Jul 07, 2021 3:00 PM

Portions of Kansas seeing upturn in COVID-19 variant

Posted Jul 07, 2021 3:00 PM

PITTSBURG, Kan. (AP) — Every time a patient enters her office, Krista Mijares, a Pittsburg, KS, pediatrician, asks them and their parent if they’ve been vaccinated. If not, she makes her pitch.

Do they want to be vaccinated? How about now? If they don’t, why?

In recent weeks the conversations have come with a warning: the Delta COVID-19 variant is in their community and makes it riskier than ever to remain unvaccinated.

And vaccinated or not, Mijares advises families to once again wear masks in public spaces if they’ve stopped.

“Don’t drop your guard, and if you are eligible to get a vaccine get vaccinated,” Mijares tells patients.

Southeast Kansas is in a shaky spot. The New York Times identified Crawford and Cherokee counties as two of the state’s most dangerous places to be unvaccinated as the Delta variant of COVID-19 spreads at alarming rates. Across the border in Southwest Missouri, Delta’s aggressive advance and escalating hospital admissions prompted the state to ask for federal help.

Though the Kansas counties have higher vaccination numbers than their Missouri neighbors to the east, they lack the herd immunity needed to insulate the community from a new round of outbreaks.

The Community Health Center of Southeast Kansas is “throwing everything at a wall and seeing what sticks” as they try to increase COVID-19 testing and vaccination rates, said Dawn McNay, the director of development. That includes various incentives, constant social media posts and walk-in appointments.

The variant surge comes as testing for the virus in Kansas has fallen off sharply. In June, the state posted its lowest numbers since April 2020, when testing resources were scarce. The dearth of surveillance testing among broad portions of the population, experts say, could damage health officials’ ability to monitor infection and intervene early to prevent serious illness or death.

“The ability to intervene early on with proper therapeutics is key to keeping hospitalizations down,” said Alan Morgan, Executive Director of the National Rural Health Association. “I worry we’re now flying blind again, just like we did at the beginning of the pandemic.”

According to the Centers for Disease Control 62% of Kansans 18 and older have received at least their first dose of vaccine, while 53% have completed the series. It put the state significantly short of President Biden’s July 4 goal of 70% with at least one shot. Twenty states cleared that bar.

The 62% also obscures wide disparities among the state’s 105 counties. Johnson and Douglas counties in eastern Kansas, and Geary and Graham Counties, closer to the north central part of the state, have all surpassed 70% of adults with at least their first dose, according to the CDC. Neosho County, in Southeast Kansas, has vaccinated only 26% of adults, the state’s lowest total.

CDC data shows the majority of Kansas counties sitting between 30 and 50 percent vaccinated among adults.

Meanwhile, the Delta variant has become the dominant strain in the state with 289 confirmed cases, hitting Sedgwick, Johnson, Riley and Crawford counties particularly hard.

“The fatigue is real but now is not the time to check out,” said Marci Nielsen, Gov. Laura Kelly’s chief advisor for COVID-19, who attributed the state’s efforts to get vaccine doses to rural counties early in the year for its relatively high vaccination rate compared with Missouri.

Jen Kates, Senior Vice President at the Kaiser Family Foundation, said testing is essential for low-vaccination areas because they’re at higher risk of outbreaks.

“Testing does two things, first of all it helps show where there are potential outbreaks that need to be addressed and checks for variants,” she said.

Lack of testing, she said, is “problematic” and may mean hospitalization and death are a better indication of viral spread.

In June, Kansas ran 29,735 diagnostic tests for the virus. That’s fewer than half the number performed in April 2020 and a small fraction of testing at its peak in November.

Dr. Linda Bean, the Chief Clinical Officer at the Community Health Center of Southeast Kansas and deputy health officer for Crawford County, said she viewed that as a result of the vaccine. With fewer people in the community getting sick, fewer were getting tested.

“That has decreased as the number of sick people have decreased,” Bean said. “Our biggest push is for people who are symptomatic or have been exposed to get tested.”

