The Dayton Daily News interviewed several health professionals on what they thought 2021 will bring related to the coronavirus. In the next months, they said we can expect to continue social distancing, prepare for a post-holiday surge in cases, and anticipate more people getting vaccinated in the early months of the year.
Cases expected to climb
There’s been a drop in the pace of newly reported cases and daily hospitalizations in recent days compared to mid December, but health officials will be watching to see if a holiday surge arrives in January stemming from gatherings around Christmas and New Year’s Day.
“I don’t think there’s any question we’re going to see a post-holiday surge,” said Dr. Glen Solomon, professor and chairman of internal medicine and neurology at Wright State University.
A post-holiday surge would start to show over the next two weeks, he said.
It will take time before the impact of the vaccine starts to slow spread and show in the statistics.
The first group of people who got the first doses of vaccines the first week available will then need a second dose to get the full vaccine. The vaccine made by Pfizer and BioNTech gets a second dose three weeks later and Moderna’s gets a second dose four weeks later.
“So, you’re talking about end of January before people get their second vaccine, and then two weeks past that for immunity, so we’re talking about mid February,” Solomon said.
When cases rise in the community, it typically translates to cases rising in nursing homes, where cases can spread fast in close quarters and where residents are particularly vulnerable to death from the disease.
“It seems like things are kind of going in the right direction but obviously with Christmas and New Years, if people broke the rules so to speak or weren’t as careful during those holidays as they were Thanksgiving, then we could see a resurgence,” Pete Van Runkle, executive director of the Ohio Health Care Association, which represents nursing homes, said. “But we’re cautiously optimistic that in addition to the vaccine, which will have its effect later on, that we’re starting to see the numbers come down a little bit.”
Pandemic restrictions and advice to social distance and wear masks aren’t going away anytime soon and people should expect to keep it up as we head into 2021, Solomon said.
“We’ve got a long road ahead of us,” Solomon said.
In the early months of 2021 there will also be a race to curb the spread of new variants of the coronavirus, including one moving through England and now detected in a few confirmed cases in the U.S. The variant doesn’t appear so far to make people more severely ill but the evidence available suggests it spreads faster, which could mean more sick people because of more infected people.
Scientists believe current vaccines will still be effective against the variant, but they are working to confirm that, the Associated Press reported. On Wednesday, British officials reiterated that there is no data suggesting the new variant hurts the effectiveness of the available vaccines.
Vaccines coming
Expect more details to take shape in early 2021 on how COVID-19 vaccines will be distributed and for more people to start to get immunized.
Ohio skilled nursing facilities all should have access to their first dose by mid January, according to Pete Van Runkle, executive director of Ohio Health Care Association, which represents nursing homes.
There’s still some unanswered questions that need hammered out, such as what the plan will be when new staff come in or new residents come in or return home from a rehab stay before they get their second dose.
Credit: JIM NOELKER
Credit: JIM NOELKER
There also seems to be significant numbers of staff members who are hesitant and declining to be vaccinated, Van Runkle. He said a possible incentive could be if they got regulatory approval to let staff who have been vaccinated get tested less, with many now being tested twice a week.
“So everybody’s getting just tested out the wazoo. And that’s not a pleasant thing to have done to you every couple days,” Van Runkle said.
He said some of their members that are homes for people with developmental disabilities didn’t get into the pharmacy program headed up by chains like CVS and Walgreens, so their timelines each depend more on the capabilities of their local health departments.
The first group that’s getting vaccinated now and into early 2021 includes health care workers involved in the care of coronavirus patients, EMS responders and vulnerable individuals who live in close proximity and their caregivers, such as residents and staff at nursing homes, assisted living centers and veteran homes; patients and staff at psychiatrics hospitals; and people with intellectual disabilities who live in group homes as well as staff.
“At this point, it’s vaccination clinics only to those groups,” Dan Suffoletto, spokesman for Public Health - Dayton & Montgomery County, said Tuesday.
As we head into January, health officials will start immunizing the second priority group. This includes adults 65 and older, school staff or those living with severe congenital, developmental, or early-onset medical disorders.
Expect delays and logistical challenges during the historic vaccination campaign. It’s not clear what the pace of vaccinations will be in early 2021.
DeWine said last week he was “not satisfied” with the slow rate at which the coronavirus vaccine is being distributed in the state though he resisted blaming any specific entities involved with distribution, calling it an unprecedented undertaking.
He set a goal for Ohio hospitals to give out vaccine doses within 24 hours of receiving them whenever possible.
Back to school
The DeWine administration has set a goal the return to in-person learning by March 1, paired with a vaccination campaign for schools staff who chose a vaccine.
Montgomery County school nurses have started receiving vaccines along with the first priority group, according to Shannon Cox, superintendent at Montgomery County Educational Service Center. The other school staff are in the next priority group, though the details are still being formed on how and when those vaccinations will start to be available.
The evidence so far points to very little spread happening inside schools both locally and nationally. However, quarantine rules aimed at preventing spread have left schools disrupted and short staffed or with kids at home.
“We want to keep people safe. We’re not against quarantining. But it does impact us to the point where we have to go to a school closure or remote learning environment,” Cox said.
She said most schools are taking two weeks in January to go to remote learning to lessen the impact from any potential holiday cases. The three districts that have been remote almost the entire year, Jefferson, Northridge and Trotwood, at this point are expected to stay remote until the end of the third quarter.
“I think it is just going to be more of the same for a little while and then we’re going to have a whole lot of rehabilitation and recovery to do,” Cox said.
Nursing homes and assisted living facilities
It’s not clear when nursing homes and assisted living facilities will be able translate to more visiting.
Visiting restrictions are set by the state and over the course of the pandemic some facilities have gone stricter than state requirements as cases surged. In addition, one case is considered an outbreak and facilities with outbreaks don’t have visiting.
Van Runkle said it will be the state’s call on when visiting rules can change, but the increase in vaccinations will help. He said considerations include not just what’s going on in a facility but also what the situation is in the surrounding community and whether visitors have been vaccinated.
“If we get to a point where everybody in the facility is vaccinated — all the residents, all the staff, or darn near — then it may not matter if the person who’s coming in from the community hasn’t been vaccinated, but I can just see those as being considerations that the government’s going to look at it,” Van Runkle said.
Patrick Schwartz, spokesman for LeadingAge Ohio, which represents nonprofit long-term care businesses, said they are looking forward to the medical experts providing guidance on how visitation will change as a result of the vaccination process “but clearly, the greater the percentage of individuals vaccinated, the greater the opportunity for enhanced visitation.”
“Right now, major priorities are continued education of the long-term care workforce on the importance of getting the vaccine, and continued efforts to get this vaccine to high-risk Ohioans and front line health care workers. Visitation will grow as a greater percentage of these individuals are vaccinated,” Schwartz said.
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