By Ben Rodgers
Editor

GREEN BAY – A spike in positive COVID-19 test results from younger people is a concern for Dr. Ashok Rai, president and CEO of Prevea Health.

“The spike to focus on is the percent positivity – in other words, just having positive results in the context of not how many were tested really doesn’t mean much,” Rai said. “It’s really the percent positive that’s rising and it’s been rising over time. It’s not just a one day thing. We actually have looked at the trends, and the trends are very concerning, as they have now started to cross those thresholds of above 3 percent, above 4 percent, and above 5 percent, which is really an area where you know you’re having significant spread and need to create a solution, otherwise it’s going to get out of control like what we’re seeing in other states.”

He said younger people testing positive will also lead to more confirmed cases.

“That’s a precursor to more spread, because it’s not like 20- and 30-year-olds only hang out with 20- and 30-year-olds,” Rai said. “They go to work, they go to school, they go home and your opportunity to infect at-risk populations continues to get higher as more and more people turn positive.”

He said the good news for now is healthcare is better prepared than it was at the onset of the pandemic.

“We’re doing pretty good right now. We checked in with our colleagues at different health systems and everybody has capacity,” Rai said. “Everybody is nervous, because once again you have this age group that’s a factor to infect others, so when is the next phase going to happen if we don’t get control over this?

“It’s important to also understand from a treatment perspective, we have a lot more we can do today than we could have done 30 days ago, 60 days ago, 90 days ago, so our hospital stays are very long, but the mortality rate is starting to go down a little, which is a good thing. But we are seeing a younger population now being admitted to the hospital. Unfortunately, I think in the press there’s a fixation on deaths, and really you have to look well beyond that. You have to look at morbidity on top of mortality.”

Morbidity is any long-term health complications from surviving COVID-19.

For example, Rai said a young, healthy and active person could come down with COVID-19 and become symptomatic, but recover from it and still have long-term health complications.

“Nobody is talking about those aspects, the morbidity, all we’re focused on is the mortality,” he said. “Are we getting better at the mortality? Yes, we know how to ventilate these patients better, we have two drugs and plasma we didn’t have at the beginning. There are things we’re doing better.

“But right now, we also have a different age group being infected. So when the older age group gets infected by this younger age group, we are worried that we will be Houston, that we will be Florida, that we will be Arizona, but it’s also important to remember with this 30 percent population that’s being infected right now – about 30 percent of the positives are in this (age) 21-30 category – that they’re going to have long-term health complications that we’re not talking about, although they did not need to be in the hospital,” he said.

Rai pointed to sports medicine journals, because athletes are considered to be in the best physical shape out of anyone.

“There’s recommendations right now in the sports medicine journals, that are based on science, that if an athlete tests positive, and was significantly symptomatic – in other words, had all the symptoms, had the fever, had the shortness of breath, had the respiratory symptoms – and it took them a week or two to get better, that athlete can’t return to the playing field without a complete heart workup or a cardiac workup, because of the complications caused by COVID, such as an underlying myocarditis that might be there, which is basically an inflammation of the muscle walls, creating weaknesses among them,” he said. “We don’t want athletes to have episodes of sudden death. So after they recover from COVID, there’s a chance of an athlete having a sudden death episode if they had no complete cardiac workup for us to assess that.”

‘Good people will die’

Rai said the current lax attitude toward COVID-19 will cause people to die.

“Unfortunately, complacency has occurred,” he said. “There’s been social media and other media outlets and elected officials that for a variety of reasons feel that minimizing the morbidity, the mortality and the infection here is to someone’s advantage. I don’t know whose advantage that is, but unfortunately because of the attitude today, good people will die and good people will have long-term health consequences, all of which were preventable if we as society had done a better job.”

Rai said things became much harder to predict when the Safer at Home order was lifted by the Wisconsin Supreme Court.

“This is not a second phase. We’re still in the first phase. I think people need to understand that,” he said. “We were pretty worried at the end of May. We had recommended in healthcare and science, the CDC, the Department of Health Services, healthcare organizations, stood behind a phased reopening. What happens in a phased reopening is you test a situation, then you try to see if there’s spread, then you open up a little more and see if there’s spread, and you slowly make sure you have the virus contained.”

Rai said he can’t gauge where Brown County would fall in the Badger Bounce Back plan, proposed by the Gov. Tony Evers administration, because of the sudden reopening.

“It’s hard to know at this point, because we didn’t have a controlled opening,” he said. “Obviously with the positivities we’re seeing right now, if we start to see this trend continue this week, we would recommend more of a phase-one type situation, really limiting those large groups, maintaining physical distancing and then seeing if we can bend this curve.

“There’s a variety of things that are necessary right now. We need people to be smarter and wear a mask when they’re indoors and can’t physically distance, and we need more testing, not less testing, because of the percent of positivity being where it is.”

Rai said the easiest thing people can do to keep safe and prevent an economic setback is to wear a mask.

‘Irresponsible reopening’

He said businesses opening when they did will also have long-lasting effects on the health and safety of people as well as the economy.

“This (spike) was inevitable when you basically said it’s all open,” he said. “You have literally no control, and all that takes when it’s all open is a couple of matches to be lit in a very dry field and you’ll get a forest fire.

“That’s what we have going on right now, is you have multiple fires and it’s really hard to fight it. If you were to look back in April, we knew where our outbreaks were by zip code, by employer. Now it’s become so rampant because it was an uncontrolled opening situation, that it’s much harder to control it right now, and we need to because we don’t want the economy to go backwards, we don’t want to delay school starting, we actually want schools to start. So there’s a lot of economic implications to what I would say was the irresponsible opening of the state.”

With the recent climb in numbers, Rai said more testing is still needed.

“When people say we’re testing too much, and that’s why we’re having positives, that’s not true,” he said. “We’re probably not testing enough. The virus is outpacing our testing capability right now. When you start to see as testing increases in a community and the percent of positivity is increasing or increasing faster than that, you’ve got a problem at that point, and that’s the concern I think we’re all seeing – is the really bad situation we have right now is we are testing more people, yet the percent positivity is going up – which means the virus spread is outpacing our testing capability and we need to test more.”

On Monday, July 6, Prevea performed a record 987 COVID-19 tests across Wisconsin, the most its completed in a single day. CDC Photo

Prevea Health has also expanded access to free COVID-19 testing.

It now has 10 locations across the state of Wisconsin that offer testing, and this includes Prevea East De Pere Health Center in De Pere and Prevea Washington Street Health Center in downtown Green Bay.

Testing is available to anyone in Wisconsin experiencing any of the following COVID-19 symptoms:

• Cough.

• Shortness of breath or difficulty breathing.

• Fever.

• Chills.

• Repeated shaking with chills.

• Muscle pain.

• Headache.

• Sore throat.

• New loss of taste or smell.

Those experiencing any of the above symptoms and who wish to be tested must sign up on MyPrevea, which can be accessed at myprevea.com or downloaded as an app on Apple or Google Play.

People do not have to be an established Prevea patient to set up an account, on MyPrevea or to access a free test.

Those tested are able to access the results within two to seven days, at their own convenience, through their MyPrevea account which is safeguarded to ensure patient privacy and confidentiality.

Community members with further questions about free COVID-19 testing at Prevea Health locations may call 920-431-1810.