Kansas COVID Weekly, 11Mar2021
Kansas COVID-19 Updates
I have some good news. I think that the pandemic is winding down enough in Kansas that this newsletter might no longer be needed. For those who have paid for your subscription, thank you ever so much! But I will turn off the paid subscription setting so that you will no longer be charged. If something changes and I need to resurrect this newsletter, I will be able to do so using the free sign up mailing list.
So today’s newsletter might be the last one for a while. You are welcome to follow along as I discuss the pandemic in my Georgia newsletter. Closing down the Kansas newsletter doesn’t mean that the pandemic is over, of course. But I think we are on a steady heading. If we keep doing what we’re doing and if vaccinations can pick up, then the state may have experienced its last surge in cases and deaths due to COVID-19.
A question I am asked often is when and how do we get back to pre-pandemic life. The key is that we get the disease burden down to something that doesn’t overwhelm our hospitals and doesn’t result in lots of death. We can get there through two mechanisms that shift in importance as time goes on. The first is non-pharmaceutical interventions (NPIs). These consist of all the things we’re tired of doing like wearing masks, social distancing, limited gatherings, proper ventilation. The second mechanism is immunity. We can get there through natural infection or vaccination. The US saw >500,000 deaths in a year and that was when we were trying to limit transmission. Even with >29 million cases (natural infection) in the US, we are nowhere close to herd immunity and we have >500,000 deaths to show for it. It’s far safer to get there through vaccination. The good news is that the vaccination numbers are improving every day. Kansas has a lot of room for improvement, but we will get there. Right now, because relatively few people are immune through natural infection or immunization, our primary tool against disease spread is the non-pharmaceutical interventions (NPIs in the graphic below). However, as more people get vaccinated, then the NPIs become less necessary. So if you’re tired of wearing a mask (as we all are), then get your vaccine as soon as you’re eligible and help those around you to do so also.
There have been just under 300,000 infections in Kansas (those who have natural immunity) and 284,796 people have been fully vaccinated. Combined, that means that 19.9% of the Kansas population has some immunity to COVID-19. Note: it is very likely that the number of infected is higher, but I’m going with what we know for sure in this example. But with about 20% of the population immune, we are somewhere between the first and second boxes in the graphic below. It’s actually a video, but Substack won’t allow me to place it here. If you click on the graphic below it will take you to the video. In the center of each box is a black dot that is meant to represent a sick individual. Blue dots around that black dot represent non-immune people. Yellow dots represent those who have immunity. When you click on the video to see the animation, you’ll see how disease can spread within a community depending on how much of that community is immune. Remember, Kansas is somewhere between the first and second boxes, but closer to the 2nd box.
What you’ll see when you watch the video is that the boxes where most of the dots are blue see disease transmit rapidly and overwhelm a population. The more dots are yellow, the less the disease has an opportunity to spread. Eventually, you reach a point that enough of the dots are immune that they shelter or protect those who are non-immune (blue dot). This is called herd immunity and it is our finish line for this pandemic. For COVID-19, herd immunity is estimated to be somewhere between 70-90% immunity in a population. So for now, Kansas and the US more broadly is very much still in the left side of the scales graphic I showed above. But hopefully by summer, we will reach 70% of the population with at least one dose of the vaccine on board. The reason I mention summer is based on the seasonal trends we’ve observed for COVID-19 surges. They tend to happen when climate makes people want to spend time indoors. So the heat of summer and the cold of winter are our points of vulnerability. So it is my fervent hope that we reach the bottom end of the herd immunity estimate by then.
Kansas is in decent shape to get there too. The US Census Bureau has done some surveys among those who have not yet received a COVID-19 vaccine, asking them about their likelihood to get a vaccine once it is available to them. The national average is 52.5% of respondents saying “definitely yes.” If you combine that with the portion of the nation that has already initiated the vaccination process (19.3% of the total population), then you can predict that the US is on track to reach 71.8% immunity. That’s just with the “definitely yes” crowd. We might be able to push that number higher as vaccination is normalized and people start to see the benefits of doing so. “Slow yes” or maybe might become “definitely yes” eventually. But the US is on a good path. For Kansas, 51.4% of respondents said they would definitely get the vaccine. So add 51.4% to 19.9% of the population already immune to COVID-19 and we are predicted to reach 71.3%. Again, we can drive that number higher, but it means giving people time and opportunity to ask their questions and address their concerns about vaccination (if they exist).
