COVID-19 Positive cases: 329,527
COVID-19 related deaths: 4047
Recovered COVID-19 cases: 292,244
Data from Tarrant County Public Heath’s (TCPH) report of COVID-19 activity in Tarrant County, updated Wednesday, September 15, 2021. Find more COVID-19 information from TCPH here.
*These data are provisional and are subject to change at any time.
Deaths and recovered cases are included in total COVID-19 positive cases.
by Catherine Colquitt, MD
Tarrant County Public Health Medical Director
This article was originally published in the September/October issue of the Tarrant County Physician. You can read find the full magazine here.
With healthcare systems, policy makers, and community partners preoccupied with the ongoing COVID-19 pandemic, other infectious diseases are percolating in the United States and across the globe, reminding us that Hamlet was right: “There are more things in heaven and on earth, Horatio, than are dreamt of in your philosophy.”1
Recently, the National Vital Statistics System (NVSS) issued a rapid release describing the effects of COVID-19 on U.S. life expectancy, which declined overall by 1.5 years between 2019 and 2020, from 78.8 years to 77.3 years.2 It is the sharpest decline in U.S. life expectancy since 1943, when World War II casualties were to blame for the decline from 1942 to 1943. Life expectancy decreased by 3.0 years for persons of Hispanic origin, and by 2.9 years for the non-Hispanic Black population over the same time period. The magnitude of the drop in life expectancy and the disparate effects of COVID-19 based on race and ethnicity are sobering.
In addition, many epidemiologists and public health experts are anticipating a busy influenza and other respiratory virus season after very low incidences of flu and other non-COVID respiratory infections in 2020 (attributed to COVID-19 shutdowns of schools, workplaces and businesses, masking requirements, and social distancing guidance). The CDC says to plan for “resumption of seasonal flu virus circulation” in the population with decreased “immunity due to lack of flu activity since March 2020” along with “co-circulation of flu, SARS-CoV-2, and other viruses like RSV” which may “place a renewed burden on the health care system.”3
The Texas Department of State Health Services attributes drops in vaccination rates to “stay-at-home measures, school and school-based clinic closures, and business closures” during the COVID-19 shutdown along with healthcare providers “suspending or postponing wellness visits including vaccinations in some cases.”4 From April 2019 to April 2020, vaccination rates through TVFC program decreased by 43 percent and remain well below 2019 rates even now. ImmTrac2, the Texas Immunization Registry, reported on July 1, 2021, that age-specific benchmarks for most VFC-supported immunizations (including pertussis, Hepatitis B, Hemophilus influenzae, rubella, measles, mumps, and varicella) remain well below benchmarks with schools soon to reopen for in-person classes.
Dallas County Department of Health and Human Services reported 100 cases of Hepatitis A in 2020 (an increase from an annual average of 19 cases for the prior 10 years) and has already recorded 52 Hepatitis A cases in the first three months of 2021.5 The outbreak in Dallas County is associated with drug use (both injection and non-injection) and homelessness. Tarrant County is working with the Tarrant County Homeless Coalition and John Peter Smith Hospital among other partners to offer homeless Tarrant County residents Hepatitis A vaccines (highly efficacious at preventing future Hep A infections).
And in July, the CDC issued a statement on Monkeypox in Texas.6 The infected U.S. resident had recently returned from Nigeria and traveled by air from Lagos to Atlanta and then to DFW International Airport. A contact investigation is underway; Monkeypox is rare in the U.S. The last large outbreak occurred in 2003 and was associated with transmission from pet prairie dogs to humans. Monkeypox can cause serious morbidity and is usually contracted through contact with infected animals (bites, scratches, or dressing wild game) but can be transmitted via respiratory droplets, body fluid contact, or fomite spread (via contaminated clothing or bedding). More information about monkeypox is available at https://www.cdc.gov/pox virus/monkeypox,index/html.
Stay tuned!
References
1. Shakespeare, William. Hamlet, Act 1, Scene 5.
2. “The 2020 Decline in Life Expectancy.” Centers for Disease Control and Prevention, July 21, 2021. https://www.cdc.gov/nchs/pressroom/podcasts/2021/20210721/20210721.htm.
3. “Frequently Asked Influenza (Flu) Questions: 2021-2022 Season.” Centers for Disease Control and Prevention, August 6, 2021. https://www.cdc.gov/flu/season/faq-flu-season-2021-2022.htm.
4. “Preliminary Report on the Texas Vaccines for Children Program: Impacts of COVID-19 on TVFC Vaccine administration.” Texas Department of State Health Services, September 16, 2020. https://www.dshs.texas.gov/immunize/docs/COVID19impactTVFC.pdf
5. Dallas County Health and Human Services Health Alert, April 5,2021. https://www.dallascounty.org/Assets/uploads/docs/hhs/health-advisories/2021/DCHHS-HealthAlert-HepatitisA-04.05.2021.pdf
6. “CDC and TEXAS Confirm MONKEYPOX in U.S. Traveler.” Centers for Disease Control and Prevention, July 16, 2021. https://www.cdc.gov/media/releases/2021/s0716-confirm-monkeypox.html.
