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‘Fighting A Monster’: MSDH Reinstates Pandemic Measures As Delta Surges

Dr. Thomas Dobbs and Dr. Paul Byers
State Health Officer Thomas Dobbs and State Epidemiologist Paul Byers are encouraging Mississippians to do what they can to limit transmission of COVID-19 over the holiday season. Photo courtesy State of Mississippi

Mississippians should return to wearing masks indoors regardless of vaccination status, especially in school settings, the Mississippi State Department of Health is warning. The brief relaxation of pandemic restrictions following the widespread availability of the vaccine has come to a close, broken under the weight of the incredibly infectious delta variant of coronavirus. 

Gatherings, especially among the unvaccinated, are driving an enormous wave of new infections across Mississippi. “We’re seeing outbreaks everywhere,” State Epidemiologist Dr. Paul Byers warned at yesterday’s MSDH press event. “Anywhere where unvaccinated folks are getting together, we’re covered up with outbreaks.” 

Byers warned that outbreaks at band camp, cheerleading camp and in social settings of every kind are occurring with intense rapidity. With the school year looming ahead, public health leadership is deeply concerned that the new wave of the virus will spill over into academic settings, disrupting the term and driving further community transmission.

In fact, Mississippi’s test positivity rate has never spiked so fast in the history of the pandemic, rushing upward to 19% to match the previous summer surge and the winter peak in only a matter of weeks. As early as the beginning of July, MSDH data show test positivity—one of many signs of rapid growth of the virus and an early sign of a coming surge—had reached an all-time low of 3%.

Mississippi’s test positivity rate has never seen an increase this rapid, even in earlier surges. Source: MSDH

Reeves Bucks CDC, MSDH Recommendations For Schools

MSDH leadership will issue additional pandemic guidance in the coming days. Chief among that guidance will be the recommendation that all students, teachers, staff and visitors wear masks at all K-12 schools this year. As the school year begins, the expected outbreaks and the at-home isolation that they inevitably cause have already begun.

“We’re recommending the (Centers for Disease Control) position (on masks in schools),” State Health Officer Dr. Thomas Dobbs explained to the Mississippi Free Press. “We’re going to recommend and promote universal masking indoors because we know that’s an important added step that is not only going to keep our kids safe, but is going to keep them in the classroom. These outbreaks are very disruptive. Even in the first few days, some schools are telling us they are having outbreaks,” Dobbs said.

The growing concern over the 2021-2022 school year comes on the heels of a fourth pediatric COVID-19 death of a Mississippi teenager with what MSDH described as a very common pre-existing condition. Ten children are presently hospitalized with COVID-19, with three in intensive-care units, a number that does not include Mississippi children hospitalized out of state. 

Dobbs and Byers are acutely concerned about the possibility for transmission among Mississippi children, but the state health officer reassured the Mississippi Free Press that he did not anticipate pediatric intensive-care unit capacity to present a major threat in the coming days and weeks, even as the possibility of superspreader events among children grows.

Gov. Tate Reeves has taken a starkly different position on school settings to his state health leadership and the CDC. Even as the delta surge continues to rise, and with the vast majority of eligible children—as well as all children under 12—entirely unvaccinated, the governor has stuck to his conclusion that the era of pandemic executive orders is over.

On Tuesday, Bailey Martin, press secretary for the governor’s office, confirmed to the Mississippi Free Press that Reeves would not reinstate the mask mandate that helped limit the transmission of coronavirus in Mississippi schools last year, in spite of new CDC guidelines calling for just that.

MSDH leadership declined to second-guess the governor’s decision, merely reiterating their strong support for full masking in schools, regardless of top-down mandates from political leadership. But some public-school systems have suggested that an executive mandate will make or break the presence of mandatory masking in their schools.

Last year, Dobbs told the Jackson Free Press that transmission in events and parties surrounding schools was the source of the majority of school-related outbreaks. Now, with children preparing to gather in many districts, unvaccinated and facing a twice-as-infectious variant of coronavirus, state health leadership is worried the burden of those outbreaks will shift to the schools themselves.

Hospitalizations in Mississippi are trending upwards with alarming rapidity, mirroring the earlier surges before vaccines became widely available. Source: MSDH

Rampant Growth in Mississippi

Today, MSDH announced 1,908 new cases of COVID-19, yet another sharp incline, bringing this surge closer in line to the highest periods of transmission during the pandemic. Today’s report included 103 outbreaks in the state’s long-term care facilities, and Byers explained yesterday that this number continues to grow.

