This story was updated at 11:51 a.m. on Nov. 13, 2020, to include comments from local hospitals.

A higher percentage of people under 30 years old have been admitted to hospitals with COVID-19 than during Montgomery County’s first surge during the spring.

Dr. Travis Gayles, the county’s health officer, said during a media briefing on Thursday that the increase was of importance because of the perception that young people are less likely to have symptoms and complications from the virus.

“‘Less likely’ doesn’t mean zero chance,” he said.

Hospitals in the county have reported there have been increases in the past week of Covid-related emergency room visits, intensive care patients and acute care bed usage, Gayles said.

“We have met with our hospital leaders this week to dust off, if you will, our surge playbook that we used early on in the pandemic,” he said. “They are ready to go and we are ready to go to continue to provide them support. We will continue to address any challenges that they may have in terms of dealing with any individuals who are coming into the hospital setting.”

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At least one medical facility in Germantown was in the “red zone” for capacity related to their intensive care unit beds on Tuesday, Gayles said, and only had one available ICU bed.

In the first wave of the pandemic in the spring, a greater percentage of COVID-19 patients who required hospitalization were 40 or older, he said.

“So far, in the early stages of this increase, it has been primarily a more diverse age distribution in comparison to the first wave,” Gayles said. “I still think it’s too early to tease out any other demographic trends.”

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The county is investigating a Halloween party hosted in Montgomery County by students from a non-public school in Washington, D.C. where more than 30 county residents attended, Gayles said. Of those students who are county residents, more than 15 have tested positive for the coronavirus so far.

“We’re continuing to conduct the investigation to find out more information and get a whole sense of what exactly transpired and what happened in that setting to enhance transmission, in addition to the fact that it was a party held that potentially. … violated a number of our guidelines,” Gayles said. “Once we have completed that investigation, we will take the necessary action according to the regulations.”

Dr. Earl Stoddard, executive director of the county’s Office of Emergency Management and Homeland Security, said during the briefing that emergency medical service (EMS) transports have seen similar increases in younger people with suspected COVID-related illnesses. There are around 25 people transported each day under those conditions, he said.

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Stoddard said the county is concerned that the increase in cases will mean an increase in deaths as well.

On Tuesday, the county cut capacity from 50% to 25% for restaurants, bars, bowling alleys, fitness centers, museums and art galleries, retail shops, religious facilities and personal service businesses.

The gathering limit was also reduced from 50 to 25 people.

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If conditions continue to worsen, the county might consider shutting down certain businesses, according to Stoddard.

“We’re going to need seven to 10 days to evaluate the impacts of the first measures , really understand what will happen next. … Our first goal was to not do any closures of any particular industries but rather to focus on the capacity limits and that’s what we’ve done in the executive order,” he said. “The second round, as it were – we do not want to have to do it, but if we did do it, we would have to consider targeted closures of particular businesses or industries where we’ve seen a higher correlation in terms of contact tracing data and where there are gatherings [that] are larger and/or involve no use of face coverings and things like that.”

The county has an inventory of more than 13 million masks and 50 ventilators, which will be distributed to hospitals if they run out of available ventilators, Stoddard said .

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“Back in the spring, there were a few cases where we had to rapidly move ventilators around because the number of ventilated patients at some of the hospitals did exceed the number of ventilators they had,” Stoddard said. “We had to actually move some of our transport ventilators to fill that gap. We feel like we’re in a much better position with the ventilators that we have in Montgomery County now than where we were in the spring.”

Both hospitals and nursing homes have been building their own stockpiles of equipment and supplies , Stoddard said.

“The county is a backstop to those organizations, meaning if they cannot acquire or run out, for some reason, [of] PPE (personal protective equipment), we are not going to allow them to be without PPE,” he said. “In the spring, we started this event with very little PPE and had to sort of provide what we could in all cases.”

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Kristin Feliciano, a spokeswoman for Holy Cross, wrote in an email to Bethesda Beat Thursday night that the increases of coronavirus hospitalizations remain manageable. Holy Cross has two hospitals in Germantown and Silver Spring.

About 30% of the COVID-19 patients at the two hospitals need ICU beds, she wrote.

“This is a different mix than in the spring at the height of the first wave where use of ICU beds was much steeper,” she wrote. “We have experience, great doctors and staff and new medications and hope that the trend for lower acuity illness continues.”

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All patients are tested for COVID-19 when admitted. All staff members, visitors and patients are screened for temperature and asked about their interaction and travel when entering the hospitals. The two hospitals have increased their cleaning protocols.

In-patient suites, operating rooms and birthing suites are all roughly at pre-pandemic levels for Holy Cross, according to Feliciano.

Taylor Kelley, a spokeswoman for Adventist HealthCare, sent a statement to Bethesda Beat on Thursday afternoon that Shady Grove Medical Center in Rockville and White Oak Medical Center in Silver Spring have had a “small but noticeable increase” in coronavirus-related hospitalizations compared to recent months.

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“Our numbers are similar to the uptick we saw at the end of the summer. … The team continues to plan for additional staffing, personal protective equipment and other needs that may arise as the number of patients increases,” she wrote.

Liz Vandendriessche, a spokeswoman for Johns Hopkins Medicine, wrote in an email to Bethesda Beat on Thursday evening that hospital staff members are “working around the clock to ensure we are able to accommodate worst-case scenarios related to anticipated patient volumes.”

Johns Hopkins Medicine operates Suburban Hospital in Bethesda.

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“That includes rethinking existing patient care spaces and devising innovative approaches in our efforts to provide the best possible care to the largest number of people who needs us,” she wrote.

The county reported 177 new confirmed COVID-19 cases on Wednesday morning — the ninth straight day of 150 or more new cases.

The county has now had a total of 28,146 known cases and 860 deaths from the virus.
As of Wednesday afternoon, the county’s test positivity sat at 4.3% and had about 19 cases per 100,000.

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According to Gayles, 20 of Maryland’s 24 jurisdictions had case rates greater than 10 per 100,000 on Wednesday. Of those 20, 10 had case rates greater than 20 per 100,000.

Briana Adhikusuma can be reached at briana.adhikusuma@bethesdamagazine.com.