OU Health's Dr. Cameron Mantor (left), surgeon and acting chief medical officer, and Dr. Dale Bratzler (right), the University of Oklahoma’s chief COVID officer, address the media in a virtual press conference on Friday.
Record numbers of new COVID-19 cases and hospitalizations have public health officials urging Oklahomans to wake up to the reality of overburdened hospital ICUs and the potential for deaths to exceed all previous predictions before Thanksgiving.
“This week has been a real peak in the pandemic,” said Dr. Dale Bratzler, the University of Oklahoma’s chief COVID officer, at a virtual press conference on Friday. “It’s not because we’re doing more testing. The percentage of tests that are coming back positive is very high right now.”
COVID-19 hospitalizations have already pushed Oklahoma City to Tier 3 of the state’s hospital surge plan, which indicates limited hospital capacity for both COVID and non-COVID patients. And OU Health says Tulsa might not be far behind given the significant uptick in community spread.
Dr. Cameron Mantor, a surgeon and acting chief medical officer there, said there is “no question” that patients from rural counties are driving up hospitalizations in both Oklahoma City and Tulsa.
“It impacts our ability to care for patients who have the virus but also our ability to care for our other Oklahoma patients who have non-diagnosed cancers, who are in bad accidents who need trauma care, who have heart disease and need to be taken care of,” he said. “So it impacts us greatly.”
Testing for COVID-19 was down significantly last week, with about 12,000 fewer tests conducted than in each of the previous several weeks.
But Bratzler noted that Oklahoma is seeing its highest rates of positive test results since the start of the coronavirus pandemic, at 12.6% — and some rural counties have positivity rates approaching 20%.
“They tend to be older, and they tend to have more comorbid conditions like diabetes or other things, so it’s a high-risk population,” he said. “As we see higher population incidence of COVID-19 in rural communities … most certainly, those patients are being transferred into the metroplex here (in Oklahoma City) and also in Tulsa for more extensive care that can’t be delivered in some of the more rural facilities.”
Bratzler said he and other public officials are concerned about the potential for Oklahoma to reach new “peaks” of COVID cases that could occur from the upcoming fall and winter holidays. He urged people to avoid large, indoor gatherings, and if possible, to take advantage of good weather days for meeting with family and friends in small numbers outdoors — and wearing masks at all times while not eating or drinking.
He referenced a prediction from earlier in the pandemic by the Institute for Health Metrics and Evaluation, an independent global health research center at the University of Washington, that Oklahoma would see 1,450 total COVID deaths by Thanksgiving.
Because of the recent surge in the virus, he said, “We are going to have that many deaths by next week. In fact, they’re now projecting 1,795 deaths in Oklahoma by Thanksgiving.”
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"They tend to have more... conditions like diabetes or other things," Dr. Bratzler said on Nov. 6
COVID-19 basics everyone needs to know as the pandemic continues
COVID-19 basics everyone needs to know as the pandemic continues
How it spreads, who's at risk
Studies have shown many infected people show no symptoms or have symptoms so mild they may go undetected; those people can still transmit COVID-19 to About 20% of patients diagnosed with COVID-19 require hospitalization.
The disease can be fatal, especially for vulnerable populations: those older than 65, living in a nursing home or long-term care facility, and anyone with underlying health conditions such as diabetes, heart disease, lung disease or obesity.
Science of virus spread
COVID-19 is spread mainly from person to person via respiratory droplets produced by an infected person. Spread is most likely when people are in close contact, within about 6 feet. A person might also be infected with COVID-19 after touching a surface or object that has the virus on it and then touching their face. According to the CDC, evidence suggests the novel coronavirus may remain viable for hours to days on surfaces, though that form of transmission is said to be minor.
Transmission between people more than 6 feet from one another may occur in poorly ventilated and enclosed spaces, the CDC says, especially where activities cause heavier breathing, such as singing or exercising.
The infectious period for patients can begin up to 48 hours before symptom onset.
List of symptoms
The CDC recently expanded its list of possible symptoms of COVID-19. The symptoms can appear from two days to two weeks after exposure.
- Fever or chills
- Cough
- Shortness of breath or difficulty breathing
- Fatigue
- Muscle or body aches
- Headache
- New loss of taste or smell
- Sore throat
- Congestion or runny nose
- Nausea or vomiting
- Diarrhea
This list does not include all possible symptoms and will continue to be updated by the CDC. One symptom not included is "purple toes," which someone may experience with no other symptoms, sometimes several weeks after the acute phase of an infection is over. The coloration and pain is caused by a lack of blood flow to the toes caused by excessive blood clotting, a late-stage concern with COVID-19 infections.
Kinds of testing
Those getting tested may experience different kinds of swabs. The viral test, known as PCR, involves a deep nasal swab that can be painful.
Other tests that require less-invasive swabs may produce results faster, but with less accuracy. These should not be used diagnostically.
It is not yet known whether COVID-19 antibodies can protect someone being infected again or how long protection might last.
The 'serious seven'
The "serious seven" refer to close contact environments where residents should take extra precautions if they choose to attend. The seven are gyms, weddings, house gatherings, bars, funerals, faith-based activities and other small events, according to Tulsa Health Department Director Bruce Dart.
Treatments being investigated
The FDA has allowed for antiviral drug remdesivir, previously tested on humans with Ebola, to treat more severe cases of COVID-19 in adults and children. Safety and effectiveness aside, preliminary studies have shown it can shorten recovery time for some patients.
After previously approving an emergency use authorization, the FDA as of July 1 cautions against use of hydroxychloroquine or chloroquine for COVID-19 outside of the hospital setting or a clinical trial. A review of safety issues includes reports of serious heart rhythm problems and other safety issues, including blood and lymph system disorders, kidney injuries, and liver problems and failure.
Convalescent serum therapy
Some patients are receiving convalescent serum, meaning the antibodies made by people who have recovered after a COVID-19 infection. Antibody-rich blood plasma is being given to severely or critically ill COVID-19 patients, including Ascension St. John, Saint Francis Health System, OSU Center for Health Sciences and Hillcrest HealthCare System in Tulsa.
From June to July, requests for convalescent plasma from the Oklahoma Blood Institute multiplied seven-fold.
Recovery, as defined by CDC
To be considered recovered (without a test), these three things must happen, the CDC advises:
- No fever for at least 72 hours (three full days of normal temperature without the use of medicine)
- Other symptoms improved (no more cough, etc.)
- At least 10 days since symptoms first appeared
Andrea Eger
Staff Writer
I'm a projects reporter, examining key education topics and other local issues. Since joining the Tulsa World in 1999, I have been a three-time winner of Oklahoma’s top award for investigative reporting by an individual. Phone: 918-581-8470
