with COVID testing. If you need to get that done. If you're sick, please stay home. Don't go out and about when you're sick. We strongly would recommend not to gather for luncheon meetings or any kind of meetings with a group of people where you're going to be unmasked even briefly, we think that omicron is about twice as easily transmitted as Delta was so something in the neighborhood of 10 times more transmissible than what we saw with the original virus and we're seeing that with the numbers the way that they've gone up. Another thing we want to sort of make sure you are aware of and and re emphasizes the importance of handwashing. Remember, wash your hands frequently. Don't touch your face, especially if you're going to eat we still want to continue to emphasize the importance of hand washing, monitoring your health, watch for symptoms like fever, runny nose, cough, shortness of breath, body aches, flu like symptoms with respect to going to your clinic visits, if you have a wellness visit, and your doctors are seeing you for that. If they're still scheduling wellness visits, please do those visits. Make sure that you stay in touch with your primary care physician and then you get appropriate care for those things that need ongoing care, like your blood pressure and your diabetes. Make sure you do all those things that you need to do to keep yourself healthy, good diet, exercise and a good night's sleep. This is a marathon that we're on and it's important for us to be able to continue going forward in a healthy way. Most of your primary care office offices will have COVID testing and maybe even vaccination or boosting available in the office.

Theresa Freed 27:07

For the very latest on COVID-19 in Johnson County. Visit us at jocogov.org/coronavirus. Thanks for listening.

Announcer 27:14

You just heard JoCo on the Go. Join us next time for more everything Johnson County. Have a topic you want to discuss? We want to hear from you. Follow us on Facebook and Twitter at JoCoGov. For more on this podcast visit jocogov.org/podcast. Thanks for listening.