Experts say overlapping causes are behind the snowballing hospitalization rate for COVID-19 in this part of Central Texas, which is higher than any other part of the state.
But even the low vaccination rate, the more contagious delta variant and the number of patients from outside counties do not fully explain just how bad things are compared to other areas.
The Texas Department of Health and Human Services designates 22 clusters of counties, called Trauma Service Areas, guided by regional advisory councils. COVID-19 patients make up a higher share of total hospitalizations in Trauma Service Area M, the five-county region consisting of McLennan, Hill, Bosque, Falls and Limestone counties, than any other in Texas, with 243 COVID-19 inpatients and 55 COVID-19 intensive care patients filling 43% of occupied beds, as of Thursday. The statewide COVID-19 hospitalization rate sits at 20%. Service Area H in East Texas is the current second highest at 38%.
Christine Reeves, director of the Heart of Texas Regional Advisory Council, said she noticed a small increase in hospitalizations the first week of August that picked up speed over the next few weeks.
Multiple days this week have seen new highs in the number of COVID-19 patients hospitalized in Waco.
Reeves said facilities in Coryell, Comanche and Freestone counties, which are in other trauma service areas, regularly transfer patients into Waco hospitals for surgeries and specific procedures not available back home. She said people used to coming to Waco for care likely would continue to do so, regardless of whether they cross the boundary of a trauma service area, a designation used for logistical purposes by the Department of State Health Services.
“Coryell is the same distance to Waco, pretty much, as Clifton is,” Reeves said. “It’s a longer drive to go to Temple, even though that’s their trauma service area.”
Still, most people hospitalized in the area are local. Of the 195 COVID-19 patients in Waco hospitals as of Friday, 159 are McLennan County residents.
No single factor appears to be pushing the area’s hospitalizations higher than other areas’, said Dr. Farley Verner, an infectious disease specialist who serves as the health authority for the Waco-McLennan County Public Health District.
“You can say we have a lower vaccination rate than others, but it’s out of proportion to that,” Verner said. “Is it an older population? Do we have more people with comorbidities? I’m just not aware of a simple answer. There’s nothing we’re aware of, no more severe strain.”
McLennan County’s full vaccination rate for residents 12 or older has increased relatively quickly, from 43% to 48%, in the past month, but the pandemic is likely to deepen the longer the vaccination rate remains that low, Verner said.
“It all comes back to vaccines once more,” he said. “Conditions are ripe for transmission to occur, and people are tired of doing things that help decrease the chance of transmission.”
The local health district reported 141 new cases Friday, bringing the active case count to 1,797. Of the 195 COVID-19 patients in local hospitals Friday, 42 were on ventilators and 54 were in the ICU. The health district announced another 10 residents had died of COVID-19, bringing the local death toll to 602. September is on track to be among the pandemic’s deadliest months here.
The local percentage of hospitalized patients who have received a vaccine has gone from consistently less than 9% through a week ago, to about 19% on Friday, according to health district figures. That also is notably higher than other areas, Verner said.
He said people who are vaccinated and have comorbidities that put them more at risk for severe illness from COVID-19 are going to remain at risk as long as the spread continues.
“As more and more people get vaccinated, and it takes a whole lot more than we’ve already gotten, then the proportion of cases in vaccinated people will go up, because there’s less and less vaccinated people,” Verner said. “But that doesn’t explain the degree that you’re seeing those numbers.”
Verner said he is watching for that percentage to even out and remain consistent at 5% or lower, based on the efficacy rates of the vaccines.
Regardless, if the vaccination rate stagnates, things will get worse.
“Then we’ll continue to see a high number of new cases, and the virus will do the only thing it knows how to do. … If we keep putting it on each other and we’re not protected, then as long as there are susceptible people it will continue to spread,” Verner said.
Reeves said hospitals have reverted back to tactics used last fall, expanding inpatient capacity by about 20% of their licensed capacity. Doctors have stopped scheduling new surgeries and delayed procedures already on the books. Surgery and post-operative care areas already have some of the monitoring equipment needed for an ICU, so staff from those areas have switched to caring for ICU patients.
Reeves said emergency rooms had sectioned-off areas for COVID-19 patients to wait for the next available bed, but about a week ago the number of people waiting began to drop.
“They went into their hall-bed capacity, additional rooms like conference rooms, rooms that are set up that aren’t used on a regular basis,” Reeves said. “They were using every possible space.”