Friday Night Update from the ER in Arlington, VA: “It’s very rare to see masks outside of the hospital now. Trust me, I get it. But the pandemic is not over.”

Thanks as always to Dr. Mike Silverman, Chair of the Department of Emergency Medicine at the Virginia Hospital Center in Arlington, for these superb updates!

It’s homecoming season. If you have high school or college aged kids, they’re making homecoming party plans. It’s also wedding season and reunion season. All of this to say that COVID is not gone. A good friend of mine went to his reunion last weekend. About 100 people at the party with 9 COVID cases as a result. Most were from the party and a few from family transmission. I had a couple of other friends out this past week with COVID. It’s very rare to see masks outside of the hospital now. Trust me, I get it. But the pandemic is not over. If you’re symptomatic or had an exposure, it makes sense to test yourself and skip the party if you’re positive.

The COVID volume this past week was interesting. I had 3 patients in my last shift. One was critically ill, one required Paxlovid because of a combination of severity of symptoms and risk factors, while the third one had very mild symptoms. I still find it so bizarre that the spectrum of disease can vary from so mild to so severe.

The number of patients we have hospitalized is down a touch from last week. In the ER, the number of patients that require our COVID isolation protocol has decreased over the last few weeks. Of course, about 40% of these patients still require further observation/admission in the hospital and that number has been pretty steady.

Testing wise, we had a slight uptick in the number of positive cases this past week compared to the previous week, but we’re still down compared to a month again. Our overall positivity rate is 8.7%. Our asymptomatic patient positivity rate was 7.6% which is up compared to previous weeks. That’s a lot of people testing positive who don’t have symptoms. Remember, the target for percent positivity is <5% and we haven’t seen numbers in that range for a long time.

Last week, the CDC quietly allowed healthcare workers and facilities to no longer require masking under certain conditions. Honestly, I’ve pretty much expected to be in a mask for the rest of career when I work clinically so I was surprised by this recommendation from the CDC. The CDC guidance says that hospitals and nursing homes can allow doctors, staff, patients, and visitors to not mask in areas without high COVID-19 transmission rates. And while there are areas of the country that don’t have high transmission rates, we’re not there yet, so expect to wear a mask, and have your doc/nurse in a mask when you come to VHC.

And you may be as surprised as I am that my son still hasn’t had COVID yet.

Coronavirus is not quite done with us yet.

Science matters. Get vaccinated (or your booster). Keep a mask handy.

Mike