Wisconsin COVID-19 hotspots reignited
For a brief, glorious few weeks, it seemed to many that the worst of the pandemic was behind us.
Half of Wisconsin residents are fully vaccinated. Beloved festivals and sporting events, forced into hiatus last year, are making a triumphant return, with hundreds of thousands of attendees in tow.
In late June and early July, many counties recorded averages of very few — sometimes zero — new coronavirus cases per day. Hospitalizations from the virus were down and deaths plummeted.
But signs of what could come our way were already emerging in the southern U.S., where states with large unvaccinated populations suddenly had overflowing hospitals and some of the highest case counts they’d ever seen.
The surge is thanks to the more contagious delta variant, which appeared first in India and now accounts for more than 86% of all COVID-19 cases in the nation, according to the Centers for Disease Control and Prevention.
Numbers haven’t skyrocketed the same way in Wisconsin, but they are rising: On July 15, the state was averaging 150 new cases per day; a little more than a month later, it’s averaging nearly 1,400. Hospitalized COVID-19 patients have increased five-fold in the last month. Deaths have remained relatively low, but at eight per day over the past week, they’re higher than they have been since February.
Even with the help of vaccines, health care workers, school teachers, business owners and others are struggling with the familiar feeling that this fall may be bad.
But how bad?
At the pandemic’s worst, outbreaks struck Wisconsin prisons, nursing homes and meatpacking plants with full force, moving quickly through populations at high risk of illness due
to age, comorbidities or poor ventilation and close proximity to others.
Today, those settings are at least somewhat protected by vaccination and natural immunity built up from previous infection, though we don’t know how long that lasts.
This time around, though, schools with relaxed mask policies and a commitment to in-person instruction could prove a breeding ground for outbreaks, as could the mass gatherings that were largely canceled last year.
“We do know that the best way to fight this even with the number of people who are now being reported to contract the virus after being vaccinated … is to get people vaccinated.” John Sauer president and CEO of LeadingAge Wisconsin
Prisons: 70% of incarcerated people are vaccinated, but less than half of staff are
Prisons have been the sites of some of the pandemic’s largest outbreaks. Prison overcrowding, cramped living quarters and limited space for isolation or quarantining made the facilities hotbeds of COVID-19.
About 11,000 Wisconsin prisoners have tested positive for the virus since the beginning of the pandemic and at least 32 have died from COVID-19, according to the Wisconsin Department of Corrections. That’s out of a prison population that, on any given day, is around 21,000 people.
Nearly 2,700 members of DOC staff have also caught the virus, according to the DOC.
About 80% of infected prisoners caught the virus in the last three months of last year, when the pandemic was at its height in Wisconsin. In some state prisons, three quarters or more of the prison population ended up infected.
By June, most prisoners had been fully vaccinated, and cases of COVID-19 among prisoners were few, according to DOC data. No large outbreaks have been reported at state prisons since the delta variant became dominant.
That’s likely due, in part, to the relatively high vaccination rates among prisoners. Nearly 70% of all current prisoners have been fully vaccinated, though at some prisons, the rate is nearer to 50%, according to DOC figures.
It’s less clear exactly how many correctional staff members have been vaccinated, said John Beard, DOC spokesperson. At least 47% of prison workers have gotten the vaccine, Beard said, though state prison officials believe the true number is higher.
Amanda Simanek, associate professor of epidemiology at the University of Wisconsin-Milwaukee, said it’s important to keep an eye on vaccination rates among staff members, who could bring the more contagious delta variant into the prison.
The prisoners “don’t have a choice of who comes in and out of their facility. They have the least autonomy over the mitigation measures they can take,” she said.
Long-term care: Vaccine boosters, staff mandates could be critical protections
Nursing homes and other long-term care facilities have been at the heart of the pandemic, their residents at especially high risk of infection and severe illness from COVID-19 because of their age and frailty.
In Wisconsin, at least 43% of the more than 7,500 people who have died from COVID-19 were nursing home or other long-term care residents, according to figures from the state Department of Health Services.
Nursing home cases and deaths plummeted shortly after the vaccine was delivered in January and February to most facilities. But in recent weeks, nursing home cases have begun creeping up.
Nationwide, nearly 2,700 nursing home residents were infected with COVID-19 in the week ending Aug. 8, more than four times the number of infections in the first week of July, and at least 188 died, according to the latest federal data.
