Local health officials said the state has been slow to report COVID-19 variant cases in McLennan County, leaving a piece missing in the puzzle of what, besides the low local vaccination rate, is driving a recent increase in cases.
Dr. Vaidehi Shah, senior epidemiologist for the Waco-McLennan County Public Health District, told the health district board Wednesday the district is working with local hospitals to try to make sure any breakthrough cases resulting in hospitalization are investigated as possible variant cases. “Breakthrough case” refers to a fully vaccinated person contracting COVID-19.
Shah said samples in those cases should be sent to the Texas Department of State Health Services for the genetic sequencing needed to determine which coronavirus variant caused the illness. The delta variant rapidly gaining ground nationwide is of particular interest.
“We’re working on it,” Shah said during a public health district board meeting Wednesday.
U.S. Centers for Disease Control and Prevention guidelines instruct the health district to investigate breakthrough cases when the patient is either hospitalized or dies of their illness. Hospitals send samples to state labs for sequencing to determine which variant was involved, then report the information to the local health district. The process often takes months.
One McLennan County hospital reported 30 breakthrough cases, but the other has not reported data to the health district yet.
“The state is taking a long time to send those results back, sometimes months on the delta variant,” Shah said. “All the samples we’ve sent to the state so far, we haven’t received those results.”
The Department of State Health Services last week reported 11 delta variant cases in McLennan County dating back to June. Four of the patients belong to the same family and five belong to a second family.
“There is a really high secondary household transmission rate with the delta variant,” Shah said.
Locally, the data does not exist to say what percentage of cases are a result of the delta variant, “just because of the way the reporting system is set up,” Shah said.
She said the increase in the rate of new cases over the last three weeks is especially concerning to her, but overall McLennan County is still in a “good place.”
The health district over the past seven days has seen an average of 25 new COVID-19 every day, about double the average from three weeks ago, she said.
Shah said the health district is trying to determine how many patients had been vaccinated before coming down with COVID-19. The reports the health district receives from doctors and hospitals do not have that information, meaning health district employees have to look up each patient in Immtrac, which doctors use to log immunizations, or ask patients if they have received the vaccine. Sometimes, patients cannot remember when they received the vaccine, or they do not show up in Immtrac, making the process more difficult.
Shah said McLennan County still has not gone one month without any COVID-19 deaths, something health officials hoped would happen once vaccines were widely available. Instead, the number has been gradually creeping up in the last month, with five deaths so far this month, compared to three in April and four each in May and June.
“What we’ve seen in the past year with the pandemic is that we will see an increase in cases, a couple of weeks later, and hospitalizations and then followed by fatalities, too,” Shah said. “This is a trend we’ll be looking at in the next couple of weeks.”
Shah said the new cases are mostly among younger adults, which has been the trend since spring, when vaccinations became widespread among older adults.
About 40% of McLennan County’s population over the age of 12 and 69% of its population over the age of 65 has been fully vaccinated. Roughly 47% of the population over 12 and 77% of the population over 65 has received at least once dose.
Mass vaccination events ended in May and have since been replaced by smaller community events, health district preparedness coordinator Stephanie Alvey said. She said just under 48,000 doses of vaccine were distributed during the mass events.
Cindy Murphy, the COVID-19 vaccine clinic supervisor for the health district, said about 531 people have been vaccinated at smaller events since May. She said interest in vaccines had been dwindling, but has been ramping back up as the delta variant has become a growing concern.
“When the people quit coming to you, you go to the people, so that’s what we’re doing,” Murphy said.
She said 397 of those 531 got vaccinated at community clinics, and 134 got vaccinated at worksite events set up by their employers. Employers have offered incentives including paid time off, gift cards and bonuses to encourage employees to participate. The health district has also held events at the Meyer Center, Salvation Army and the Hangar day shelter facility that were open to the public but intended for homeless residents of the county.
“Right now, we’re set up in a way that I can get a call for an immediate clinic and have somebody there actively injecting in 24 to 48 hours,” Murphy said.
Recurring clinics are scheduled to start soon at Texas State Technical College, McLennan Community College, Sanderson Farms and McLennan County Jail.
“We’re trying to put in some table clinics that get a known revolving population and still pursuing the community clinics,” Murphy said.
She said she and other health district employees are working on a plan to reach as many school districts and outlying communities as they possibly can.
“Now we have the staff, we have the product, we can reach out all the way across the county and set up these clinics with little to no notice,” Murphy said. “The next step is getting farther out. We want those tentacles going everywhere.”