From April 2020, New Orleans Health Department Director Dr. Jennifer Avegno in a homemade protective mask. (Michael Isaac Stein/The Lens)

New Orleans’ relatively high rate of COVID-19 vaccinations will not protect the local health system from becoming overwhelmed in the event of a statewide surge in infections, city Health Director Dr. Jennifer Avegno warned New Orleans City Council members at a Tuesday meeting. 

Avegno’s warning, delivered during a presentation before the council’s Community Development Committee, comes amid a recent uptick in COVID cases across the country. Currently, the CDC estimates that at least 60 percent of COVID cases in Louisiana are caused by the extra transmissible, virulent delta variant. But Avegno said that she believed that was a low estimate. 

“I think it’s the vast majority of cases in New Orleans,” she said.

At the meeting, Avegno also updated council members on the city’s efforts to restart its hotel shelter program, which began last year to safely house homeless city residents during the pandemic and ended in November. The federal government has denied a city funding request, she said. 

As of Wednesday, New Orleans reported an average of 49 new cases over the last 7 days, a sharp increase from June. That mirrors a statewide spike that public health officials are attributing to the delta variant.

The city’s average positive test rate has climbed to 4.5 percent, higher than at any point since mid-January, according to data posted on the city website. The city’s testing has declined significantly over the summer, although Avegno said that there’s still consistent demand at the free, National Guard-administered site at Mahalia Jackson.

In particular, Avegno highlighted reports of outbreaks at daycares and summer camps among children under 12 who are ineligible for the vaccine. While those cases among children are overwhelmingly mild, Avegno said that “they’re coming home, and spreading it to anyone else in the house.”

Outbreaks among children are especially concerning, she said, because regional children’s hospitals are swamped with outbreaks of seasonal illnesses, like respiratory syncytial virus (RSV) and norovirus, that would normally hit in the fall. Avegno attributed those surges to the end of masking and social distancing over the summer.

Experts generally estimate that five- to 12-year-olds will be eligible in September or October of this year.

The rapid spread of the delta variant among unvaccinated people has also increased the risk of breakthrough cases, Avegno said. Still, 99 percent of deaths in the state are occurring among those who haven’t been vaccinated — and the median age of those who’ve been hospitalized or died with a breakthrough case are 73, indicating that cases are happening primarily among those who are already at extremely high risk.

Those with unvaccinated kids or at-risk relatives, she suggested, “should strongly consider wearing a mask indoors” to avoid passing on COVID.

As of this morning, 68 percent of New Orleans residents over 18 have received at least a first dose of the vaccine. Among residents of all ages, 54 percent have received a first dose.

“We are at and above the national average, which is something to be proud of,” Avegno said. 

But there are significant geographic, racial, and age disparities within those averages. More than 80 percent of people over 60 have been vaccinated, while only 53 percent of those between 18 and 39 have been.

And, Avegno said, “we are continuing to see disparities in terms of race.”

About 69 percent of the city’s white residents have received at least one dose, while about 40 percent of black residents have. Currently, the city’s vaccination campaign is emphasizing door-to-door canvassing. Avegno said that recent efforts had targeted Central City and St. Roch, and that more new vaccinations were going to Black residents. The pace, she said, is “slow and steady, slow and steady.”

Although New Orleans’ vaccination rate is among the highest in the state, a COVID wave in undervaccinated areas of the state would impact the city’s hospital capacity.

“Nursing shortages statewide are real, and they mean that often, patients are transferred to our regional hospitals for specialty care from hours and hours away,” Avegno said at a press conference later in the morning. She said that a bed shortage in New Orleans hospitals has impacted the speed at which New Orleanians can receive emergency care.

FEMA

Avegno also provided an update on the city’s request to renew its hotel shelter program for unhoused people. During the height of the pandemic’s first wave, in the spring of 2020, the city housed hundreds of people in hotels using funding from FEMA.

That program was extremely successful. During its operation, 90 percent fewer people were living unsheltered on New Orleans streets.

But the program ended in November. This spring, the city requested FEMA funding for a new version of the program that would shelter people in hotels while they were vaccinated.

At the hearing, Avegno said that FEMA had denied the request, and that the program would likely not restart. According to the National Low Income Housing Coalition, city’s across the country have had trouble accessing or renewing programs this year because of a lack of concrete guidance from the agency.