A new study released last week by the CDC showed that nursing home residents experienced a “significant decline” in vaccine effectiveness against COVID-19 infection from March to July, likely due to the delta variant and waning immunity over time.
As of Aug. 8, nursing homes in Wisconsin had seen a slight rise in cases. At least 23 nursing home residents tested positive for COVID-19 in the two weeks from July 26 to Aug. 8. That’s compared to six residents in the two weeks prior. Of the latest 23 cases, 18 were breakthrough cases, according to federal data.
Brookside Care Center in Kenosha went more than five months this year without a resident testing positive for COVID-19. According to federal data, 93% of residents and 76% of staff had been fully vaccinated. But then, in the week ending Aug. 1, three residents who were fully vaccinated were infected.
The Biden administration hopes to boost immunity by offering third shots, called booster shots, starting with nursing home residents and some others in late September.
Nursing home industry leaders are hopeful they will not return to the level of transmission seen late last year, when over two months, more than 4,500 residents were infected and more than 1,000 died. They don’t want to have to shut down visitation again or impose facilitywide quarantines.
John Sauer, president and CEO of LeadingAge Wisconsin — a statewide association of nursing homes and other long-term care providers — said facilities are stocking up on personal protective equipment, such as masks, gowns and gloves.
The Biden administration also announced recently that all nursing home staff would be required to get the vaccine, as a condition for those facilities to continue receiving Medicare and Medicaid funding.
“We do know that the best way to fight this even with the number of people who are now being reported to contract the virus after being vaccinated … is to get people vaccinated,” Sauer said.
Meatpacking plants: Hit hard early in the pandemic, they may be better protected now
Wisconsin’s meatpacking plants were among the first places to be devastated by the virus.
By May of last year, more than 800 employees at 16 meatpacking and food processing plants across the state had been infected. That included an outbreak at Seneca Foods in the city of Gillett, where one in 14 migrant workers died of COVID-19.
In Green Bay, an outbreak at JBS Packerland was linked to more than 400 cases and four deaths and ultimately resulted in a fine from the Occupational Safety and Health Administration. In early May 2020, Brown County health officials said at least 200 employees at American Foods Group in Green Bay had tested positive.
The Green Bay outbreaks hit the area’s Latinx community particularly hard — 60% of county residents who contracted the virus through June of last year identified as Hispanic or Latino, despite that group making up less than 10% of Brown County’s overall population.
Employees and advocates blamed work environments that prioritized mass production over safety from respiratory disease: People work close together in buildings that may be poorly ventilated.
Vaccines could help change the outlook. JBS USA said in an Aug. 13 news release that more than 70% of its 66,000 employees had been immunized, crediting its on-site clinics, $100 incentive bonus, paid time off and multilingual education campaign. More than 75% of its Green Bay workforce is vaccinated, according to the news release.
Tyson Foods, which has plants in Green Bay and New London, said almost half of its U.S. workforce was vaccinated, Bloomberg News reported.
Tyson also announced earlier this month that it would require its U.S. employees to get the shot by Nov. 1 and will give $200 to each fully vaccinated team member.
It’s the first major meatpacking company to require the vaccine. But companies need to be cautious in requiring proof of vaccination or risk putting their undocumented employees in danger, said Christine Neumann-Ortiz, executive director of Voces de la Frontera.
It’s common for undocumented people to work under a different name, she said. Having to show a vaccine card with their real one could out them to their employer, she said.
She suggested businesses ask for attestation of receiving the vaccine but not the card itself.
Workers are in better shape in the factories than they were at the beginning of last year, Neumann-Ortiz said, because of the employee-led push for masks, distancing and better access to testing and tracing.
But they won’t be in the best shape until barriers to getting vaccinated are removed, she said. Voces de la Frontera is hosting pop-up clinics, dispelling vaccine myths and pushing for more Spanish-language education. Hispanic or Latinx Wisconsinites are still slightly less likely to be vaccinated than white residents, according to data from the state health department, despite having nearly twice the COVID-19 case rate.
Vaccine clinics should communicate extra clearly that they don’t require insurance, don’t ask about immigration status and are free, Neumann-Ortiz said.
This school year will look different from last year — for better and for worse, health experts say.
