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Why rising Covid-19 vaccinations aren't cutting down positive cases and hospitalizations

Why rising Covid-19 vaccinations aren't cutting down positive cases and hospitalizations

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Covid-19 nurse Sarah Dempsey (copy)

Covid-19 hospitalizations in Erie County have continued an unrelenting surge despite more people getting vaccinated. Covid-19 nurse Sarah Dempsey on a Covid-19 floor at Millard Fillmore Suburban Hospital in December. 

Recently released data now highlights a stark contrast in the Covid-19 public health crisis.

The number of local residents vaccinated against Covid-19 is rising by tens of thousands a week.

Yet the number of county residents testing positive for the novel coronavirus is also rising by the hundreds each week, and Covid-19 hospitalizations are at the highest point they've been since early February, even though vaccine doses are now plentiful. 

"We have continued to see this growth," Erie County Executive Mark Poloncarz said last week during a media briefing. "We're not in a good situation."

As of the past week, 43% of the Erie County population  more than half of all eligible residents  has received at least one vaccine dose and 30% have received all necessary doses.

Meanwhile, confirmed positive cases have risen steadily over the past five weeks. Western New York's average positive test rate stands at 5%, the highest of any region statewide, according to state data released Sunday. Comparatively, New York City has a positive test rate of 3.1%

Poloncarz also said that of the hundreds of people hospitalized with the virus as of early last week, and the two dozen who so far who have died in April, none was fully vaccinated.

Covid-19 hospitalizations have been rising sharply since mid-March.

But if the number of vaccinated residents is going up, shouldn't the number of people contracting the virus be going down?

Not necessarily.

Covid-19 variants originating in California, the United Kingdom and South Africa have been identified in Erie County. They are more infectious and transmittable than the original version of the virus. That means that while more people may be getting vaccinated, the ones who aren't are getting infected faster.

Many vaccinated, older adults are protected from the virus, but the county has seen a sharp rise in infections among younger people. This includes those who are not eligible to be vaccinated, or just recently became eligible. County leaders are concerned that these people are also taking fewer precautions, including mask wearing and social distancing.

Data makes this case. While the county Health Department has recently seen an average of 127 positive cases for every 100,000 residents ages 80 and up, the number of positive cases per 100,000 residents in their 20s and 30s each exceeds 600. The rate of infection among children and teenagers also now rivals that of residents in their 40s, 50s and 60s.

"That's a huge concern," said Health Commissioner Dr. Gale Burstein, who noted the 50% increase in cases among 20- and 30-year-olds in less than a month.

Dr. Manoj J. Mammen, a pulmonary critical care physician at Buffalo General Medical Center, who has treated many ICU patients, said it used to be more of a rarity to see patients under age 40 admitted for Covid-19. That is not true any longer.

"I do see more younger patients," he said.

In addition, some adults who have been vaccination-eligible for many weeks are still hesitant or unwilling to get a shot, prompting an increased focus on public outreach and education by government and health care leaders as the push toward herd immunity encounters more resistance. Last week, vaccination ads began running on WBLK-93.7 urban radio, and WYRK 106.5, the local country music station. 

"There’s a lot of skepticism, anxiety, mistrust," Mammen said. "Our goal as health care professionals is to educate everyone."

He encouraged residents who aren't sure about getting the vaccine to speak with their primary care physicians. 

Mammen has had instances where he's needed to reassure some patients who received the Johnson & Johnson vaccine. Its distribution has been paused after six women  out of nearly 7 million vaccinated  developed rare blood clots after they got the vaccine.

The fact that the U.S. Centers for Disease Control and Prevention paused vaccine distribution for further evaluation is a sign that the process for determining vaccine safety is actively working as it should, said Mammen, an associate professor with the University at Buffalo Jacobs School of Medicine and Biomedical Sciences.

"It should be understood that these clots are very rare," said Dr. Elad Levy, co-director and neurosurgeon at Gates Vascular Institute and chairman of the Department of Neurosurgery at the UB Jacobs School. "The main symptom to watch out for is new onset headaches that continue to get worse over time."

A University of Oxford medical study of 500,000 patients reported last week that the risk for the same type of clot in those who contract Covid-19 is eight times greater than for those who have received the AstraZeneca/Oxford vaccine, which is similar to the J&J version.

"The societal and individual benefits of vaccination are critical," Levy said in a statement from UB. "I personally have been vaccinated, as have my parents and spouse. I recommend getting vaccinated."

During the past two weeks, Poloncarz has stated that people are needlessly being hospitalized, and some are dying.

"The individuals who died recently, not a single one of them, that we know of, had been fully vaccinated," he said. "And that's disconcerting because we know there's ways to protect people, and that's to vaccinate them."

Mammen said that has also been his experience as a treating ICU physician. Those who have been admitted have generally been unvaccinated. Some have come to the hospital for treatment after a single shot of a two-shot regimen, or even after getting two shots but before the two-week waiting period for the strongest possible immunity.

Most, he said, if not all, were not sick enough to warrant hospital admission.

The Buffalo News: Good Morning, Buffalo

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