The North Texas Medical Society Coalition is sharing two important and timely COVID-19 updates as you help navigate care for your patients.
First, the Texas Department of Emergency Management (TDEM) has opened a second COVID-19 antibody infusion center in North Texas. The new facility, located at Collin College in McKinney, will be in addition to the existing center in Ft. Worth. Click here to access the referral form and here for location details for the McKinney location. Click here for the referral form and here for location details for the Ft. Worth location.
Second, regional hospital emergency departments are requesting that well and mildly ill patients requiring a COVID-19 test (e.g. students, teachers and others who are seeking to return to school/work, or, individuals with mild symptoms), be directed to offsite COVID testing facilities. Emergency departments are being inundated with both sick patients and COVID-19 testing requests and have asked for the assistance of referring physicians to direct test-only patients to offsite locations. To access an offsite testing location, please click here. Please advise patients to contact the testing center prior to arriving to inquire about any limitations (e.g. no pediatrics, hours, appointments needed, etc.), and other important details. Hospitals have advised that patients who present at the emergency department for testing only may be charged an emergency department visit fee. While the COVID test itself is free, a facility visit fee may apply.
Thank you for all you are doing to serve your patients and our community. You are appreciated!
The NTMSC represents more than 11,500 physicians in the communities of Collin-Fannin, Dallas, Denton, Grayson, and Tarrant County. Founded in 2020, the NTMSC works with community healthcare partners, including public health departments, hospitals, and business leaders, to advise on medical recommendations to serve the health care needs of the residents of North Texas.
COVID-19 Positive cases: 309,051
COVID-19 related deaths: 3907
Recovered COVID-19 cases: 279,153
Data from Tarrant County Public Heath’s (TCPH) report of COVID-19 activity in Tarrant County, updated Friday, September 3, 2021. Find more COVID-19 information from TCPH here.
*These data are provisional and are subject to change at any time.
Deaths and recovered cases are included in total COVID-19 positive cases.
The North Central Texas COVID-19 Regional Infusion Center, which is located in Fort Worth, is now accepting both scheduled and walk-in patients; however, it is not guaranteed that walk-in patients will be able to get an appointment. The Emergency Medical Coordination Center said that it is best if patients talk to a doctor before pursing treatment.
“It is strongly recommended that patients visit a physician to see if they are eligible for the treatment and have their physician submit the referral form to the Regional Infusion Center to schedule an appointment,” the group said in a statement. “Walk-in patients will be seen by a medical professional but turned away if they do not meet the Eligibility Criteria.”
Walk-in patients are also required to provide documentation of a positive COVID-19 test.
COVID-19 Positive cases: 305,996
COVID-19 related deaths: 3881
Recovered COVID-19 cases: 276,983
Data from Tarrant County Public Heath’s (TCPH) report of COVID-19 activity in Tarrant County, updated Wednesday, September 1, 2021. Find more COVID-19 information from TCPH here.
*These data are provisional and are subject to change at any time.
Deaths and recovered cases are included in total COVID-19 positive cases.
By Kathryn Narumiya
This article was originally published in the July/August issue of the Tarrant County Physician. You can read find the full magazine here.
After nearly a decade under the leadership of Dr. Jim Cox (and during a pandemic, no less), Dr. Stuart Pickell joined Project Access Tarrant County as the new medical director. He reviewed his first patient chart in December 2020 and made the transition seamless.
Dr. Pickell has long been involved in Tarrant County’s charitable network. He volunteered at Beautiful Feet (Christian Community Health Clinic) for over fifteen years and became involved with an informal gathering of clinic leadership, led by then-TCMS CEO Robin Sloane. In these meetings, attendees shared challenges and possible solutions regarding their patients’ barriers to care. Dr. Pickell says, “Access to specialists and surgeons was always at the top of the list.” As a member of the TCMS Board of Advisors and the current TCMS vice president, Dr. Pickell has stayed apprised and supportive of PATC’s activities over the past decade.
We are blessed with many gifted and generous physicians willing to donate their time and expertise to care for patients in need. Our next hurdle is to build and expand collaborative relationships with the entities we need to allow those physicians to do just that. David Capper, MD, long-time PATC board member, says, “Stuart Pickell carries forth from the superb foundation of medical direction and immense respectability established by Dr Cox. He also enriches the position with practical insights that benefit both patients and clinicians.”
