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Omicron variant peak not here yet, infectious disease chief says

The area has not yet seen the peak of the omicron variant and as cases increase Pardee UNC Health Care is experiencing a heavy patient census, Chris Parsons, Pardee's medical director for infectious disease, said Friday. Statewide, data shows that the Covid burden on providers is higher than at any time during the pandemic.

Here is the full message from Dr. Parsons on the current situation:

Current projections indicate that the peak of the overall caseload in Western North Carolina may occur around the beginning of February. Many cities have already seen a decline in cases, and we certainly hope that will occur soon in our area as well.

Covid-19 data

The number of patients hospitalized for Covid-19 this week remained in the 20s until Thursday, when we hit 40. That’s the highest number we’ve seen during this surge, with the number of patients requiring intensive care or the use of a ventilator mirroring that trend. As of Friday Jan. 21, we were caring for 35 patients, with four of those in our ICU (average age 59).

Thanks to Dr. Curran from the Henderson County Health Department, we also reviewed state data trends and this month the Covid burden in the state exceeded any previous point during the entire pandemic, with:

  • About 25% of ED visits related to Covid-like illness.
  • Daily new cases numbers approximately triple the rates both last winter and during the most recent Delta surge this fall.
  • Approximately 35% of all tests statewide last week were positive.
  • Nearly 4,700 patients are currently hospitalized in the state.

Statewide for the week ending Jan. 8, about 77% of all hospitalized patients were unvaccinated, and approximately 87% of all patients in the ICU were unvaccinated. For Pardee, the proportion of unvaccinated individuals this month has remained in the 80-90% range for all hospitalized Covid-19 patients, and well above 90% for those Covid-19 patients in the ICU.

Infusion therapies

This week we temporarily reopened the hospital-based infusion unit for eligible outpatients to receive either sotrovimab or remdesivir (RDV). Sotrovimab continues to be in very short supply as we only had 12 doses allocated to us this week. This treatment requires strict eligibility criteria and unfortunately, will continue to be in very short supply for the foreseeable future. As of this morning, other sites which have Sotrovimab include LifeWay Health practice in Asheville, and St. Luke’s Hospital. But these locations have very small supplies as well.

We will be closing the hospital-based infusion site effective today, and shift outpatient infusion treatments to an offsite location where we will continue to administer RDV and sotrovimab, and by provider referral only. Unlike sotrovimab, Pardee has an adequate supply of RDV with more than 600 courses. RDV is an antiviral drug that blocks SARS-CoV-2 replication. This treatment has been used since Spring 2020 for inpatients with reduction in mortality in the hospital setting using this drug. It has more recently proven effective for prevention of hospitalization and death in outpatients with Covid-19, if it is received in three doses separated by 24 hours each and within 5 days of symptom onset. If a patient tests positive for Covid-19, they should ask their provider if they meet eligibility criteria.

Oral therapies

The Pardee pharmacy had 95 courses of Legevrio and 10 courses of Paxlovid as of Tuesday, Jan 18. Eligibility and other considerations for these therapies were provided in prior communications.

I am grateful that you all continue to show up and work on behalf of our patients.