Kansas COVID Weekly, 25Feb2021
Kansas COVID-19 Updates
Vaccine Update
Kansas is ranked #42 in the nation in terms of persons receiving at least 1 dose per 100,000 residents (last week #45). According to NPR, 12.6% of the Kansas population has received at least one dose of the vaccine and 5.5% of the population has received 2 doses. For reference, the national average is that 13.6% of the population has received at least one dose and the leader is Alaska, with 21.3% of its population vaccinated with at least one dose. Kansas has used 70% of its dose supply, ranking it #43 in the nation. What does all of this mean? It means that Kansas has a lot of room for improvement in its vaccination effort. Doses are limited across the country, of course. However, the state needs to be doing more to organize and administer the vaccines it *does* have available.
You can see the Kansas vaccine information page here. The Centers for Disease Control and Prevention COVID-19 Vaccine Data Tracker is also a useful too, but be advised that the Kansas numbers are only updated with them on Monday, Wednesday and Friday.
I’ve done some additional writing on the COVID vaccines recently.
An early look at the clinical trial data for the Johnson and Johnson COVID-19 vaccine that was released yesterday. We also have some early indications that the vaccines are working - we see a big drop in the number of deaths among long term care facility residents, even as deaths surged for the US.
A vaccine Q&A on the process of vaccine development (was it rushed this time?), how are the phases of eligibility determined, etc.
A vaccine Q&A on logistics including why two doses are needed, the importance of matching the same vaccine manufacturer, storage conditions, vaccine ingredients and the science behind them, what to do if you get exposed or sick in between doses, can a person who has already had COVID-19 get the vaccine, etc.
The White House state report for Kansas can be viewed in full here. The summary table is provided below. Kansas is mostly in the red and yellow zones with good improvement over the past week (see all the green in the second column). The exceptions are the test rate, which showed a big spike last week (-27%) and a 50% increase in hospitals reporting staff shortages.
Kansas has the following rankings within the US.
#13 for new case rate per 100,000 (light red zone)
#27 for test positivity (yellow zone)
#32 for new hospital admissions per 100 beds for COVID-19 (yellow zone)
#2 for new deaths per 100,000 (red zone).
Combined Data
The graph below shows us how some of our most important data points are moving over time using data provided by the Kansas Department of Health and Environment. Cases are represented by the blue line and correspond with the left y-axis. All other metrics (hospitalizations, ICU admissions, deaths) correspond with the right y-axis.
Cases have decreased a lot since Thanksgiving, but their descent has slowed down. In fact, they increased slightly in the past week. Hospital admissions and ICU admissions both increased over the past week. Deaths have declined after a big spike two weeks ago. I should note that all of these data points are based on date of report. The state of Kansas shows metrics by date of occurrence in its graphs, but it does not show us where newly reported cases/hospitalizations/deaths fit on that timeline as they are reported. So it’s possible that the spike two weeks ago was due to delayed reporting.
Overall, Kansas seems to be in a much better position than it was in November and December. However, the more transmissible variant of the SARS-CoV-2 virus has been detected in Kansas City wastewater. So it’s very likely that it is already here and potentially widespread. There is not a robust surveillance system in the US (or Kansas) to look for these variants. So the numbers we do have are just the tip of the iceberg. The variant is 40-80% more transmissible than the virus we’ve mainly seen so far in the US. That means that the people who ignore the public health guidance have a greater chance of transmitting the virus to others than they did a month ago. We have vaccines now (hooray!) but we aren’t administering them fast enough and the populations we’re targeting (mostly those >65 years of age) are not the ones who contribute the majority of the cases. So it’s really important to adhere to public health guidance until we get more of the population vaccinated.
Testing
The graph below shows us how Kansas is doing for tests performed (blue line, left y-axis) and the percent of those tests that are positive (red line, right y-axis) on a weekly basis. The goal line for test positivity (5%) is indicated by the gray, dashed line.
Test output has declined 60% in the past month. Kansas is ranked #32 in the country for tests performed per 100,000. So while the test rate has declined, it is declining for the rest of the country too. You can see what I mean in the graph below that compares the trend for Kansas to the US.
A lot of this is due to a shift from testing to vaccination at health departments. So far, that decline in testing output hasn’t corresponded with an increase in test positivity - this can happen when you aren’t testing widely enough. But the percent positive rate has slowed in its decrease. Either way, the state’s percent positive rate is now below the 5% goal line - exactly where we want it to be. The key is keeping it at or below that line for the long term.
Cases
In the past week there have been 4120 cases newly reported by the Kansas Department of Health and Environment. That’s an increase of 7.8% compared to the previous week. The 7-day case rate per 100,000 residents for the state is 30% below the pre-surge level, which is very good. The case rate is lowest in semi-urban counties and highest in urban counties. You can check to see your county’s classification here.
The map below comes from the Brown School of Public Health. It grades each county’s level of risk, based on the average daily cases per 100,000 over the most recent 7 days and is current as of Sunday. Risk is greatest for red counties and least for green counties. Around the beginning of the year, the entire state was red. Now, we see definite signs of improvement, especially for the western half of the state where many counties are now green (lowest risk).
