The Week in Context, 16Nov2020
Kansas COVID-19 Updates
The World
Globally, the SARS-CoV-2 virus that causes COVID-19 disease has sickened > 54.6 million people (+3.9 million since last week) and killed at least 1,320,100 (+59,300 in the past week) as of this morning.
The US is ranked in the top color category for hot spots, where the dark red represents counties with >14 average daily case rate per 100,000 for the past week. Noticeable changes in this week’s global map is that things have intensified in Canada and Russia. Canada was doing really well for a long time. But October 11th was Canadian Thanksgiving. So just understand that even a country that is doing everything right can have a major escalation of disease when people gather. In the US, we are not doing everything right and our amount of disease is greater than Canada was experiencing prior to their Thanksgiving holiday. The entire European continent is shaded dark red with the exception of Norway, Finland and Belarus. We are ranked 23rd in the world for average daily case rate per 100,000 people over the past 7 days (last week, 31st) with a rate of 45.3 compared to 33.5 last week. The top five countries for average daily case rate per 100,000 in the past week are Montenegro, Luxembourg, Andorra, San Marino, and Georgia (the country in Eurasia).
For deaths, our average daily death rate per 100,000 over the past week is 0.3, the same as last week, and we are ranked #41 in the world for this (last week we were ranked #39). The top five countries for average daily death rate per 100,000 in the most recent week are Czech Republic, Belgium, Slovenia, Bosnia and Herzegovina, and Montenegro.
The United States
This week we see escalation of disease rates for the Colorado front range, the entire west coast and in the midwestern states of Ohio, Michigan, Indiana and Kentucky. In the south, we see increases for Louisiana, Mississippi and Alabama.
As of this morning, there have been over 11.1 million cases (+1 million in the past week) and 246,083 deaths in the US (+7,837 in past week). Keep in mind that both of these numbers are probably an under-count of the situation in our country.
The top five states in the nation for average daily case rate in the past 7 days are North Dakota, South Dakota, Iowa, Wyoming and Wisconsin. The top five states in the nation for average daily death rate in the past 7 days are North Dakota, South Dakota, Montana, Wisconsin and Wyoming.
I’m changing up the format for this week’s comparison of rates and rankings. The table below tells you where we are this week and how that compares to the previous week (in parentheses). The data for everything but the percent of inpatients with COVID-19 comes from the New York Times coronavirus tracker and is current as of this morning. The hospital data comes from the HHS Protect Public Data Hub and was last updated on 11Nov2020.
Here’s a look at how COVID-19 is contributing to hospital admissions. The map below shows how many inpatient beds in each state are occupied by COVID-19 patients.
Next, let’s look at how seasonal influenza is impacting different states across the US. This week Iowa jumped from Moderate to Very High. Things also ticked upward for North Dakota, Idaho, New Mexico and Oklahoma. Things are steady among the other states in the US this week. You can consult FluView any time you’d like to see this map and other data visualizations.
Kansas is in the top shade of the minimal category. Keep in mind that influenza is not a mandatory notifiable disease for public health departments like COVID-19 is. But there is a robust surveillance network for tracking trends. So we aren’t likely to see case counts and death counts like we do for COVID-19 because we are seeing estimates for influenza rather than actual numbers. Both diseases feature a wide spectrum of disease severity that can make it hard to identify all cases. You can read the weekly report from Kansas Department of Health and Environment here.
Another graph offered by the FluView resource is this updated look at deaths due to three things that look at lot alike - pneumonia, influenza and COVID-19. In the past, all we’ve seen is the black and red lines that show the epidemic threshold and percent of deaths due to pneumonia, influenza or COVID-19. Even that piece alone shows us the three surges we’ve seen so far with COVID-19, with the greatest amount of death so far associated with the first surge that impacted the northeast (especially New York City). The second surge was ours in the south. The third is ongoing and for now it looks smaller, but this is an artifact of the reality that death reporting can be delayed by as much as 8 weeks. We should expect this number to rise, due to better data reporting and also just because with our surge in cases nationwide we should expect a surge in deaths to follow. You’ll note that I use the word “surge” and not “wave”. If we were experiencing waves, then the trough of that wave would dip back down to the epidemic threshold. But we haven’t ever had a time that we had COVID-19 under control.
The new features of this graph are the deaths coded as influenza and those coded as COVID-19. These codes come from the death certificates themselves. You’ll notice that COVID-19 is causing far more PIC deaths than influenza has historically.
Lastly, I’m not sure when CDC started offering these data on cases and deaths in correctional facilities, but I wanted to share this. If you click on the map below, it will take you to the site where you can interact with the data.
Kansas
Here’s the latest map from the Harvard Global Health Institute for the state of Kansas. You’ll notice that most of the state is filled in red, the most intense category. there are only three counties in the orange category and one in the yellow category.
Next, let’s look at where outbreaks were recorded last week compared to the previous week. The top sources of outbreaks last week were long term care facilities, private businesses and schools.
But, those settings aren’t necessarily where the most outbreak-associated cases came from. The top three cluster settings for cases are corrections, long term care facilities, and schools.
For hospitalizations, the top three cluster settings are long term care facilities, religious gatherings and private events. For deaths, the top three cluster settings are, again, long term care facilities, religious gatherings and meat packing facilities.
Cases increased across all age groups last week. The next two graphs show how hospitalizations and deaths have trended over time for each age group.
Hospitalizations increased for the age groups of 0-9 and 35-54. But they increased most dramatically for those aged 65-74, it’s an age group in which you don’t want to see increases.
More broadly, this next graph shows how many currently occupied ICU beds are occupied by COVID-19 patients. You’ll see that this percentage has steadily increased. And in three weeks’ time, the percentage has doubled. This rate of increase isn’t sustainable. We need to limit cases to limit burdens on our healthcare infrastructure.
Looking next at deaths, there were decreases for many age groups (thank goodness). But this most recent week did see increases for those 45-54 and 65-74.
Remember, we each have the opportunity and responsibility to save lives here. Limit your exposures by avoiding indoor interactions with anyone who lives outside of your household. Wear a mask when you’re around others who don’t live with you. Keep a distance of 6 feet between you and others. And if you have any symptoms, even things you might attribute to seasonal allergies, then stay home.
References
https://www.coronavirus.kdheks.gov/160/COVID-19-in-Kansas
https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html
https://www.nytimes.com/interactive/2020/world/coronavirus-maps.html
https://protect-public.hhs.gov/pages/hospital-capacity
https://www.cdc.gov/flu/weekly/index.htm
https://globalepidemics.org/key-metrics-for-covid-suppression/
https://covid.cdc.gov/covid-data-tracker/#correctional-facilities