So the bottom line is that we need for people to continue to do the annoying things like wearing a mask, remaining socially distant, and limiting their gatherings or prioritizing them outdoors. Be sure to get your vaccine as soon as you are eligible and follow up if you’re getting the two-dose series (Moderna or Pfizer). You are considered “immune” 2 weeks after the final dose. There are 3 doses authorized for use in the US -Moderna, Pfizer and Johnson and Johnson. They all achieve the goal of ending the pandemic - they either prevent infection altogether or they reduce its severity to nothing more than the common cold. And honestly, I suggest you take whichever one is offered to you first. There really is no need to “shop around.” However, there are differences or tradeoffs between them. Johnson and Johnson’s advantages include a single dose (one and done!) and fewer side effects. However, with the Johnson and Johnson vaccine it’s possible that you may still get infected with COVID-19, but the symptoms will be mild - certainly nothing that requires a hospital stay like natural infection can cause. With the Pfizer and Moderna vaccines you are less likely to get infected in the first place. But they do require two doses which can be inconvenient and it takes longer to achieve immunity (5-6 weeks compared to 2 weeks for the Johnson and Johnson). In addition, these two vaccines are more likely to induce reactogenicity - the headache, fever, malaise, fatigue and other symptoms that are part of an immune response.
You can search for a vaccine at retail pharmacy locations using Vaccine Spotter. You can also search using the Kansas Department of Health and Environment tool. If I can answer questions about the vaccine to help you move from a “slow yes” or maybe to definitely yes, then please email me.
Some Kansas data
The graph below shows us how three of the four big metrics are trending (plus ICU admissions). The left y-axis is for cases and corresponds to the blue line. Everything else goes with the right y-axis.
We can see that cases have been descending since mid-November, albeit not always in a straight line. Deaths had an opposite trajectory, but they too have come down back to pre-surge levels. Hospitalizations and ICU admissions are also on the decline.
According to the most recent White House state report, Kansas has the following rankings:
#45 for new case rate per 100,000 (orange zone)
#28 for test positivity (light green zone!)
#38 for hospital admission rate per 100 beds (yellow zone)
#18 for new death rate per 100,000 (light red zone)
According to CDC data, Kansas has a surplus of 410,553 vaccine doses on hand that have yet to be administered. They don’t help us while they’re sitting in freezers. Hopefully the state can administer them more efficiently or expand eligibility soon.
Moving on to testing, Kansas has been below the 5% goal line for 17 days. By WHO standards, that means that Kansas has the pandemic under control (14 days is the threshold). However, this is not a finish line and the real challenge is keeping test positivity below 5% for the long term. Let’s work together to keep case rates and test positivity low until more of the population can be vaccinated.
The graph below shows how case rate per 100,000 has trended over time for different county types in Kansas. The state average is now 64% below the pre-surge baseline, so the state is doing really, really well. Let’s see this through to the end.
The death rate has not yet reached pre-surge levels but it is really close. It is really important that we continue to make good choices that protect both ourselves and our communities. It would be a shame to lose more people when we are this close to the end.
So thank you so much for being a reader. I hope that these newsletters have helped you to better understand the data and the trends for Kansas. Please don’t hesitate to reach out if I can help answer questions. Be safe and be well!
References
https://www.census.gov/data-tools/demo/hhp/#/?measures=GVR
https://www.coronavirus.kdheks.gov/160/COVID-19-in-Kansas
https://covid.cdc.gov/covid-data-tracker/#vaccinations
https://beta.healthdata.gov/browse?tags=covid-19-spr&page=1
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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.