The Week in Context, 30Nov2020
Kansas COVID-19 Updates
I want to begin today with a reminder that the data for the past week might not reflect reality very well, with laboratory closures and reporting delays over the Thanksgiving holiday. There are things that look really promising in the data and things that don’t. But I think we need to get to the later part of this coming week to see how much of this is due to delayed reporting.
A second reminder, if you traveled for the Thanksgiving holiday, ate inside a restaurant, or gathered with non-household friends or family indoors, please plan to get a COVID-19 test this week. Then be sure to communicate your test results (if positive) to those with whom you gathered so that they can quarantine and seek their own test. Do not assume that they will be notified by a contact tracer.
The World
Globally, the SARS-CoV-2 virus that causes COVID-19 disease has sickened > 62.8 million people (+4 million since last week) and killed at least 1,460,600 (+71,100 in the past week) as of this morning.
The US is ranked among the top color categories for hot spots. Things are similarly intense in parts of Europe, Jordan and Armenia. We are ranked #15 in the world for average daily case rate per 100,000 people over the past 7 days (last week, 17th) with a rate of 48.8 compared to 51.6 last week. We should anticipate that some of this case rate drop is due to the Thanksgiving holiday. The top five countries for average daily case rate per 100,000 in the past week are Georgia, Serbia, Montenegro, Luxembourg, and Andorra.
For deaths, our average daily death rate per 100,000 over the past week is 0.4, less than last week (0.5), and we are ranked #37 in the world for this (last week we were ranked #33). Again, the Thanksgiving holiday may be a factor here. The top five countries for average daily death rate per 100,000 in the most recent week are Liechtenstein, Slovenia, Bulgaria, North Macedonia and Bosnia and Herzegovina.
The United States
As of this morning, there have been over 13.4 million cases (+1.1 million in the past week) and 266,758 deaths in the US (+10,003 in past week). Keep in mind that both of these numbers are probably an under-count of the situation in our country and the effect may be even worse this week due to Thanksgiving.
The top five states in the nation for average daily case rate in the past 7 days are North Dakota, South Dakota, Minnesota, Wyoming and New Mexico. The top five states in the nation for average daily death rate in the past 7 days are South Dakota, North Dakota, New Mexico, Wyoming and Illinois.
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 but was last updated on 23Nov2020, and I reported those numbers last week. So they are not shown in this week’s table.
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.
Kansas remains in the minimal section, and is in the mid-range of that section. 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.
Kansas
The map from the Harvard Global Health Institute is pretty boring for Kansas - though alarming. The entire state is red save for one county (Greeley) on the western border.
We are starting to have what appears to be a leveling of our case curve - ordinarily a good thing.
I certainly hope that is real and continues. But we should also brace ourselves for two possibilities that are not mutually exclusive: (1) part of this leveling is due to holiday and weekend effect when most commercial laboratories (that do the majority of COVID-19 testing) are closed or have reduced capacity, and (2) due to Thanksgiving gatherings and travel that took place we will see a surge upon a surge that leads us into Christmas when we might repeat this cycle again. For possibility #1, you can see the effect of a holiday on testing in the graph below. The state follows a trend where there’s lots of testing on weekdays and not very much on the weekends. But in the past week, we didn’t see that peak for the week, we just had sort of a continuing avalanche of poor test output. We should anticipate for this to bounce back this week (after all, the disease does not take time off) as laboratories process samples that arrived over the holiday. For that reason, we might expect to see big numbers this week.
For the time being, the case rate in rural and frontier counties peaked at a level that was 51% higher than the statewide average. Cases are decreasing for every age group except for 65-74 who saw a small increase. Meanwhile, take a look at what is happening with hospitalizations over time for each age group.
If cases are indeed leveling off, we are not done yet with worrisome hospitalization trends. Increases continue for those 65+ who include some of our most vulnerable in our population.
Please do all that you can to limit your exposures. Avoid activities while in the company of people who live outside of your household that require you to remove your mask, to include eating and drinking. Avoid unnecessary errands and travel, if possible. Wear a mask whenever you’re in public and avoid being within 6 feet of non-household contacts. I recognize that none of this is ideal. But the vaccines are coming. We just need to keep disease transmission as low as possible, and preserve hospital bed capacity as much as possible, while waiting for those vaccines to be administered to our population.
References
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.coronavirus.kdheks.gov/160/COVID-19-in-Kansas
https://www.cdc.gov/flu/weekly/fluviewinteractive.htm
https://protect-public.hhs.gov/pages/hospital-capacity
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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.