Oklahoma has amassed more COVID-19 cases and hospitalizations in October than in any other month and is poised to surpass the monthly deaths record before the weekend.
Dr. Jennifer Clark offered her data presentation Wednesday morning during the weekly COVID-19 session of Project ECHO, an Oklahoma State University Center for Health Sciences program that helps serve rural and underserved areas.
She pointed to multiple charts that depict ways to view the state’s positive cases, which she said last peaked in mid- to late July.
“We’ve definitely blown that out of the water with no end of this peak in sight,” Clark said.
But Clark, an expert on health care delivery sciences and a former hospital administrator, added context to illustrate her growing concerns.
Clark said she is most concerned with the 65-and-older demographic if current rates continue unimpeded, given the hospitalization situation.
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She said about 6,000 or more infections are projected for that demographic statewide in the next three to four weeks, of which about 30% will require hospital admission, based on historic rates.
“So that translates into 1,800 hospitalizations (of those 65 and older) to be sustained in the next three to four weeks and forward,” Clark said.
There have been 8,609 hospitalizations in Oklahoma since the pandemic began seven months ago, with the state’s seven-day rolling average of hospital admissions at 76 on Wednesday.
Going into this week, Oklahoma had set a record for COVID-19 hospitalizations 12 of the past 15 weekdays that data was released by the state.
The latest record was 956 COVID-19 hospitalizations reported statewide Oct. 22. For COVID-19 patients in ICUs, the record is 319 reported Oct. 19. On Wednesday, the state reported 874 hospitalizations, of which 305 patients were in ICUs.
For comparison, the state’s high during the summer peak was 663 COVID-19 hospitalizations reported July 28. The record in the first wave, in the spring, was 560 reported on March 30.
Oklahoma has had at least 15,000 residents with active cases since Oct. 22, when the state first breached the 15,000 mark. The seven-day moving average of active cases Wednesday was 15,454.
Clark said that in Oklahoma each infected person on average infects one to two others.
“If they decide to go to a wedding or church or school or what have you, we could have a big dispersion event, depending on the circumstances,” she said. “With over 15,000 people currently infected in our (state), as you can imagine it’s just an exponential growth.”
White House report
The White House Coronavirus Task Force this week recommended that the state increase its mitigation efforts to control community spread of the virus as rates worsen across the state.
Sixty-five counties — 84% of the state’s 77 — have moderate to high levels of community transmission, with 42 — 55% — in the red zone for high levels of spread, according to the Oct. 25 task force report released Wednesday by the state.
The counties in red in northeastern Oklahoma are Tulsa, Craig, Delaware, Haskell, LeFlore, Lincoln, Mayes, Okfuskee, Okmulgee, Osage, Ottawa, Payne, Pittsburg, Rogers, Sequoyah, Wagoner and Washington.
“All indicators of community spread are increasing, including percent of nursing homes with positive staff members and residents, and community spread is increasing hospital admissions, leading to potential resource constraints,” the report states.
The task force recommends mask wearing, physical distancing, hand washing or sanitizing, and avoiding crowds. It specifically notes that private social gatherings are a concern.
“We are finding that as the weather cools, friends and families are moving social gatherings indoors, significantly increasing spread,” the report says.
Oklahoma’s new weekly case rate reached a new high of 217 per 100,000 people (14th highest in the nation), up for the fourth straight week. The U.S. average rose for the fourth consecutive week, too, now sitting at 133 per 100,000 people.
The state’s weekly test-positivity rate hit its second-highest mark at 11.4% (eighth highest in the U.S.), compared to the U.S. average of 5.8%.
The data are from Oct. 17-23.
Oklahoma’s weekly new case rate
The numbers signify the weekly rate per 100,000 people. Red zone is 100 and above; yellow zone is 10 to 100
Oct. 25: 217 (133 national average; 14th highest in U.S.)
Oct. 18: 207 (117; 11th)
Oct. 11: 190 (100; 9th)
Oct. 4: 178 (90; 10th)
Sept. 27: 201 (93; 5th)
Sept. 20: 175 (86; 6th)
Sept. 13: 142 (74; 5th)
Sept. 6: 146 (88; 9th)
Aug. 30: 114 (88; 13th)
Aug. 23: 123 (93; 12th)
Aug. 16: 117 (112; 15th)
Aug. 9: 146 (114)
Aug. 2: 186 (137)
July 26: 126 (140)
July 19: 128 (140)
July 14: 102 (119)
July 5: 69 (100)
June 29: 67 (74)
Oklahoma’s weekly test positivity rate
Red zone is 10% and above; yellow zone is 5% to 10%
Oct. 25: 11.4% (5.8% national rate; 8th highest in U.S.)
Oct. 18: 10.9% (5.4%; 7th)
Oct. 11: 10.0% (5.8%; 8th)
Oct. 4: 11.0% (4.6%; 5th)
Sept. 27: 11.8% (4.8%; 3rd)
Sept. 20: 9.9% (4.4%; 3rd)
Sept. 13: 10.0% (4.8%; 5th)
Sept. 6: 11.3% (5.2%; 4th)
Aug. 30: 9.6% (5.4%; 9th)
Aug. 23: 9.9% (5.8%; 8th)
Aug. 16: 9.4% (6.5%; 11th)
Aug. 9: 9.8% (7.1%)
Aug. 2: 9.8% (8.2%)
July 26: 10.1% (8.5%)
July 19: 9.8% (9.1%)
July 14: 9.7% (9.6%)
July 5: 6.0% (8.3%)
June 29: 5.8% (7.0%)
Source: White House Coronavirus Task Force reports. Each of these reports can be found online at coronavirus.health.ok.gov/white-house-coronavirus-task-force.
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Jake Henry Jr. also said that Oklahoma has always had a shortage of doctors and nurses, especially in rural areas, even before the pandemic.
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