While he was not surprised, Dr. Pickell was pleased to learn the number of physicians who volunteer with PATC. Because of his history of volunteering in a primary care clinic setting, he was well aware of the barriers clinics face with accessing specialty care. He also knew that many specialists want to give back but do not feel they have a mechanism to utilize their area of expertise. This connection, Dr. Pickell believes, is where PATC shines. “By creating networks of charity clinics, specialists, and surgeons, supporting personnel and outpatient facilities specialists and surgeons can treat as many patients as they want in their own clinics on their own time. It’s a win-win.”
Dr. Pickell recognizes the challenge that PATC faces in trying to provide care to as many patients as possible. “Leveraging the strength of many team members with unique skill sets and gifts, we can realize better outcomes for patients,” Dr. Pickell says. “Medical systems, which are the community’s greatest tangible resource for healthcare, value collaboration as well, but most of their energy is spent within their systems. They may share common goals and understand the community value of bridging silos, but they continue to function independently, competing rather than cooperating with the other systems.” Dr. Pickell sees this as a critical area of growth to sustain PATC.
When asked what his vision for PATC’s future is, Dr. Pickell says, “There are several priorities that I believe will help PATC continue to be strong and expand. The first is financial sustainability. Even though we offer charity care, there are still costs. We seek to minimize these, but they are an ever-present reality. The second is to expand networks – build a stronger team of partners willing to donate time, equipment, and facilities. Finally, we need to expand the specialty services we can offer. We already do well at this, but there is always room for improvement, and we still have needs in some specialties.”
“Fundamentally, my long-term vision is that Project Access Tarrant County would become a model for providing healthcare services to the underserved. We need to expand on the excellent foundation that has been laid by Dr. Cox and his team and expand our network so that patients who need specialty services will be able to access them.”
Dr. Pickell is a welcome addition to PATC leadership. “I am a strong advocate for teamwork in healthcare, for collaboration, and for cooperation,” he says. “Project Access is about improving the healthcare of our most vulnerable residents through collaboration. It seeks to create bridges between the silos in health care – the hospital systems, the physicians, the all-important ancillary staff – to improve the health of those who otherwise would be unable to afford it. Project Access seeks the common ground of shared values, those things that unite us in our human condition. This may be aspirational, but it is an aspiration worth striving for.”
Due to the resurgence of COVID-19, the TCMS Alliance has moved The Party of Medicine: Casino Night to November 13, 2021.
You can find more information about the event here.
As physicians across the state toil against the third wave of the COVID-19 pandemic, Texas Medical Association leaders met with Gov. Greg Abbott’s office [on August 20] to ask for greater flexibility at the local level to respond to and slow the surge and its emotional and physical impacts on you and the health care system.
As this latest wave has shown, we are seeing many more patients who are younger and sicker requiring hospitalization and intensive care, the vast majority of whom are unvaccinated. This is particularly concerning for kids under the age of 12 who do not yet have access to a vaccine.
Because all disasters are local – and because so many of you have reached out to us – the TMA Board of Trustees, in an emergency meeting last Sunday, unanimously decided we needed to take action to reach out to the governor.
On Friday, I led a meeting with the governor’s chief of staff, Luis Saenz, and deputy chief of staff Garland Pate. Joining me in the virtual meeting were TMA President-Elect Gary Floyd, MD; TMA Board of Trustees Chair Richard W. Snyder II, MD; TMA Board of Trustees Vice Chair G. Ray Callas, MD; and TMA Executive Vice President and CEO Michael J. Darrouzet.
Our request to the governor on behalf of the TMA Board of Trustees: Please allow all institutions – including schools, school districts, hospitals, health care facilities, medical schools, and medical centers, regardless of funding source – to make local, independent decisions regarding vaccinations and the use of masks, preferably in consultation with physicians in those communities, and always using evidence-based data to inform their decisions.
The lengthy discussion underscored the need for physicians and state leadership to continue educating Texans about the importance of getting vaccinated against COVID-19 and to address vaccine hesitancy.
TMA understands and appreciates all you are doing during this difficult time to address the needs of your communities and your patients. We are taking steps to ensure your viability, resiliency, and knowledge of the current crisis.
Please continue to share your stories, issues, and concerns. And we will always be keeping you abreast of the association’s advocacy activities in Texas Medicine Today and through the COVID-19 Resource Center.
Sincerely,
E. Linda Villarreal, MD
President
Texas Medical Association
Today, a COVID-19 Regional Infusion Center offering the monoclonal antibody treatment Regeneron – COV (Casirivimab plus Imdevimab) opened in Fort Worth. According to the Infusion Center Info Sheet, “[t]his site will accept patient referrals from healthcare providers across TSAs C, D, and E to help administer COVID therapeutics quickly and safely with the goal of preventing patients from needing hospitalization.”
Referrals are required for treatment. To see if your patients qualifies, check the North Central Texas COVID-19 Regional Infusion Info Sheet. If they are eligible, you can complete the referral by filling out this form and sending in in by fax (210-208-5295) or email (InfusionReferral@bcfs.net).
Tarrant County Physician Online 