TARRANT COUNTY PHYSICIAN (21)
March/April 2021
Public Health Notes
or the first time since May 2020, Trauma
Service Area E (the most populous Trauma
Service Area, or TSA, in Texas, comprising
25 percent of the state’s population including
Tarrant, Dallas, and 16 surrounding counties)
recorded dramatically reduced COVID-19 fatalities
for three consecutive days (1/24/2021-
1/26/2021). TSA-E COVID-19 hospitalizations peaked on 1/9/2021
at 4,172 with 920 ICU beds occupied by COVID-19 patients. On
1/26/2021, TSA-E COVID-19 hospitalizations totaled 3,585, and
COVID-19 ICU patients numbered 824. Eighty-five ICU beds were
available in TSA-E, 26 percent of hospitalized patients were COVID
19 infected, and 40 percent of patients in ICUs were COVID-19
positive. The cumulative case count in TSA-E was 594,678, with
4,777 deaths. Both Tarrant and Dallas Counties surpassed 2,000
COVID-19 fatalities on the weekend of 1/23/2021-1/24/2021. As
of 2/23/2021 TSA-E reports 1748 hospitalized COVID-19 patients
for a COVID-19 hospital percent occupancy of 10.61. New cases
and deaths from COVID continue to decline from their peaks in early
January 2021. Since our first COVID-19 case in Tarrant County in
March of 2020, the U.S. has so far reported over 28 million COVID
19 cases and 501,181 deaths (2/24/2021), making us accountable
for 25 percent of cases and deaths from COVID-19 despite
comprising only four percent of the world’s population.1,2
Various entities (TCPH, THR, JPS Heath System, and City of
Arlington, among others) have been vaccinating groups 1a (health
care workers and critical infrastructure workers) and now 1b (65 and
older, or under 65 with preexisting comorbidities likely to adversely
affect COVID-19 outcomes) as well, and several national pharmacy
chains have vaccinated residents and staff in skilled nursing and assisted
living facilities. So far 211,874 Tarrant County residents have
received one COVID-19 vaccine, 101,970 Tarrant County residents
are fully vaccinated, and vaccines are now being distributed to retail
pharmacies.2 More mass vaccination sites are opening in Tarrant
Tarrant County
COVID-19 Situation and
Vaccination Report
County as well and we are working with our community partners
to implement strategies to reach persons in Tarrant County who
are unable to access mass vaccination sites or retail vaccination
options.
There are now two infusion centers in TSA-E (one in Fort Worth
and the other in Irving) offering the monoclonal bamlanivimab or
combination monoclonal casirivimab + imdevimab. Physicians,
nurse practitioners, and physician assistants can refer patients who
are COVID-19 positive for 10 days or less, mildly symptomatic, and
not requiring supplemental oxygen for COVID-19-related hypoxia
who have at least one of the following conditions: those 65 or older
with a BMI of 35 or over who also have chronic kidney disease, diabetes
mellitus, or chronic immunosuppression, or those 55 or older
with cardiovascular disease, hypertension, COPD, or other chronic
lung diseases.
Two vaccines are now being widely distributed in the U.S. under
emergency use authorizations after rigorous vetting, and a third
(the Johnson & Johnson COVID-19 vaccine) is advancing through
clinical trials.3 We use remdesivir, dexamethasone, and convalescent
plasma in hospitalized patients, and we have two monoclonal
injectables for use in mildly ill outpatients.
Our experience is short with COVID-19 but our arsenal is growing.
Though there is some vaccine hesitance, overall, there is
widespread interest in and acceptance of the vaccines. Our case
counts, fatalities, and hospitalizations reflect the remarkably rapid
progress in development of treatment (pharmacologic) and prevention
(vaccination, with 95.6 percent efficacy after second Moderna
vaccination and 92 percent efficacy after second Pfizer BioNTech
vaccination) of this scourge.3 The situation is improving but the
losses have been tragic, and the economic burden is as yet incalculable.
The best hope for continued situational improvement lies in
mass vaccination supported by hand washing, mask-wearing, and
distancing. We are well on our way.
References
1“CDC COVID Data Tracker,” CDC, Retrieved January 26, 20201 and February
24, 2021, https://covid.cdc.gov/covid-data-tracker/#datatracker-home.
2“ArcGIS Dashboards,” Retrieved January 26, 2021 and February 24, 2021,
https://txdshs.maps.arcgis.com/apps/opsdashboard/index.html.
3“COVID-19 vaccines,” FDA, Retrieved January 26, 2021, http://www.FDA.
gov/COVID19vaccines#FDAVaccineFacts.
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by Catherine Colquitt, MD
Tarrant County Public Health Medical Director