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.
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.
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.”
A message to the community from Tarrant County physicians
The current surge in COVID-19 cases in the Tarrant County area is having serious consequences that could impact patient outcomes.
Hospitals are currently at, or over, their staffing capacity with very few open ICU beds available across Tarrant County.
Doctors, nurses, and other healthcare professionals are straining to meet the overwhelming needs in the hospitals.
COVID-19 hospitalizations aren’t just a problem of the unvaccinated, they also strain the resources that are needed to treat other medical conditions and emergencies.
To avoid this, we urge the community to recognize this current crisis and take the simple and familiar steps that are proven to be effective against the spread of COVID-19.
We must continue to wear our masks, wash our hands, and be cautious about how we gather.
Because the Delta variant is the most contagious variant yet and has the potential for spread by both vaccinated and unvaccinated individuals, we encourage everyone to wear a mask in public while indoors and outdoors when unable to socially distance.
In addition, those who are not fully vaccinated should limit gathering with those outside of their household, especially while indoors.
Vaccination is the safest and most effective way by which we can protect ourselves from this deadly virus and get back to normal.
With over 350 million doses of COVID-19 vaccine given in the U.S., evidence of the safety and effectiveness of the vaccines is overwhelming.
Being fully vaccinated results in an 8-fold reduction of having symptomatic COVID-19, a 25-fold reduction in being hospitalized and a 25-fold reduction in death from COVID-19. We strongly encourage every eligible person to get vaccinated – immediately.
As a community, we are at a tipping point. Let’s move in the right direction.
Each one of us can do our part to stop the spread, break the cycle, and defeat this pandemic once and for all. The choice is ours.
The Tarrant County Medical Society is a membership organization for the physicians serving the Tarrant County community. TCMS has been dedicated to the improvement of the art and science of medicine since 1903.
JPS Health Network announces the opening of a new outpatient Behavioral Health clinic that will both increase the number of patients it can treat and allow it to enhance the services it offers people in need of care.
Called the JPS Center for Behavioral Health Recovery, the facility has replaced the outdated, Hemphill Outpatient Behavioral Health clinic, which was on the southwest corner of the JPS campus in Fort Worth. The facility is located a few blocks to the north in a more inviting and more purposefully designed building at 601 W. Terrell Avenue.
Slightly larger than the Hemphill site, the new clinic features a much more efficient use of space. Doctors, nurses and other team members cared for about 160 people each day at the former building. They expect to be able to greatly expand their capacity to serve those with behavioral health needs at the new site.
“I challenge people who say facilities don’t have anything to do with the quality of care that we can provide to patients,” said Teneisha Kennard, Executive Director of Behavioral Health Ambulatory Services at the health network. “We prioritize treating our patients with dignity and respect, and this new building will show our patients and community our commitment to caring for them. There is dignity, respect, and a sense of worth in this new building.”
The Center for Behavioral Health recovery will unite traditional outpatient Behavioral Health services offered at Hemphill including evaluation, diagnosis, medication management, brief psychotherapy, psychological testing, and group therapies with access to primary care physicians and lab testing under one roof.
Features of the new Behavioral Health clinic include:
Space for a primary care physician and phlebotomists who can perform tests on-site instead of sending patients to the main hospital, requiring an extra trip back and forth.
Dedicated space for psychological testing and for psychologists to meet with patients
More open and inviting spaces that will contribute to a more constructive environment for patients
Easier to get to, with more on-site parking and a bus stop in front of the building for patients who rely on public transportation.
The new location, which previously served as the home of the JPS Center for Cancer Care, has been extensively remodeled since cancer services were moved in May 2019 to a much larger, updated JPS Oncology and Infusion Center on 8th Avenue.
The Hemphill site will be torn down in the coming weeks, and turned into a parking lot to facilitate the next moves in the health network’s $800 million bond construction project. Tentative Phase I plans call for a new Psychiatric Emergency Center to be built on existing employee parking lots closer to the center of the main JPS campus.