Dr. Manuel Gordillo talks of special study indicating that daily case counts reported to CDC well below actual figures
On Feb. 23, Sarasota Memorial Hospital (SMH) reported that it had a total of 80 patients who were positive for COVID-19 between its campuses in Sarasota and Venice.
That was near the end of what local medical professionals called the Omicron surge, referring to the new variant infecting people at that time.
By March 25, as the surge was waning, SMH had a total of 22 COVID-19 patients.
With a new subvariant — BA. 2.12.1 — proving even more highly transmissible than previous strains of the coronavirus, SMH this week nearly reached that Feb. 23 figure again. On June 7, the health care system said it had 76 COVID-19 patients, six of whom were in the Intensive Care Units (ICUs).
Moreover, SMH reported five more COVID-19 deaths between June 2 and June 8, when the total rose to 666. That figure remained the same in the health care system’s June 9 report — the last available prior to the publication of this issue of The Sarasota News Leader.
In a June 8 video that SMH released, Dr. Manuel Gordillo, SMH’s medical director of infection prevention and control, pointed out that, given the increased use of home testing kits, far more people in the community likely are contracting the latest subvariant of COVID-19 than the U.S. Centers for Disease Control and Prevention (CDC) has been reporting.
Just that morning, he noted, the CDC showed that Sarasota County was experiencing approximately 200 new cases a day. That figure compared to 30 a day just six weeks ago, he said.
However, Gordillo explained, a special type of study undertaken over two weeks in New York City, which tracked people to try to get a more definitive count of infections, showed that for every single new case reported to health care professionals, 30 more were going uncounted. Home testing has made it far more difficult to get accurate information, he said, which is why analyses such as the one in New York are so valuable.
Gordillo pointed out that, based on that study, the actual figure for new cases in Sarasota County could be as high as 6,000 a day. He noted that almost everyone knows one or more individuals who recently have learned of a positive test result.
“If you have symptoms,” he emphasized, “don’t just assume that this is a cold or allergies. Test yourself.” That is the responsible action, he indicated, given the level of virus circulating in the county. It is very likely, he added, that an individual with cold or allergy complaints has the new subvariant.
A typical home kit has two tests in it, he noted. If a person gets a negative result with the first one, Gordillo said, the individual should wait two days and then take the second test.
If the person proves to be positive for COVID-19, Gordillo stressed, “You have to be isolating for five days.” Then, on Day 6, he continued, “You can start some of your [regular] activities …”
However, he also emphasized that, for the following five days, “You may still be contagious.” From Day 6 through Day 10, he added, an individual who does not live alone “must be wearing a mask.” Research has shown, he said, that about 40% of people still are contagious on Days 6 through 10. “Those days are critical,” he pointed out.
At SMH’s Sarasota and Venice campuses, Gordillo noted, the protocol calls for keeping in isolation through Day 10 any individual who has tested positive for COVID-19.
Positivity, caseloads, prevention and treatment
Illustrating Gordillo’s remarks, the CDC in its June 9 update for Sarasota County again classified community transmission as “High,” advising that everyone should wear a mask indoors in public and on public transportation.
That day, the CDC said the case rate per 100,000 people was 290.03, averaged over the previous seven days. New COVID-19 hospital admissions per 100,000 people were 15.9, it noted, and the proportion of staffed inpatient hospital beds in use by patients with confirmed COVID-19 was 3.5%.
Sarasota County’s COVID-19 positivity rate had ticked up from 22.29 for the seven-day average through May 29 to 22.93 for the seven-day average through June 5, the CDC also reported.
In its June 9 update for Florida, the Johns Hopkins University School of Medicine Coronavirus Resource Center showed Sarasota County again had the highest COVID-19 caseload of any county in Southwest Florida: 92.4 per 100,000 people. That compared to 84 for Hillsborough County; 81.3 for Pinellas; 80.4 for Manatee; 72.6 for Lee; and 71.5 for Charlotte County.
The highest caseloads continued to be reported in Miami-Dade, Broward and Palm Beach counties, the Johns Hopkins map indicated. For Miami-Dade on June 9, the figure was 187.2 per 100,000 people; for Broward County, it was 124; and for Palm Beach County, it was 96.4.
In the June 8 video, Gordillo characterized SMH’s COVID-19 patient situation as “creeping up,” though fewer people were having to be placed in the ICU. Data has shown that about 10% of current COVID-19 patients in the United States need ICU care, he added. That generally is what SMH physicians are observing, as well, Gordillo said.
No one knows at this point how the situation will evolve at SMH, he pointed out.
An SMH news release issued along with the video interview pointed out, “Fortunately, approximately 90% of admitted patients nationally, and at SMH, are treated successfully and discharged without developing severe disease that requires intensive care.”
The release also noted that, typically, a rise in hospitalizations follows three weeks after the increase in infections.
Just before Memorial Day weekend, The New York Times reported that the BA.2.12.1 subvariant was responsible for about 58% of all new cases being reported in the United States, according to CDC estimates for the week ending May 21. At that point, The Times article added, the country was averaging “more than 100,000 new confirmed cases per day for the first time since February.”
Along with wearing masks when indoors and outdoors in crowded spaces, Gordillo is urging people to take “all other precautions recommended to reduce transmission (washing your hands frequently, maintaining physical distance in groups and meetings and getting vaccinated or boosted if eligible). For those at highest risk of developing severe disease, primarily immunocompromised individuals,” he recommends that they “ask their doctors if they are eligible for the preventive therapy Evusheld, a long-acting monoclonal antibody that can provide up to 6 months of added protection against developing severe disease if they contract the virus,” as noted in the SMH press release.
Further, Gordillo recommends that all county residents learn the steps they should take if they develop any COVID-19 symptoms. Several anti-viral therapies are available at local pharmacies and at SMH’s walk-up clinics “to help prevent severe illness and hospitalizations in people who develop mild symptoms,” he said. However, to be effective, a person must start treatment within five days of the first symptoms. Learn more at www.smh.com/treatcovid.