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Louisiana Health Alert Network (LA HAN): Substantial Increased in COVID-19 Transmission Throughout Louisiana

Date: 07/15/21

Louisiana Healthcare Connections would like to share with providers a recent alert from the Louisiana Department of Health Emergency Operations Center (LDH EOC) and from Dr. Frank Welch, ESF-8 Medical Director, regarding substantial increases in COVID-19 transmission throughout Louisiana.

The Louisiana Department of Health is issuing this advisory to alert clinicians of substantial increases in COVID-19 transmission throughout Louisiana. This increasing transmission is attributable to the widespread circulation of the Delta (B.1.617.2) SARS-CoV-2 variant of concern. The Delta variant is highly transmissible and is now the dominant lineage circulating throughout the U.S. CDC estimates that Delta accounts for nearly 60% of the circulating SARS-CoV-2 lineages in the South Central U.S. region that includes Louisiana. In addition, the current proportion of Louisiana’s population that has been fully vaccinated is currently 36%, whereas proportion of the overall US population that has been fully vaccinated is 48%. Because of the increasing circulation of the Delta variant in the context of comparatively low vaccination rates, COVID-19 cases, hospitalizations, emergency department visits, and outbreaks in Louisiana are all increasing:

  • The number of new cases diagnosed each day has been increasing for the past 28 days and is now increasing in all nine regions of the state. The statewide average daily number of cases per 100,000 residents has increased 167% over the past 14 days.
  • Statewide percent positivity of new COVID-19 tests conducted is now 6.3% and has been increasing for the past four weeks.
  • The number of patients hospitalized with COVID-19 throughout Louisiana has been increasing for the past 13 days, with more than 200 additional hospitalized patients added during that time.
  • The number of emergency department visits related to COVID-like illness has been significantly increasing throughout the state over the past 14 days.
  • During the past week, 35 new outbreaks and 200 new outbreak-associated cases have been identified. This represents a 169% increase in the number of reported outbreaks and a 96% increase in the number of outbreak-associated cases compared to the previous week.

Testing

Early detection of COVID-19 infections remains an important public health priority. The following people should be tested for COVID-19:

  • People who have symptoms of COVID-19, including those who are fully vaccinated.
  • People without symptoms of COVID-19 including:
    • People not fully vaccinated with COVID-19 vaccine who have had close contact with someone with confirmed COVID-19.
    • People not fully vaccinated with COVID-19 vaccine who have taken part in activities that put them at higher risk for COVID-19, such as attending large social or mass gatherings, or being in crowded indoor settings.
    • People not fully vaccinated with COVID-19 vaccine who are prioritized for expanded community screening for COVID-19.

Reporting

There are four COVID-19 Reportable Conditions that should be reported by healthcare providers to LDH using the secure online portal: LDH COVID-19 Priority Events Portal

  • COVID-19 associated mortality: All deaths occurring in individuals diagnosed with COVID-19 or have a positive COVID-19 lab result.
  • Pediatric Hospitalizations: Hospitalizations in individuals <18 years old who have a positive COVID-19 lab result.
  • COVID-19 during pregnancy: Infections in individuals who are pregnant and have a COVID-19 positive result.
  • COVID-19 Vaccine Breakthrough: Individuals who have had a positive COVID-19 test 2 weeks after completing vaccination series.

Vaccine Breakthrough Sequencing

LDH is requesting submission of PCR-positive SARS-CoV-2 specimens from vaccine breakthrough infections for genomic sequencing. Healthcare providers can notify LDH of the availability of vaccine breakthrough specimens for sequencing through the priority reporting portal or by calling the Infectious Disease Epidemiology clinician hotline: 800-256-2748.

Vaccination

The presence of the delta strain makes it even more important for you to promote vaccination against COVID-19. When more people are vaccinated, there are fewer chances for COVID-19 to spread, regardless of the mutation. From the data that are currently available, the vaccines appear to be effective against the new strains of SARS-CoV-2, including the delta variant.

Breakthrough Cases

Breakthrough cases (positive COVID-19 cases in patients 2+ weeks from completing their vaccine series) have been reported. While rare, breakthrough cases can be expected to increase as community prevalence of COVID-19 increases. Patients should be counseled that the 3 currently-available COVID-19 vaccines provide excellent but not absolute protection.

General Recommendations for Patients

  • If you are not yet fully vaccinated you should mask and distance in public settings and particularly indoors, for your safety and for the safety of those around you.
  • If you are fully vaccinated you have very good, but not absolute protection. Your risk, while relatively small, will increase as the amount of COVID-19 circulating in your community increases. Masking and distancing particularly when indoors will increase your safety should you desire extra protection.

If patients are at increased risk for complications of COVID-19 by virtue of advanced age or underlying medical condition or have a member of their household family unit who is, LDH strongly recommends they consider masking and distancing when indoors and/or in close proximity to others for added protection.