“We currently have over 100 long-term care outbreaks in Mississippi. Seventy-two of those are in nursing homes. The primary driver of those nursing-home outbreaks are infections in unvaccinated staff and employees, and regrettably, in some cases, these infections are spilling over into the residence and into fully vaccinated residents,” Byers said.

Those outbreaks are worse than in previous surges, with the terrible transmissibility of the delta variant’s spike protein aiding in the growth of mass-spread events. “One of the things we’re seeing with the delta variant as opposed to (earlier forms of coronavirus) is, in some of the other strains we’ve seen previously, the transmission (was often) limited to a handful of folks, the household around the person. We’re seeing broader transmission that’s occurring with the delta variant.”

The vaccine is still remarkably effective against the current outbreak, which state health leadership confirmed yet again is almost exclusively the delta variant. But a concerning trend has emerged. Although 96% of all new infections for the month of July come from unvaccinated sources—a number precisely in line with clinical trials of the vaccines’ efficiency—20% of all new deaths are now in fully vaccinated adults.

The reasons for this are simple, Dobbs explained. Elderly and immunocompromised individuals are more likely to be vaccinated, more likely to experience waning and limited immunity from weakened constitutions, and also more likely to suffer severe or fatal cases of COVID-19 in the first place. These spillover infections, including those in the state’s health-care facilities, are the consequence of a mostly unvaccinated population, Dobbs explained.

“By and large, these (vaccinated deaths) are people over 65 who have serious underlying medical issues or have serious immunocompromised states,” he added.

MSDH used what firm authority it does have to mandate that hospitals change their system of care to make room for the coming surge of the COVID-hospitalized. “By Monday, Aug. 1, hospitals must begin to delay certain elective procedures that require overnight hospitalization, and this should increase our critical resource availability within these hospitals,” explained Jim Craig, MSDH’s director of health protection. The delay will remain in effect until Aug. 15 at the earliest.

Breakthrough cases in vaccinated people are still found in a small portion of the population, meeting the 95% efficacy benchmark set in early vaccine trials. But the more vaccinated population of elderly and immunocompromised Mississippians is seeing a pronounced growth in breakthrough hospitalizations and deaths. Source: MSDH

Vaccinations Show First Uptick In Months

One small ray of hope shone through the dismal news at yesterday’s MSDH press event: Vaccinations are up for the first time in months. New shots are being administered at twice the rate of previous weeks, still down significantly from the busy days of the vaccine’s early availability, but up from a deep trough beginning in late May.

That said, Mississippi still trails the entire nation in virtually every metric of vaccination, struggling at just over one-third of the population fully vaccinated, compared to just under half for the nation. Even over-65 vaccinations, the most at-risk group, lingers at 70% compared to 80% in the rest of the country, representing a dangerous opening for COVID-19 to claim more vulnerable lives than elsewhere.

For the younger populations in the state, less at risk of death and hospitalization, questions remain about the severity and impact of the growing surge. “We don’t have clear information on the prevalence of long COVID,” Byers acknowledged yesterday, suggesting that the lingering symptoms that have plagued many for months well after the virus itself abates will be the consequence for a totally unknown segment of Mississippi’s population.

Vaccines showed a meaningful uptick last week, that increase keeping pace through today. But with roughly two-thirds of the state still unvaccinated, Mississippi has a long way to go. Source: MSDH

‘Fighting a Monster’

The exhaustion of a fourth wave of COVID-19, well over a year after the virus first came to the U.S., is readily apparent in the voices of the state’s health leadership. The forces of disinformation spreading anxious fantasies about both the virus and the vaccine are challenging their task of eliminating COVID-19 in the Magnolia State.

“We’re fighting a social-media monster that’s been fed with endless misinformation,” Dobbs said. Still, the state health officer added that the majority of Mississippi’s unvaccinated population were not committed vaccine reactionaries, but rather individuals who could still be reached and convinced that the shot is worth taking.

“Most of the folks out there who are unvaccinated are unsure,” Dobbs said. “We need to make sure the unsure folks know how to make the right decision. And that’s the main thing we can do: Try to speak the truth about what’s going on. Even if people don’t like it, that’s our job. We know what works, we know what masking works. It’s going to keep our kids in school.”

Somehow, with another brutal surge bearing down on the state’s health-care system, Mississippi’s nurses, doctors and other caregivers must summon the force of will to muddle through. “If you’re in a (hospital), be patient. You may be in the ER twice as long as you’re used to. You may be transferred many hours away. That’s just the inevitability of where we are,” Dobbs lamented. 

“It’s going to be a challenge like we’ve never seen. I know that sounds remarkable, but it’s true.”

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