REGIONAL- Although the Omicron surge of the COVID pandemic is well behind us, St. Louis County Public Health Division Director Amy Westbrook has scant time for a sigh of relief. Case levels are far below the Omicron peak but cases still remain, new surges could lie ahead, and a department that’s been at the fore of the regional COVID battle has to remain at the ready while transitioning its focus to other health matters.
“Our numbers are looking much better,” Westbrook said on Tuesday. “They’re getting to be where they were last summer when we saw a really low number of cases reported. We’ve seen it level off over the last week or so, but we’ve come down dramatically since our peak in January.”
Monday marked the second anniversary of the first COVID case documented in the county.
“I remember when we got the call about that first case, at least a couple of weeks after the first case in Minnesota. We were kind of surprised that it took that long for us to get our first case. It was probably just three weeks where we saw our first assisted living outbreak and that was what really hit us hard.”
It’s something that remains fresh in Westbrook’s mind because two years later such outbreaks haven’t gone away.
“Last week we saw five congregate care facilities experiencing outbreaks, so it’s still a very real pandemic for a lot of our vulnerable populations, especially the aging adult population,” she said.
While most of the general public is settling into more normal routines that no longer include masking or close attention to social distancing, there are still those for whom the coronavirus poses a serious threat.
“There are still vulnerable populations outside of the aging population, such as people with compromised immune systems, especially younger children who may not be eligible for vaccines yet,” Westbrook said. “We don’t want to forget that there are populations that this is still a real threat and concern for them. That’s something that we can’t lose sight of.”
COVID also remains a threat for those who haven’t been vaccinated or who haven’t received all of their recommended doses, Westbrook said. Sixty-six percent of Minnesotans have completed their one- or two-dose vaccine regimens, but less than half, 45.8 percent, are completely up to date with the recommended boosters.
“Vaccine immunity does wear off,” Westbrook said. “Not completely, so if you’re unvaccinated you’re still much more likely to be hospitalized. But the numbers show that if you have a booster, you’re even less likely to be hospitalized or have severe illness.”
And the end of the Omicron surge doesn’t signal the end of the pandemic, Westbrook said. “I don’t anticipate that the World Health Organization will declare it anything else besides a pandemic anytime soon because there are still many countries that are really seeing spikes and increases and low vaccination rates,” she said. “There’s always a chance that new mutations could happen and variants could develop. We’re in a good place here in our country, in Minnesota, and in St. Louis County right now, but making sure we remember that it is still a pandemic is pretty important.”
Shifting resources
At the outset of the pandemic and throughout its first year, county health departments served as the boots on the ground as state and federal governments geared up to bring the many facets of the health care system into a coordinated and widespread approach to combat the virus.
The health department in St. Louis County stepped up to fill the gaps where health services needed some support, Westbrook said, by setting up community-based testing and vaccination sites to supplement state-operated clinics in the county. As community health centers, pharmacies, and hospitals stepped up in those arenas, the department continued to target areas such as the Iron Range where certain services, particularly testing, were deemed to be inadequate to meet the growing demand.
County health department workers also took on the added demands of providing technical assistance to health care providers, congregate care facilities, and schools both public and private. A data-informed response to the pandemic required data, so the department also increased its monitoring, data collection, and data processing activities. Ongoing public education efforts related to mitigation practices, testing, and vaccinations also had to ramp up.
All those efforts required a shift in responsibilities for department staff, often requiring reassignment of staff to new positions to support all of the department’s pandemic activities.
As the pandemic has progressed through multiple waves, health care systems have developed to the point where they have been able to largely handle the demand for vaccinations and testing, demand that has been shrinking as the percentage of vaccinated people has grown and at-home testing was introduced.
One person whose new pandemic role will continue is Aubree Hoover, the department’s specialist working with schools on COVID issues. Westbrook said that Hoover proved to be a valuable asset to school districts, and rather than cut back her role, the diminished need for COVID-related guidance will give Hoover the opportunity to work with schools on other health issues, including mental health and substance abuse.
The department is also shifting its focus to what Westbrook called “secondary impacts” from the pandemic.
“Public health impacts (from the pandemic) are mental health and substance abuse,” she said. “Our overdose rates are increasing. There are a lot of impacts we’re going to find, including food access. The public health issues that were priorities before the pandemic have been exacerbated by the pandemic. Unfortunately, during the pandemic we’ve had to pull some resources away from those priority areas, so I want to make sure that we’re realigning our resources to focus on those COVID recovery aspects and secondary impacts.”