Three years later: Taking a look back at the COVID-19 pandemic in Lamar County

And in March, everything changed.

It was March 11, 2020, when the World Health Organization declared COVID-19 a pandemic. Extended spring breaks became indefinite virtual school; restaurants and businesses closed; grocery store shelves were bare. People stayed home, quarantined, practiced social distancing and ceased travel.

In the midst of drive-through gatherings and visits divided by windows, citizens looked to find a new normal.

The first confirmed case of COVID-19 in Lamar County was reported on March 19 of that year. On April 29, news broke that the first COVID-related death had occurred.

By the end of 2020, Lamar County had over 4,000 total cases of the virus. By that time, Texas had 1.7 million.

Three years after COVID-19, Dr. Amanda Green, chief medical officer at Paris Regional Health and health director of the Paris/Lamar County Health District, reflects on the effects the universal pandemic had on health care, its political implications and what measures are needed to continue treatment and prevention.

“Looking back on the time of the COVID pandemic, as a health professional there are a few things I wish we had done differently as a country,” Green said in response to an email inquiring as to her thoughts on the pandemic, which first hit Lamar County in March 2020 and was in full swing a month later.

“We didn’t know that April 2020 was going to be one of the lowest months in COVID infections,” Green said. “We had a new virus, compared to the bird flu, and the idea that if we kept everyone home for a few weeks the virus would not spread and would die out of the population was a good one. However, with not everyone able to quarantine, and certainly not on an international level, it was a waste of economic risk. The anger by some members of society in reaction to the required shutdown and quarantines caused inappropriate negative reactions to the good ideas that followed.”

Although masking around groups of people indoors has been shown to be a good measure to reduce viral spread, Green noted that there were no controlled trials on masking at the beginning of the pandemic and some argued there was no proof of efficacy in masking.

“Many good studies on masking were done throughout the pandemic, and we have proof that masks work,” Green said.

Green cited controversy concerning vaccines, noting that there was hesitation by people to use vaccines created through modern technology in a comparably brief period of time compared to earlier vaccines although those vaccines were found to be low risk with high effectiveness to prevent infection, and with even more success in preventing death.

Response, lessons learned

“Most of us in healthcare feel that the harm with no hospital/nursing home/etc. visitation policies while we were in our highest Covid infection hospitalization times probably was not worth the benefit,” Green said. “We may have prevented some infections to our vulnerable hospital population, but I think that the emotional toll on patients, families and our health care team was too high.”

Because of COVID, many therapeutic ideas and medications have become available, but the most important outcome in how someone responds to the disease has been their underlying risk factor, Green noted.

“We have had many therapeutic ideas roll out – monoclonal antibodies, convalescent antibodies, various vitamins, veterinary medicines, antidepressant medicines, Remdesivir, steroids, prone positioning, different ways of giving oxygen,” Green said. “Not many treatment options have ended up showing much difference in studies. The most important outcome in how someone responds to this disease has been their underlying risk factors (overweight, high blood pressure, diabetic, genetic factors) and vaccination status once that was available.”

Where are we now?

According to Green, Lamar County’s infection is rated as low while Paris Regional Health continues to admit one to three Covid patients daily. Hospital personnel still use appropriate protective gear and protocols, and hospital visitation has returned to pre-Covid. Masking is still recommended in clinical spaces and in large crowded areas, especially if a person has symptoms that might be Covid, Green said.

Quarantines of five days from positive tests are still applicable, with the person wearing a mask when around other people for the next five days. Covid vaccinations are still recommended. The new mRNA technology proved highly successful and is to be used for the development of future vaccines, Green said.

For persons who have never received a vaccine, having the initial two-vaccine series, six months apart, is recommended. If a person has had the two vaccines, and even another booster of the same type, the bivalent booster is recommended six months after those vaccines, or six months from the last Covid infection.

“The bivalent booster is excellent for at least six months in preventing Covid infection from the variants that are circulating now, and still has the benefit of nearly eliminating hospitalization due to Covid,” Green said. “It does not have the arm pain and tired feeling after vaccination that the first series of shots had for many of us.”

Green noted that many patients do not have symptoms with infections from the COVID variants that have been circulating for the last year, but many do have severe flu-like illness, with older patients requiring hospitalization for a low-oxygen viral pneumonia.

“These recent variants do not seem to cause the deep scarring of the lungs that we had with the early two Covid waves, where ventilators often couldn’t even help,” Green said. “Covid is still the cause of death of 3,200 Americans a day - more people are still dying daily than died on 9/11. Our older population continues to bear the risk for this disease, with the majority of deaths in patients older than 70.”

“We do have a few treatments with some data for improvement, but these benefits tend to be low,” Green continued, adding that health professionals continue to use the few treatments that have any positive benefit to include Paxlovid for outpatients with new Covid infection and risk factors, steroid in patients who have low oxygen, and immunosuppressant medication for hospitalized patients.

Patients with post-COVID infections, or Long COVID, continue to challenge providers.

“There are some large centers enrolling patients, but no treatments have shown any improvement yet,” Green said. “Allowing 6-12 months seems to result in improvement in some symptoms.”

What is next?

“We seem to have reached a current steady state,” Green said. “This virus continues to mutate and is still extremely infectious. Avoiding infection should continue to be the goal. Masking and the vaccine have shown to be the best tools to avoid infection and is the best way for the community to do their part to continue to get past this terrible chapter in world history.”

She added, “The Paris and Lamar County health care system continues to be vigilant and ready to support our community through whatever illnesses present.”