Districts shuffled between virtual, hybrid and in-person learning last year as the coronavirus spread. Even after the first doses of vaccine started to be distributed in early 2021, masks were required per Gov. Tony Evers’ statewide mandate through the end of March. And even when the Supreme Court struck down the mandate, most schools kept their mask requirements.
About a month later, vaccination numbers were climbing, cases started to drop, and parents, teachers and administrators looked toward what they hoped could be a normal school year.
But even though vaccines could help, many districts have shed another key tool to slowing the spread: a mask requirement. This is out of line with CDC recommendations, as well as the recommendation of the state Department of Public Instruction.
Data does show that children typically don’t get as sick from COVID-19 as adults, but experts still worry that sending kids — especially those younger than 12 who haven’t been able to get vaccinated — back without more protection could cause problems.
The delta variant hasn’t been shown to cause worse infections in children, but because it’s causing more infections overall, the proportion of kids who need to be hospitalized is increasing. As of Aug. 12, children made up 2.3% of all COVID hospitalizations, according to data from the Children’s Hospital Association and the American Academy of Pediatrics. That’s a high point for their age group since the pandemic began.
In Wisconsin, Children’s Hospital locations in Neenah, Madison and Milwaukee have seen an increase in patients with COVID-19, though they aren’t necessarily hospitalized for that reason, a spokesperson for the health system said. In May, eight children in their hospitals tested positive for COVID-19; in July, it increased to 16.
But even the large majority who aren’t hospitalized could contribute to spreading the virus further.
Evers said at a news conference Aug. 18 that he supports local vaccine requirements for teachers.
But aside from that, there are other known ways to stop the spread, said Simanek, the UW-Milwaukee epidemiologist.
Universal masking, improved ventilation and physical distancing when possible in the classroom helped tamp down case rates in her children’s school district last year, she said.
In Simanek’s other work as a contributor to Dear Pandemic, a group of women scientists who answer common questions about COVID-19, she and her fellow contributors have fielded concerns from parents in districts that are going mask-optional.
In the absence of district policy, the more protective factors parents can layer on to protect their child in the classroom, the better, Simanek said.
Otherwise, she said, we could face school closures similar to last year, a reality already happening in parts of the country where students have already gone back to school. In some southern states, where cases are surging, thousands of students and staff are already in quarantine.
Events: Return of large events could pose problems, especially indoors
One big change from 12 months ago: The big events that had to be put on hold last summer and fall are happening now, even as cases rise.
Vaccines brought relief to music festival organizers, sports teams and other major event planners throughout the state. Armed with varying levels of COVID-19 safety protocols, they stuck them on this year’s calendar.
More than 600,000 aviation enthusiasts attended the Experimental Aircraft Association’s 2021 AirVenture in Oshkosh. Close to 90,000 packed Appleton for its annual Mile of Music festival. The Wisconsin State Fair drew over 800,000 visitors, and the Deer District outside Fiserv Forum attracted thousands of fans throughout the Milwaukee Bucks’ playoff run, including 100,000 the night the team won the NBA championship.
Summerfest is on for September in Milwaukee, the Ryder Cup will attract golf fans from around the globe to Sheboygan County, and the Green Bay Packers will welcome a full stadium of fans for the NFL season.
One element these gatherings have to their advantage: They’re outdoors, where studies have found that COVID-19 transmission is almost 20 times less likely than indoors. (The delta variant may be more transmissible outdoors, but experts say it’s still unclear.)
But health department contact tracers found almost 500 COVID-19 cases linked to celebrations during the Bucks’ run to the championship in July. It’s a small sliver of those in attendance at the Deer District, but it still dismayed health officials, who said the number was likely an undercount.
Many large events will be pushed indoors as the weather turns colder, which could cause problems.
“The only thing that likes large events more than the people who attend them are viruses,” said Dr. Patrick Remington, former epidemiologist for the CDC and director of UW-Madison’s preventive medicine residency program.
Still, the answer may not be canceling gatherings altogether, Remington said, but rather evaluating them to add as many protective factors against COVID-19 transmission as possible.
He hosted a high school reunion recently at which he asked attendees to wear masks when physical distancing wasn’t possible.
“Did we cancel the event? No,” Remington said. “Did we change from having a potluck to ‘bring-your-own food’? Yes.”