La Crosse County has recently been shaken by the novel coronavirus.
The disease has been present in the area since March, but for several months, the county had no more than 50 cases. That changed in June, shortly after the state was reopened by a Supreme Court ruling, and cases began to surge.
For those first few weeks of summer, cases doubled and grew rapidly, but fortunately brought little in the way of severe cases.
But that’s beginning to change.
In July, not a day has gone by without a hospitalization, which is stark in contrast to past months, which only saw sporadic low numbers of hospitalizations. Every day during the last week, there have been at least five individuals hospitalized.
And, just a week ago, La Crosse County lost its first resident to the virus.
This is the area’s first surge in severe disease, and compared with other parts of the state, it’s relatively small — there are currently five hospitalized and 101 active cases — but health officials view it as a warning for the coming months.
“What’s going to happen in the fall, if every one of those people infected two more, and we’re getting 300, 400, 500 cases,” said Jacquie Cutts, the La Crosse County public health nursing manager.
“This is our warning sign,” Cutts said.
So, why is the area experiencing more severe disease than before, and what must change to prevent it from growing in the coming months?
In June, 20-somethings accounted for nearly 60% of all individuals infected that month — individuals who generally don’t experience severe risk, though it’s not impossible.
In July, that’s changed, and people in more age groups are getting the virus, including older individuals who are experiencing the disease more severely.
“The cases that we’ve had recently are more universally distributed,” Cutts said.
When the surge hit in June, it coincided with several things, Cutts said: move-in dates for college students, the Wisconsin Supreme Court order and summer — and fewer safety practices like social distancing or mask-wearing.
And now, as summer heats up, more groups and families are gathering after months apart, spreading the disease to more than just those who were previously going to bars and beaches.
“People are really tired of having to stay apart and not go on vacation and wearing their mask,” Cutts said. “But at the same time this is not the time to become complacent. This is the time when we have to up the game and stick it out.”
Some see this slow start to a trend in severe disease as nothing to be alarmed about, since other areas are seeing more deaths and hospitalizations than La Crosse.
But officials urge against that mentality.
“I know that that individual didn’t have to die,” Cutts said of the La Crosse County man in his 70s who passed away from complications of COVID-19 earlier this month.
“COVID can kill,” she said, adding that the man was not in an assisted-living facility and had no underlying health conditions, also noting that young people are dying from the disease, too.
Recently, too, officials are understanding that even those who survive the disease are sometimes battling it for months, and are seeing long-term health effects including severe lung damage, increased risk of stroke and blood clots.
“Just because somebody doesn’t die, doesn’t mean that they’re free and clear,” Cutts said, who said that for every person who dies from COVID-19, up to 20 people survive with complications.
“It’s a good thing that there aren’t that many right now, and we want to keep it that way,” Cutts said. “Don’t take a success that we have now as evidence that we don’t need to be proactive.”
What does ‘severe risk’ mean?
Criticism about the county’s current pandemic status has also made its way to the data the health department reports to the public.
Recently, the health department has received pushback on its Coulee Region COVID-19 Compass — a tool used to determine and demonstrate the risk level in seven counties in the area, and the Coulee Region as a whole.
She said some residents have grown upset by the compass, even accusing the health department of data manipulation to make the risk level look worse than it is.
Specifically, some have pushed back that labeling the county with a “severe risk” when case numbers are low, or that changes to how they report on data, are dishonest.
“They think that we’re the no-fun police or something. But we’re not. We’re trying to save lives,” Cutts said.
The La Crosse County Health Department logs a large amount of data every day, looking at those infected, the status of local hospitals and the processes public health officials work through, and takes it all into account when determining the level of risk in the community that it announces each week.
That means in addition to the total number of cases, health officials are also looking at such things as:
- Do hospitals have enough beds, ICU rooms and equipment?
- Could they handle a surge in severe cases?
- How long did it take cases to double?
- How much did cases increase in the last week?
- Where did an individual get the virus and where might they have spread it?
- Was it spread at a store or a crowded bar, where it might be harder to narrow down who came into contact with it?
- Are those infected cooperating with contact tracers so officials can better understand the spread?
- How many tests are available?
- How many tests are coming back positive?
- How severe are an individual’s symptoms?
Each Wednesday, the health department updates the compass using all of this same data, and more — health officials say they don’t cherry-pick information that might lead to a certain result.
And, Cutts noted, the total number of cases when the compass is updated is reflective of behavior from two weeks ago, since that’s how long it takes between becoming infected and becoming aware of having the virus.
All of the data is put into three categories — epidemiology, which is details about the actual disease; health care, details about our hospitals and clinics; and public health, details about health officials work at tracking the disease.
If two or more of those categories are in the “red,” meaning their targeted goals aren’t being met, the county or region is considered at a severe risk.
Though the results of the compass can be daunting and disappointing, Cutts said she hopes residents can use it as a reminder to continue to take precautions like wearing a mask, washing hands, social distancing and staying home.
“I can’t change the fact that our community is where we are, I cannot change the risk level, I can just communicate it,” Cutts said.
“If people don’t take this seriously and we have a massive surge in the fall, I cannot explain how concerned that makes me for our community,” she said.