Kansas COVID-19 Update, Week 17

We're in a depressing phase of the COVID-19 pandemic in Kansas: record new cases, record hospitalizations, record ICU admissions and hospitals now under daily, ongoing strain. The novel coronavirus is circulating widely through nearly every corner of the state and the vast majority of our residents still have no immunity to it. It's like a fire that will continue to burn out of control unless we starve it of fuel by staying home as much as possible, staying away from other people when we leave home and wearing masks (made of several layers of fabric, over our mouths AND noses) whenever we are indoors with other people.

The Neutral: The infection reproduction rate, or Rt, is still estimated at 1.22, with a bottom-range possibility of 0.94 and a top-range possibility of 1.45. It's good that it didn't go up, but cases are so widespread now that anything above 1.0 really creates a damaging number of new infections. 

The Bad: ICU availability in the state was officially down to 33% on Nov. 5, and it's functionally lower (potentially much lower). As I wrote last week, hospitals (including KU, the biggest in the state) are opening overflow ICU beds because of the influx of patients. That has increased the total number of beds in the state past 1,100, but the problem, like I wrote last week, is that it's difficult to staff those beds. For example, at one point last week there were 32 open ICU beds across most of Kansas City, but only 22 that were actually staffed. Meanwhile, we keep setting new records for COVID-19 patients who need ICU care. Three weeks ago, the record was 128. This week we hit 183. 

The strain is being felt throughout the state. In Topeka, a destination for severely ill patients from a wide range of surrounding rural counties, there was only one available ICU bed at one point last week. As the county health officer pointed out, that means that if there had been a single serious auto wreck on Interstate-70 that day, the hospitals probably wouldn't have been able to handle it. Oh, and Wichita's hospitals actually reached full ICU capacity last week, meaning the same was true for Interstate-35. 

We are running out of places to send sick people. Barnes-Jewish in St. Louis, the largest hospital in the bistate region, is also reportedly near capacity and considering suspending elective procedures. 

So, even though on paper it looks like we still have more ICU beds, the on-the-ground reality is that the medical system is probably already strained to the point where some patients who would have survived will die because they can't get the attention they need as quickly as they need it. Hospitals can’t just create trained staff out of thin air. When New York City was swamped with COVID-19 in the spring, nurses came from all over the country to help. Now most are desperately needed in their home states. There is no cavalry coming. We are in deep trouble. 

The Ugly: Test positivity was up to 37.1% last week, according to Johns Hopkins, the fourth-worst in the country (behind South Dakota, Iowa and Idaho). Which means that we still don't know how bad our current outbreak is because we're missing a lot of cases. 

Bonus: I don't know what it will take for Kansans to realize what a fraught position we're now in with this virus. One would think that a county commissioner in Johnson County — which has by far the most robust health care infrastructure in the state — raising the specter of erecting temporary hospitals would be enough to do it. Well, that happened this week.

Commissioner Jim Allen, per the Shawnee Mission Post: “The numbers today are worse than they’ve ever been, and if people don’t take it seriously and these numbers keep going up exponentially we could be building temporary hospitals in Johnson County,” he said. “That’s how serious it is.”

And yet, in that same article the county's public health director says he's getting deluged by hundreds of emails a week urging us to just let the virus run through our population until we reach "herd immunity." That seems profoundly unwise, given that even with some minor mitigation measures in the county, like a mask mandate, our hospitals are already nearly full and COVID-19 is so prevalent that nursing home workers who have tested positive are still being allowed to come to work because there just aren't enough well people to replace them. Trying to reach "herd immunity" without a vaccine is a recipe for nothing but thousands of preventable deaths — and we don't even know how long the immunity would last (recent studies suggest COVID-19 antibodies wane quickly).

There is no reason to give up on trying to slow the spread of this virus. Other countries have done it very successfully; rich countries like Australia, New Zealand and Finland, as well as relatively poor countries like Uruguay, Vietnam and Rwanda. They took different approaches in terms of government intervention, but what they all broadly have in common is that their people listened to the advice of epidemiologists and public health officials and more or less did what they said, either voluntarily or because it was the law. 

That's the only path out of months of depressing death in Kansas: listen to the people who have studied infectious diseases their entire lives and do what they say, even if it's hard or inconvenient or ideologically unappealing. With every day that we fail to do that, the path narrows further.