COVID-19 in Kansas, 25Nov2020
Kansas COVID-19 Updates
Good evening! Before I begin, I just want to wish everyone a restful Thanksgiving. I know this year’s celebrations likely look and feel very different compared to past years. It is my hope that we can celebrate what we have and look forward to more “normal” in the future. Today we’ll be doing a deep dive on the most recent White House Coronavirus Task Force (WHCTF) report and some of the latest data from the Kansas Department of Health and the Environment.
Be prepared for the case numbers to stall this week as we have the Thanksgiving holiday. Testing centers and laboratories will likely have reduced hours, if they’re open at all, and reporting will be delayed. Then, we need to be prepared for really large increases in numbers next week as the backlog of specimens are processed and reported. Some of that increase will be real, there’s a lot of momentum for the virus right now, but some of the increase will be an artifact of the holiday impact.
First, here’s the summary table from the latest report, which you can review in its entirety here. There’s a new color coding scheme with three shades of red now, to better describe the extremely high numbers in some of the states, including Kansas. There’s also a new row at the bottom for COVID-19 hospital admissions.
There are two interesting notes in the recommendation section:
“This is the first week where the rise in cases is less than previous weeks. COVID-related hospitalizations will continue in the coming weeks; however, with increased strong mitigation cases could decline to the yellow zone within 4 to 5 weeks, like in states that strongly mitigated during the summer surge.”
If our rise in cases continues to decrease each week, then we might cresting this peak and that would certainly be welcome news. Of course, that would assume that we don’t have Thanksgiving this week, and unfortunately there may be enough people ignoring the public health recommendations that we have super spreader events across the country.
Here’s their note regarding hospitalizations:
“New hospital admissions in Kansas are increasing across all age groups; investigate the rise in new admissions in those under 18 years old.”
Testing
The test rate per 100,000 residents for Kansas is declining, for the past two weeks. Usually, as the pandemic grows, you want to test more, not less. That’s because you’re responding to people who are symptomatic who need to be diagnosed, but also because your contact trace investigation workload increases, offering testing to each of the close contacts for each identified case. So as the number of identified cases grows, the number of tests should also rise. It’s therefore not a great sign to see testing decrease this way. The national test rate is increasing and the rate for Kansas is 61% less than the national rate. It is possible that part of this decline is the result of a shift to the antigen test, since this graph only measures PCR-based testing. If that’s the case, perhaps Kansas is doing a lot better at testing its population than this graph would suggest.
PCR test positivity is considered alongside case rate. Case rate per 100,000 tells you how intense disease is in a given area. The positivity rate indicates how much of the case rate might be an under count. The higher the percent positive rate, the more likely we are not testing widely enough to identify cases. Those who go unidentified unknowingly contribute to ongoing disease spread. The positive rate for Kansas and the US is shown below over time.
The percent positive rate for Kansas is more than twice as high as the national rate but it is now slightly lower than last week, a good sign. However, Kansas is ranked #4 in the nation for percent positive rate. We have a long way to go to get back to the green zone.
Cases
The Kansas case rate is 88% higher than the national rate. But as the WHCTF noted, the increase in the most recent week is less than we’ve seen in past weeks. That’s really good news. It might be a sign that we are flattening the curve. We’ll have to see what happens in the coming weeks. Even if this is a flattening of the curve, we need to continue to be diligent about wearing masks, social distancing and avoiding transmission opportunities. Because it takes a lot of collective work to bring disease transmission rates back down to baseline or pre-surge levels.
This leveling in the statewide rate is explained by the leveling observed for urban, semi-urban and densely-settled rural counties in the state. However, the disease rates on in rural and frontier counties. You can check to see how your county is classified here.
Most of the state is in the red zone. The counties that aren’t had too few cases to be shaded in this map.
The proportion of red zone counties have grown over time.
Kansas is ranked #12 in the nation when it comes to new case rate per 100,000 residents over the past week. The national map is shown below.
Hospitalizations
This is the graph that the WHCTF was referring to in the quote I provided in the introduction today. This graph shows the total weekly COVID-19 hospital admissions where each week gets its own bar. The colors correspond to age groups. The darker shade of each color represents confirmed cases - those who already have laboratory results confirming COVID-19 prior to hospital admission. The lighter shade of each color represents suspected cases - those whose symptoms are similar to COVID-19 but who are awaiting laboratory results at the time of admission.
The WHCTF pointed out a big jump in the number of new COVID-19 hospital admissions that are taking place among children under the age of 18. Hospital admissions stayed relatively flat for those 18-39 (orange) but all other age groups saw a big expansion. Of course, things have escalated rather dramatically since early October.
The summary table in the WHCTF report (shown in the introduction of today’s post) includes a new row that compares the total new COVID-19 hospital admissions to the past as well as to the national rate. The Kansas rate of admission per 100 beds is 27 and this is a 25% increase over the previous week. Meanwhile, the Kansas new admission rate is 42% higher than the national rate.
Deaths
The death rate has been doing a weird fluctuation each week, but the overall trend is an ongoing increase. At present, the death rate in Kansas is 80% higher than the national rate and Kansas is ranked 13th in the nation. So as bad as this looks, it is even worse for 12 other states.
To sum things up, there seems to be some good signs in the data, but our percent positive rate is still very, very high. And no matter what the data show now, if Thanksgiving gatherings do lead to a dramatic increase in cases, then it doesn’t matter what the data show this week. As mitigation efforts appear to be in the early stages of improving case rates in more populated counties, we need to do more to achieve the same success in rural and frontier counties. That’s it for today. Happy Thanksgiving!
References
WHCTF report for Kansas was provided by the Kansas Department of Health and Environment through an open records act request and then submitted to the Center for Public Integrity. Many thanks to both organizations for making this document available to the public. https://beta.documentcloud.org/documents/20416388-kansas-11_22_20
http://www.ipsr.ku.edu/ksdata/ksah/population/popden2.pdf
https://www.coronavirus.kdheks.gov/160/COVID-19-in-Kansas
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My Ph.D. is in Medical Microbiology and Immunology. I've worked at places like Creighton University, the Centers for Disease Control & Prevention and Mercer University School of Medicine. All thoughts are my professional opinion and should not be considered medical advice.