As the Delta variant began spreading across Southwest Missouri, more people were coming in because they’d been exposed to the virus. The clinic ramped up testing and identified more cases.

Over the past two weeks, 18% of COVID-19 tests run in Crawford County have been positive, a sign of increasing community spread and inadequate surveillance testing.

Just south of Crawford, Cherokee County’s positivity rate is 27%. In Crawford, where Pittsburg is located, 46% of residents 18 and up have had at least one dose while 42% of adults in Cherokee County are vaccinated.

As more cases are identified hospital capacity is shrinking.

According to the New York Times Cherokee and Crawford counties are now averaging five and six new cases each day. As of Friday, there were only two open ICU beds in Pittsburg’s hospital — six were filled by COVID-19 patients.

Once the Pittsburg hospital is full, the first option for ICU patients is in Joplin, Missouri. But as of Friday, Freeman West was serving 42 COVID patients with a full ICU, Mercy Hospital has admitted 37 COVID-19 patients and only had 9 remaining ICU beds.

Once area hospitals are full, patients in Southeast Kansas will need to be transported north to Kansas City.

“Even though we have seen a little bit of an increase in cases recently, it’s nothing to the level that we were,” Bean said. “Primarily unvaccinated people are the new cases and the ones that we’re seeing in the hospital.”

Morgan, with the Rural Healthcare Association, said, it’s harder to keep patients out of the ICUs without robust testing.

“It’s really difficult from a resource perspective and from a public health perspective to get a good sense about what’s happening in rural America when you’re not having (testing).”

Bean said her hope is that recent spikes can be brought under control by the fall, when weather cools and kids return to school.

“The vaccine is the game changer,” Bean said.

Vaccinations, she said, are essential to keeping the stress off hospitals as their regular surge of flu and respiratory patients arrive in the fall and winter.

A partnership with KU Health and federal dollars are helping the community center offer several vaccination and testing clinics. They’re planning events across the Southeast corner of the state and are trying to talk a Pittsburg bar into a “shot for a shot” campaign when college students return to campus in August.

Mijares, the pediatrician, said plenty of people are interested in getting the vaccine but need more information before they’ll take the leap. Others, she said, are dead set against it.

“There are some people that you’re not going to be able to educate because they’ve got some preconceived notions,” Mijares said.

Dennis Kriesel, Executive Director of the Kansas Association of Local Health Departments, said his impression from state health departments is that almost everyone who wanted to get vaccinated had already.

“The long term concern is continued lack of herd immunity. If we see more and more folks getting Covid, are we going to see a variant that the vaccines aren’t going to catch?” Kriesel said.

Statewide, Gov. Laura Kelly and Congresswoman Sharice Davids issued a Public Service Announcement Thursday, urging Kansans to get vaccinated and get tested over the holiday weekend.

Kelly’s administration has helped organize vaccination incentive events at the Kansas Speedway and brought in a Mexican soccer star to encourage vaccinations in Western Kansas.

Nielsen, Kelly’s advisor, said vaccinations are key but the two efforts need to go hand in hand as the state is surrounded on all sides by areas with rising cases of the Delta variant.

“We have those individuals who are not interested in getting vaccinated but if we can convince them of the importance of getting tested, that allows us to control COVID-19 out in the Kansas population,” Nielsen said.

“In addition to making vaccines widely available we need to be doing the same thing with testing.”

But opinions vary on how to encourage vaccinations and even how necessary it is for the government to push vaccines.

Kelly’s administration proposed a vaccine incentive lottery but Legislative leaders, who would need to approve the plan, said last week they were unsure it was the best use of federal funds.

U.S. Rep. Ron Estes echoed that sentiment, saying an unequal distribution of vaccinations was inevitable.

“I think people are going to make decisions about vaccinations just like they do for anything else and some people will get it and some won’t. And the president’s goal’s not going to be hit throughout the country. Some places will be higher than others,” Estes said.