Next, let’s look at where the most recent week’s cases are coming from in terms of age groups. The graph below shows 8 week timelines for each age group with the most recent week shown in maroon. One heads up, the “week” of 19-23Dec was a shorter week than usual so that week’s data are an anomaly.
Remember that there was a 7% increase in cases this week? This graph helps us see where they’re coming from. We see increases among 0-9, 18-24, and 45-74 year olds. There was a significant decrease in the “unknown” category. This is a holding spot for cases that are pending contact trace investigation and follow up. So seeing this number decrease is a good sign that the case load is manageable for the contact tracers in Kansas.
An interesting study came out yesterday from the Kaiser Family Foundation that assessed the cases and deaths that have happened in the prison population. Kansas has the third highest percentage, at 63% of the prison population in Kansas testing positive for COVID-19. Because this is a percentage of the state’s prison population, this isn’t an issue of “Kansas has more prisons.” It shows that Kansas is doing poorly compared to other states.
Hospitalizations
This week there were 187 newly reported hospital admissions compared to the week prior, an increase of 15%. The graph below shows us where those hospital admissions are coming from in terms of age group, over the past 8 weeks. I want to again remind you to not worry too much about the week of 19-23Dec because it was a short week.
Increases were noted for all age groups except 10 - 44 year olds. However, it is concerning that we are seeing increases among the older age groups, considering that they’re at higher risk of severe cases and death.
There were 50 new ICU admissions in the past week for COVID-19, an increase of 61% compared to the previous week.
Deaths
Using the HHS Community Profile Report (date 24Feb2021), Kansas has the 6th highest newly reported death rate per 100,000 residents in the country.
In the most recent week, Kansas has reported a net increase of 203 deaths, a decrease of 7% compared to the previous week. The graph below shows us how deaths have trended over time, adjusted for each county type’s population size. The statewide average is shown in the black line. You can check your county’s classification here.
The death rate for Kansas has been trending up over the past couple months, however we’ve seen a decrease recently. The death rate is highest in semi-urban counties and lowest in frontier counties.
We can also see where deaths are coming from in terms of age group in the graph below. Like the other demographic graphs, this shows 8-week timelines for each age group. This week we saw increases for those who are 25-34, 65-74 and 85+.
Another great report to come out from the Kaiser Family Foundation is that we’re starting to see the earliest impacts of the vaccine in long term care facilities (LTCFs). As you may recall, they were prioritized first for healthcare workers and residents of long term care facilities (LTCFs). As of 24Nov2020, LTCF residents accounted for 6% of the US cases but 40% of the US deaths from COVID-19. So I think it’s pretty easy for us to appreciate WHY they were prioritized for the first phase of vaccination. The graph below comes from the Kaiser Family Foundation. It tracks weekly COVID-19 deaths per week, for the overall US population and for the nursing home population. Vaccinations at nursing homes began 21Dec2020. And whereas the overall US population (minus the nursing home population) saw deaths increase 61% over the next seven weeks, they decreased 66% for those in nursing homes.
So there’s a lot of hope with data like this that the end of this pandemic is getting closer. In the meantime, it’s important that we continue to be careful to follow public health guidance until we’ve vaccinated enough people to bring cases down to manageable levels, hopefully for good.
Another vaccine is being considered for Emergency Use Authorization tomorrow, the Johnson and Johnson vaccine. So far, the clinical trial data indicates that the J&J vaccine might not be as good as the Pfizer and Moderna vaccines at preventing infection. However, it is just as good as the other two at preventing hospitalization and death. So more people might get infected following vaccination than those vaccinated with the Pfizer and Moderna vaccines, but their infections are far more mild than what the placebo group experienced. Remember, COVID-19 infections are mild for most people in this pandemic even without the vaccine. But there are people for whom it is far more intense, including previously healthy people. I think it’s a significant goal to make the infection (if it happens at all) mild for EVERYONE. Eventually, as case rates drop in our communities, then there would be even fewer infections for those vaccinated with the J&J vaccine. And if the only cases that happen are mild, then this becomes a much more manageable situation from a community stand point. We don’t disrupt society due to the common cold. If we can bring COVID-19 down to common cold severity, then a return to “normal” is a lot more attainable. The bottom line to me is that there is no need to shop around for the “best” vaccine. Please just get the first one that is made available to you.
That’s it for now. See you next week!
References
https://covid.cdc.gov/covid-data-tracker/#vaccinations
https://www.kansasvaccine.gov/
http://www.ipsr.ku.edu/ksdata/ksah/population/popden2.pdf
WHCTF report repository: https://beta.healthdata.gov/Community/COVID-19-State-Profile-Report-Kansas/scin-7ddt
https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html
https://beta.healthdata.gov/National/COVID-19-Community-Profile-Report/gqxm-d9w9
https://www.kcur.org/health/2021-02-24/dangerous-covid-19-variants-found-in-kansas-city-wastewater-even-as-restrictions-are-eased
https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2020-12/COVID-02-Dooling.pdf
https://www.kff.org/policy-watch/is-the-end-of-the-long-term-care-crisis-within-sight-new-covid-19-cases-and-deaths-in-long-term-care-facilities-are-dropping/
https://www.kff.org/coronavirus-covid-19/issue-brief/key-issues-to-watch-for-justice-involved-populations-covid-19-vaccines-medicaid/
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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.