Immunity slows spread of latest COVID-19 surge; clarity needed on access to therapies

SARASOTA – The latest COVID-19 variant appears to be spreading more slowly than previous versions, but official numbers reported by the state are less accurate than in the winter, when the original omicron strain prompted a spike in cases, meaning the numbers are likely significantly higher.

That’s the gist of the latest COVID-19 update from Sarasota Memorial Hospital infectious disease specialist Dr. Manuel Gordillo, in a video released by the hospital on Wednesday.

“What we are experiencing personally, anecdotally, what we see ourselves, is more reflective to what we see is really happening compared to the numbers published by the CDC or the state, because testing has changed tremendously from last year to this year, with the advent of testing at home,” Gordillo said. “The numbers that the CDC or the state publishes regarding cases is a huge underestimate of the true numbers.”

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As of Thursday morning, the number of people hospitalized with COVID-19 at both the Sarasota and Venice SMH campuses was 67, with four in the intensive care unit. On Wednesday, the numbers were 67 and 3.

“We are seeing a rise in hospitalizations in the past two weeks,” Gordillo said. “That is where we are, lots of cases – due to immunities in our population, not that many coming into the hospital.

“But the numbers are creeping up and we don’t know where we’re going to be headed.”

While published numbers indicate a surge in cases, Gordillo stressed that “we know for a fact that those numbers are not reflective of the real numbers; every one of us knows people that are infected.

“Everybody knows that there’s a surge,” he added

Current federal Centers for Disease Control numbers indicate a trend of 200 cases per day in the Sarasota area, compared with 30 a day six weeks ago.

Gordillo cited a prevalence study in New York that follows a specific population for two weeks and then finds out the number of those people who are infected in that two-week period.

“Those are the best studies to determine how many people are infected,” Gordillo said, then added that those studies showed that for every case found, there may be up to 30 that go unreported.

Thousands of COVID-19 cases may go unreported daily

Using that guidance, Gordillo said the 200 cases a day may be closer to 6,000 cases a day.

Gordillo said that even though there may be 5,000 to 6,000 new cases a day in the area, increased immunity from either vaccinations or previous infections have lessened the overall impact.

“This is how the pandemic is changing,” he added.

Asked about Florida Department of Health data that showed the overall infection rate as being slower than the winter Omicron surge, Gordillo noted that the original Omicron variant was extremely contagious and easily spread through an overall population that had fewer people with immunity through previous infection or vaccination.

More people were infected as Omicron BA.2 progressed, increasing the percentage of the population of people with some degree of immunity through previous infection or vaccination – as well as hybrid immunity afforded by a breakthrough infection after previous vaccinations.

The current Omicron subvariant in Sarasota is BA.2.12, which is infecting people who had been previously infected.

“That’s a fight between humans' immunity and the virus,” Gordillo said.

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Gordillo urged people experiencing symptoms that they believe to be a cold or allergies to at least do a home COVID-19 test.

Most home test kits include two individual tests. Even if the first results come out negative he said that people should take the second test to confirm that.

Every household in the U.S. is now eligible to receive a third round of free COVID-19 home tests. For more information, visit https://www.covid.gov/tests or for help ordering those free tests, call 1-800-232-0233.

Gordillo noted that a person who tests positive should be isolated for five days.

For days 6-10 it’s OK to go about one’s business but wear a mask in public, since you may still be contagious. Gordillo noted that 40% of the people infected are still contagious for days 6-10.

At SMH, the isolation is more conservative for hospitalized patients. Patients who test positive for COVID-19 are isolated for 10 days.

Confusion abounds on how to find COVID-19 therapies

Accessing free therapies locally — primarily Paxlovid and Lagevrio, aka molnupiravir — can be problematic.

The Sarasota County COVID-19 Therapy Coalition — which is made up of Sarasota Memorial Hospital and other area health care providers — has been trying to raise awareness of where people can get the therapies, which are available only by prescription.

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The main website for the coalition is https://www.smh.com/treatcovid.

That website includes a link to a federal government-sponsored website that lets anyone search for the location of pharmacies that stock the medicines, as well as test-to-treat site.

To access that site, visit: https://bit.ly/3mxBRS9.

In theory pharmacies throughout Sarasota and Manatee counties — including Walgreens, CVS, Sam's Club, Walmart and Costco — stock one or more of the therapies.

Some also provide the monoclonal antibody Bebtelovimab, which is available for those who cannot receive Paxlovid because of a significant interaction with another medication, and Evusheld, a preventative antibody therapy available for those who are immunocompromised.

But there are only four test-to-treat sites listed in Manatee and Sarasota counties. While the federal database lists available doses, that information can be outdated.

And that federal search will not list whether doses are actually available at any given time. Another more complex search, available at https://bit.ly/3H6qytI does, but it’s most helpful to plug in the address of a specific pharmacy. It might be easier to just call to verify availability.

For example the Walgreens at 3550 Fruitville Road in Sarasota had 21 courses of molnupiravir available as of June 7 and the CVS at 4302 Cortez Road West, Bradenton, had 19 courses of molnupiravir as of June 8.

The Bradenton Family Medical Center at 1505 26th Ave. E, Bradneton had 384 courses of molnupiravir and 77 courses of Paxlovid available as of June 7.

The Walgreens at 149 U.S. 41 Bypass in Venice had 4 courses of molnupiravir and 29 courses of Paxlovid available as of June 7.

Treatment also depends on whether your health care provider is willing to prescribe the new therapies. In at least one instance described to the Herald-Tribune, the health care provider refused.

Some of the pharmacies will accept prescriptions from a telehealth provider. Most will accept prescriptions from health centers approved by the federal Health Resources and Services administration. The website for that search is https://findahealthcenter.hrsa.gov/ but in Sarasota County, four of those locations are affiliated with CenterPlace Health.

In a prepared statement, James Reid, interim CEO for CenterPlace Health noted that CenterPlace Health has seen a significant increase in COVID-19 diagnosis from April to May 2022.

“Although our case numbers are small in numbers there has been a three-fold increase in confirmed cases from April to May,” the statement from Reid said.

It is also possible to get a prescription tor COVID-19 therapies from an urgent care center.

In an email response, SMH spokeswoman Kim Savage noted that “there are some drug interactions, restrictions and contraindications for different treatments, so it is important that a doctor evaluate a patient and go over their medical history to determine which treatment is best."

In some cases, to get a same-day prescription, an urgent care center or doctor's office may accept a home-test result. In others, patients would need proof of a positive test from a state testing site or accredited lab.

“They should call the walk-in center or talk to their doctor before seeking care, so they are aware of any extra charges for a test," Savage wrote.

A patient with a positive test from a state testing site or credited lab may be able to get a same-day prescription.

Otherwise, Savage noted, “If they are tested at SMH Urgent Care Centers, they would likely have to return later in the day, or next day, for their prescription, after we process and receive their PCR test results.”

Earle Kimel primarily covers south Sarasota County for the Herald-Tribune and can be reached at earle.kimel@heraldtribune.com. Support local journalism with a digital subscription to the Herald-Tribune.

This article originally appeared on Sarasota Herald-Tribune: SMH COVID update: Doctor says case numbers underestimate latest surge