The Week in Context, 21Dec2020
Kansas COVID-19 Updates
You may have noticed that I haven’t talked about the White House Coronavirus Task Force (WHCTF) report from 13Dec, still. And the most recent one was issued yesterday (20Dec), so the 13Dec one is already out of date. A colleague at the Center for Public Integrity found out that the WHCTF no longer automatically sends the reports to the state governors. Instead, the governors have to request the document now. In any case, we do have the 50 states report for 13Dec now that covers all 50 states and the District of Columbia. There is a new section on the summary table page that indicates how many Kansas hospitals are experiencing staffing and supply shortages. That will be important as hospitals continue to cope with high levels of disease in Kansas due to COVID-19. Thirty eight percent of Kansas hospitals reported staff shortages and 33% of Kansas hospitals reported PPE shortages last week. We’ll see what the current week’s report shows when it is made available. And those alarmingly high numbers are improvements over what the WHCTF was tracking the week prior.
The World
Globally, the SARS-CoV-2 virus that causes COVID-19 disease has sickened >76.9 million people (+5.4 million since last week) and killed at least 1,694,700 (+81,600 in the past week) as of this morning.
The US is ranked in the second highest color category for hot spots. We are ranked #12 in the world for average daily case rate per 100,000 people over the past 7 days (last week, 8th) with a rate of 65.1 compared to 63.3 last week. The top five countries for average daily case rate per 100,000 in the past week are Lithuania, Liechtenstein, San Marino, Georgia, and Gibraltar.
For deaths, the US average daily death rate per 100,000 over the past week is 0.8 (previous week was 0.7), and we are ranked #21 in the world for this (last week we were ranked #25). The top five countries for average daily death rate per 100,000 in the most recent week are Slovenia, Liechtenstein, Croatia, Bulgaria, and San Marino.
The United States
As of this morning, there have been over 17.8 million cases (+1.5 million in the past week) and 317,800 deaths in the US (+18,472 in past week). Keep in mind that both of these numbers are probably an under-count of the situation in our country.
This week we see things have gotten better for parts of the Midwest, upper plains states and the Rocky Mountain states of Colorado, Wyoming and Montana. The top five states in the nation for average daily case rate in the past 7 days are Tennessee, California, Rhode Island, Arizona and Oklahoma. The top five states in the nation for average daily death rate in the past 7 days are Iowa, South Dakota, Rhode Island, Pennsylvania, and North Dakota.
There’s a new data resource available to us now from the federal government, called the COVID-19 Community Profile Report and it is a TREASURE TROVE of data for counties and cities. It is formatted in much the same way as the White House Coronavirus Task Force reports but provides far more data than the WHCTF reports. There is both a PDF and an excel file (this is the gold mine of data) of the report at the link above that you can download and review. They break the US into FEMA regions and you can find how your state is classified here. My Georgia readers are in region 4. Kansas readers are in region 7. Among the maps and graphs that the 20Dec2020 Community Profile Report provides is this map below of rapid riser counties. What you’ll notice is that the red counties (most rapid rise) are clustered in California and Tennessee. The upper Midwest and northern Plains states are relatively quiet, although there are some counties of concern in Kansas still, also. Instead, the counties of concern are mainly clustered in the coastal states and sunbelt. There’s more to discuss in this report and I’m thinking it may ultimately replace my analysis of the WHCTF reports, both because of the breadth and depth of the data provided and the fact that this is publicly available and does not require an open records request to obtain. I honestly wish we’d had this resource since the start of the pandemic.
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 that was last updated on 15Dec2020.
Next, let’s look at how seasonal influenza is impacting different states across the US. You can consult FluView any time you’d like to see this map and other data visualizations. You can read the weekly report from Kansas Department of Health and Environment here. The maps below show last year’s map for the 50th week of the year (left side) and this year’s map for the same week on the right side.
This week we see that Oklahoma has moved up into the moderate category. Overall, influenza activity is low in the US right now. Compare that to where we were a year ago for week 50 in the map on the left. The things we’re doing to limit the transmission of COVID-19 are also interrupting the transmission of influenza. Good job! Remember, it’s not too late to get your flu shot. Please do so, if you haven’t already.
Kansas
Here’s a look at how our major metrics are trending week to week as of Friday. Cases (in blue, correspond to left y-axis) are decreasing and so are hospitalizations (gray), ICU admissions (yellow) and deaths (red line).
We’ve had several really difficult weeks in Kansas but there are signs of hope. Among them is our decreasing percent positive rate. That’s despite the fact that Kansas is doing less test volume than weeks past, with a decrease in the most recent week of 8% according to that new Community Profile Report I referenced in the national section above.
The Harvard Global Health Institute risk level map for the state of Kansas is provided below. You can explore it further on your own here. The top 14 counties for average daily case rate are shown on the right side of the map. The top ten counties feature mostly rural and frontier counties (low population density counties). But there is one semi-urban county, Saline county.
Case rate per 100,000 residents is trending flat or small decreases over the past month. That’s definitely a welcome sign, but we are still experiencing a high rate of disease as we head into the week of Christmas. Urban counties are faring better than all other county types.
Thankfully, we’re seeing cases decrease across most age groups. The exception, however, is among children. Cases increased slightly for children aged 0-9 and held steady for those 10-17.
We are seeing mixed results, however for hospitalizations by age group in the most recent week. Many age groups saw a decrease. However, increases were noted for those 35-44, 55-74 and 85+.
The graph below shows the 7-day average death rate per 100,000 for the different county types in Kansas. You can check your county’s classification here. Whereas frontier counties (really sparsely populated) had the heaviest burden of death for much of the pandemic to date, rural counties have taken over that unfortunate leadership position. The state’s current death rate per 100,000 is 10.7 times higher than what it was four months ago.
So there are definitely positive signs for Kansas, even as we remain high-ranked among our state peers. However, I can tell you from experience following the progress of other states in the pandemic that this is the time to double down on the disease prevention strategies. If we have any hope of getting back to “normal” or anything close to it any time soon, then we need to bring our current level of disease much closer to where it was this summer. The vaccine is here and that is very, very exciting. But until we achieve herd immunity (~70% of the population immunized) then our non-pharmaceutical interventions such as masks and social distancing are the best ways we have to protect our communities.
References
https://www.coronavirus.kdheks.gov/160/COVID-19-in-Kansas
https://www.nytimes.com/interactive/2020/world/coronavirus-maps.html
https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html?name=styln-coronavirus®ion=TOP_BANNER&block=storyline_menu_recirc&action=click&pgtype=Interactive&impression_id=97ba8610-2dbb-11eb-a0bf-4f82d045d121&variant=1_Show
https://www.cdc.gov/flu/weekly/fluviewinteractive.htm
https://protect-public.hhs.gov/pages/hospital-capacity
https://beta.healthdata.gov/National/COVID-19-Community-Profile-Report/gqxm-d9w9
https://www.fema.gov/about/organization/regions
https://globalepidemics.org/key-metrics-for-covid-suppression/
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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.