Where county stands in the fight

Still more uncertainty as battle continues

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Uncertainty is the only thing certain about the fight against coronavirus (COVID-19) across the country and here in Harnett County.

One of the men tasked with leading the fight, Harnett County Health Director John Rouse, said there’s no definition as to where the county stands beyond saying it’s much the same here as it is throughout the rest of North Carolina, changing everyday.

Rouse admits the numbers are on the rise, something which can be attributed, at least in part, to Labor Day. Then throw in the easing of more restrictions and he says you have everything you need to see the increase.

“We got hit really hard back towards the end of September,” Rouse said. “I think that’s where we were seeing from the Labor Day holiday and the relaxation of some of the restrictions on large gatherings.”

Labor Day, Memorial Day and Independence Day have all played a major role in the fluctuation of new cases per week. That number includes about 216 new cases reported in a matter of a week. That happened in the third week of September and was followed by a drop to around 145 cases the following week.

Then came Labor Day and with it another increase as the 14-day infection period came into play.

“When it comes to the three big holidays over summer, we had a real large increase in cases about 10 to 14 days afterwards,” he said. “Now that time has passed since the end of September and I think we’re back down to about 140 a week.”

The complexity of the number of cases each week may be more defined by what lies ahead than what’s already happened. As the testing for the virus changes, Rouse believes the trending could change as well.

Initially, tests were done using the nasal-pharyngeal test.

That’s where the swab was pushed completely into the sinuses of the person being tested; something very uncomfortable and, according to Rouse, something which was a barrier to more people getting tested.

“As the swabs and the rapid tests become more accessible, it will be interesting to see how those numbers will be affected and how many more people will be willing to get tested,” Rouse said. “If someone has to make a choice between the nasal-pharyngeal or the nasal swab, I think most people would take the nasal swab.”

There’s another factor coming into play as well in the fight against the virus — the time is approaching for cold and flu season.

“With flu and upper respiratory seasons kicking in, it’s going to be interesting to see what the COVID numbers do related to that,” Rouse said. “The social distancing and mask wearing will help us in cold and flu season. So that will be interesting to watch. It’s going to be interesting how that’s going to play out over the next six months.”

While there might be some parallels between cases of the flu and COVID-19 in some areas, Rouse says numbers such as the total cases and the deaths related to each, are far different.

Rouse said he doesn’t recall ever having 2,400 reported cases of the flu in one Harnett County flu season during his tenure. And he also doesn’t believe he’s ever seen the 60 deaths so far related to the pandemic matched by the flu in any year.

The case for flu deaths vs. COVID deaths is more difficult to determine because of the way the data is compiled. Rouse admits the flu numbers are not real time, while COVID deaths are reported almost immediately.

“When I get flu death numbers, the next report I get, they’re probably going to give 2018,” he said. “Any of those state and national statistical numbers that we get are always at least two years behind.”

Doctors treat the flu without much external reporting. And reporting of total confirmed cases of flu done is basically for tracing purposes, while COVID cases are all confirmed and reported.

“Comparing the number of confirmed COVID cases with the number of confirmed flu cases from January to May of this year, we’ve probably got a lot more COVID cases,” he said. “When you look at it in a total of how many flu cases we’ve had, including the number of undiagnosed cases of flu, I have no idea what that number would be.”

One factor in the fight, which never materialized, was the old belief that warmer weather would slow the virus. Now the colder weather is approaching again, leaving more uncertainty.

“I do think (social distancing) is going to help with other things like colds, flu and strep throat,” Rouse said. “But as far as COVID goes, it’s a big uncertainty.”

Rouse, like many other health professionals, believes the fight will have to continue through social distancing measures and mask usage until a vaccine is developed. And the timeline for a widely-available vaccine is still a question mark.

“I know there’s some talk about there being a vaccine by the end of the year,” he said. “I don’t know if there will be or not, in all candor.”

But if a vaccine is developed, approved and ready to be shipped, there’s still a long process before the general public will be able to get it.

The frontline health care workers and first responders will receive the vaccine first. Then residents in congregate living facilities, followed by those in the high risk categories, will receive it before the general public.

“Me, personally, I still think we’re a year away from having a vaccine readily available for the general population,” Rouse said. “Unfortunately I think we’re still looking at an iceberg. We still don’t have a magic pill or vaccine we can give to people, I think we’re still a ways from that.”

Rick Curl can be reached at rcurl@mydailyrecord.com or 910-230-2037.

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