Trotter starting to see light at the end of the COVID-19 tunnel

Dr. RC Trotter sees his community’s COVID-19 battle as one that’s slowly being won.

Since the first cases started appearing in Dodge City, Kansas, Trotter, who is the Ford County physician adviser in addition to being a doctor at Family Practice Associates, said there’s been some ebb and flow. In 2020, there was a lot more testing being done, and there were more than 200 tests being done a day.

“We were just really getting a handle on who had it and trying to keep everybody safe,” he said.

At the time, there were a lot of cases in the beef packing plants, and according to Trotter, it was because employees often are members of the same household or family.

“That’s why it was there,” he said. “It’s kind of like living in New York. You live on top of each other and you work together.”

By summer 2020, positive cases in Ford County were down to single digits daily, and Trotter felt it was safe enough to put on the Dodge City Roundup Rodeo, of which he has been president of since 2003.

“There was not a surge after the rodeo,” he said. “There has been a surge obviously with school reopening and the cases were pretty much all over town.”

The packing plants have limited cases now, and around Nov. 30, 2020, the number of positive cases had dropped off some.

“We’re down to around maybe 40 cases a day, sometimes 27,” Trotter said. “You know, it peaked up a little bit because school’s open, the college is open. Kids we’re getting the disease, bringing it home to the parents.”

All in the numbers

Infections started to slow some during the holidays, but he expects the numbers to go up again in January because of children going back to school.

“We’ll just have to see after everybody gets back into school, and see where the numbers going,” he said. “Right now if you look at KDHE the most recent number was three, but then that was Jan. 1. On Dec. 30, 2020, there were 19 cases reported. So, we’re on a downward trend right now.”

Trotter isn’t seeing nearly the number of positives at his office compared to the peak, but they’re also not testing nearly as much either.

“Each one of us at that time had a whole afternoon—that’s all we did behind our office and now it’s kind of sporadic,” he said. “So it’s slowed down in terms of cases.”

At the hospital in Dodge City, Trotter said it was hard to measure because some days the patient number was low and they didn’t have anyone, but yet other days they were full.

“So obviously it waxes and wanes in the hospital, and it was filling up the beds,” he said. “Then the biggest problem with the COVID in the hospital is—any normal illness in the hospital, the average length of stay is 3.5 days. COVID patients are a couple of weeks, two to three weeks.”

So once the beds are starting to be used for treating COVID patients, they start using a lot of resources—ventilators, nursing staff, etc.

Vaccination process

Officials in Ford County have also been able to vaccinate healthcare workers with one round of the vaccine. Others are waiting for their second round. Trotter said with the Pfizer vaccine after the initial dose the second comes at 21 days. With Moderna, the second dose comes at 28 days. He polled a lot of health care workers and said there weren’t really any side effects yet reported.

“At this point there is a limited supply,” Trotter said. “Phase one is health care workers and trying to get to them.”

After the health sector has been vaccinated and there are more supplies, the general public will get their turn.

“We haven’t gotten anything here at the office in terms of vaccine,” Trotter said. “I know that Walgreens nationwide has a contract, CVS does, so eventually we’ll be able to roll it out like we did with polio and some of those things.”

Until the vaccine arrives and those who need vaccinated get it, Trotter encourages people to be patient and keep doing all the social distancing measures they have been doing.

Trotter has been in touch with Kansas Department of Health and Environment Secretary Lee Norman and he said KDHE hasn’t advised him of any plan for the vaccine roll out or priority for those who should get it.

“More than likely I’m going to guess that the health department will get it first and then they will prioritize it in terms of age and comorbid conditions,” Trotter said.

Ford County Health Department officials don’t have any concrete information as to how many doses they’re going to get after the first round is complete.

“So, yes, there will be a plan,” he said. “Can I tell you what it is? No, I can’t.”

Self restraint important

For those people concerned about themselves or others with medical conditions or in high risk age groups, Trotter suggests to keep doing your usual activities in terms of mask wearing and self distancing, and he himself has made some tough choices when it came to attending certain events or not.

“People see me places, but that’s because I pick and choose those that I think are necessary for Mary and I to be at and those that we can bypass this year, which we did,” he said. “We spent Thanksgiving alone.”

Many others limited their travel during the holidays because of COVID-19, but Trotter expects there to be an increase in cases because of school returning to session. Even when fully vaccinated, there will be an interval of three to four weeks for antibiodies to develop. He’s concerned with people’s actions after they’ve gotten vaccinated.

“That’s a concern that we have—that the people will get shots, you’re going to get cocky and stop wearing masks and doing things that they should,” Trotter said. “My advice to them, yes, you will be developing antibodies pretty quickly within probably two to four weeks.”

But those vaccinated aren’t bullet proof and studies have shown the vaccinated will carry those antibodies for “quite some time.”

“Don’t walk around with a ‘big V’ on your forehead so that you don’t have to wear your mask to social distance,” he said. “Just show some caution. Show some respect to other people.”

Flu also on people’s minds

Speaking of vaccines, media reports that the number of flu cases are down, and some suspect it is because many more people are getting vaccinated for the flu.

“We can all assume that maybe if we’ve been wearing masks last year we wouldn’t have had as much flu,” Trotter said.

He believes by June or July health officials will be able to determine what the flu rates truly were.

“It’s interesting to speculate that we’ll have a lower flu rate, simply because we have more advanced social distancing and certain things,” he said. “I don’t know that our flu vaccine rates are up. I haven’t seen data to really know. I know we tried to get as many in the office as we have to see how it plays out we’re kind of early into the flu season.”

Don’t jump to conclusions

Trotter said treatments have varied for those caring for COVID patients, and recently the use of Ivermectin has been making the rounds on the internet and news cycles. Most commonly Ivermectin is used to treat livestock for parasites, and for Trotter, whose undergraduate degree is in pharmacy, it’s concerning when there’s use of medicines without prescription or in a different way than labeled. Medicines also need to be manufactured in a certain way to ensure high standards and have some scientific data available.

“The bottom line is it hasn’t been studied that it is intended for human disease,” he said. “From a physician perspective, unless it is CDC recommended, FDA approved, we couldn’t say that it was worthwhile to do. People will do whatever they want.”

Trotter can’t recommend or endorse something in good conscience that hasn’t been fully studied.

Dodge City was in the news during the end of 2020, but despite all the press being directed toward his town, Trotter hasn’t wavered in his appreciation for those in the community who have been on the front lines.

“On one thing I’ve totally been impressed with is our hospitalist. Their expertise in the hospital was just phenomenal,” he said. “They were on top of everything using the latest stuff like remdesivir, convalescent plasma, starting people on anticoagulants on admission, and then upping the dose if need be. So they did an excellent job in our hospital and we had a very low death rate.”

The Ford County Health Department has been dealing with all their regular duties as well as COVID testing.

“I just had to deal with a TB patient—that’s the kind of thing we’re usually used to in county health,” Trotter said. “They’re still taking care of all the normal day-to-day activities plus all the COVID activity, so they’re working hard. The offices are doing a great job.”

Kylene Scott can be reached at 620-227-1804 or [email protected]. Jennifer M. Latzke can be reached at 620-227-1807 or [email protected].