Sunday, February 27, 2022

Kansas COVID-19 Update, Week 82

 

coronavirus
Everything continues to trend in the right direction. New cases are at their lowest level since last summer, hospitalizations are down and deaths are also leveling off (though we're still certainly going to hit 8,000 as a state soon).

The Good: Test positivity fell from 16.2% to 9.8%, according to Johns Hopkins. That still places Kansas 10th-highest in the nation, but the number continues to decline steadily. With both new cases and test positivity falling simultaneously, we can be quite certain we truly have less virus circulating among us.

The Also-Good: COVID hospitalizations continue to drop. 

  • Statewide COVID hospitalizations fell from 639 to 503 this week, according to the Kansas Hospital Association. That's a slight slowdown compared to the decrease we saw last week, but still quite good. 
  • Statewide cases in ICU fell from 119 to 94. This is going to drop more slowly because these patients are seriously ill.  
  • COVID hospitalizations in the Wichita area fell from 137 to 98, and cases in ICU fell from 45 to 29. Both Wichita hospitals are still managing through surge ("contingency") plans, but hopefully will be able to scale back to normal operations soon. 
  • COVID hospitalizations in the KC area (bistate) fell from 671 to 529 and cases in ICU fell from 114 to 87. 
  • Overall ICU availability in the KC area rose from about 19.2% to 21.5%. Regular hospital bed availability only rose from about 15% to 16.2%. We are still catching up on delayed medical care, but fortunately the drop in COVID cases allows our hospitals to do so more comfortably.

The Stable: The infection reproduction rate, Rt, stayed at 0.69. Still good. 

Saturday, February 19, 2022

My neighbor died of COVID

My neighbor died of COVID a couple weeks ago and I’ve been thinking about her lately. Workers have been next door removing her belongings from the house — placing some in the back of a box truck but most in a dark blue dumpster that takes up nearly all of her driveway. Soon all traces of her will be gone from the neighborhood. Then we’ll get new neighbors, I suppose.

My wife and I were not particularly close with our neighbor, but we did interact with her regularly. She was in her late-60s, with myriad health problems that made it difficult for her to get around, even on her good days. On her bad days, she was basically homebound. She had our cell phone numbers and would occasionally ask us if we were going to the store and could pick up some groceries for her. We would deliver the groceries and then spend a couple minutes just talking about the usual small stuff — weather, our dogs, if we’d be traveling for upcoming holidays. She paid us for the groceries and occasionally threw in a Starbucks gift card for our trouble.


Once the pandemic hit, these visits became even shorter. My wife and I were acutely aware of our neighbor’s vulnerability to COVID and never wanted to be the exposure that cost her her life. So we went over there masked and often just left the grocery bags on the porch. More and more, our interactions with her were only via text.


Meanwhile, her other health problems left her constantly in danger of exposure to COVID. Multiple times the fire department showed up at her house to help after she’d fallen. Sometimes an ambulance would show up and take her away for a few days. Sometimes she would drive herself to the hospital and check in. It’s a testament to the masking and infection control procedures of the first responders and hospital workers that she never got COVID during those times.  


When the vaccines were approved, she needed some coaxing to take them. My wife and I both told her we had gotten ours as soon as we were eligible, and that seemed to ease her mind somewhat. Still, she backed out of her initial vaccine appointment and had to wait a couple more weeks, which was frustrating for us. After she finally got her shot, she texted that “We are all pioneers” on a journey with these new vaccines. I considered the real pioneers the people who signed up for the clinical trials, but I could understand her perspective. 


When she got her second dose, we breathed a sigh of relief, but given her health issues, we knew the vaccine wouldn’t be a silver bullet. As the months passed, we never followed up with her about getting a booster, which I really regret now (based on conversations with some of her friends, we don’t believe she ever got it). 


When the delta/omicron surge hit and it seemed like COVID was everywhere, it happened: our neighbor checked in to the hospital with a breakthrough infection. She told us via text that she thought her home health aide had brought the virus into her house. She also told us that a friend was getting her mail and her dog was being boarded. 


That was her second day in the hospital. We asked how she was doing and she said she was on oxygen and it seemed to be helping. She was at a small satellite hospital and was awaiting transfer to a bigger facility. 


That was the last text we got from her. About a week later we learned that she had died. I don’t know if she ever got to that bigger facility. Our hospitals were absolutely slammed at that time and beds were hard to come by. Nor do I know whether it would have made any difference. She was very medically fragile.


Those “what ifs” are not what I’ve been thinking about for the past few weeks. Instead, I’ve been wondering what her last days were like. What happened in the time between when she sent us that last text and when she passed away. She would not have been allowed any visitors other than family, and her only family was a sister who lives on the East Coast and was not able to be here. It comforts me some to know that she was not truly alone — that the hospital staff was there at least.


But I still wonder what it was like. Was she sedated and put on a ventilator and just never woke up? Did she opt against “extraordinary measures” like intubation and drift away on a morphine drip? Or did it all happen too fast for that, and she died “coding” — gasping for air as medical workers rushed into her room and tried to help? Was she resigned to death, or was she fearful? How much did she suffer, physically or emotionally?


It’s impossible for me to know. The only potential clue I’ve found is that in our last text exchange she mentioned “dog’s boarded” twice. In those exact words. Once at the beginning and once at the end. 


Her only daily companion, the one creature in this world that relied on her, was safe. She wanted us to know that. I think maybe she wanted to remind herself of that too. 


For much of the last two years our national conversation around this disease has focused on disagreements over masks, school closures and vaccines. All of that is important, and Lord knows I have engaged in a lot of those conversations myself. But I also think maybe we’ve gravitated toward those discussions because it’s easier than trying to just grapple with the immense human suffering the pandemic has caused. It saddens me to think about what my neighbor might have gone through in those last days. Then I remember that more than 900,000 other Americans and almost 6 million people worldwide went through the same thing and, well, that’s just impossible to fathom.  

Kansas COVID Update, Week 81

coronavirus

New cases and hospitalizations continue to fall rapidly. Kansas is still at a "high" transmission level under the CDC's guidance, but so is every other state except Maryland. We're moving in the right direction. As seen in other countries, the omicron wave is receding as quickly as it came. By mid-March we should be in really good shape.

The Good: Test positivity dropped again, from 22.1% to 16.2%, according to Johns Hopkins. I honestly can't remember the last time it was that low. Kansas is now eighth-worst in the nation. Still need more testing.

The Also-Good: Hospitalizations continue to plummet: 

  • Statewide COVID hospitalizations fell from 889 to 639 this week, according to the Kansas Hospital Association.
  • Statewide cases in ICU fell from 203 to 119. 
  • COVID hospitalizations in the Wichita area fell from 218 to 137, and cases in ICU fell from 54 to 45. Both Wichita hospitals are still managing through contingency plans, but they have now moved their status from "critical" to "cautious" for the first time in months. 
  • COVID hospitalizations in the KC area (bistate) fell from 922 to 671 and cases in ICU fell from 179 to 114. 
  • Overall ICU availability in the KC area rose from about 14.7% to 19.2%. But regular hospital bed availability stayed steady at about 15%. We are probably still working through a lot of delayed medical care, and even after the omicron surge has fully petered out, it will take time to catch up on that and ease bed space.

The Not-As-Good: The infection reproduction rate, Rt, rose from 0.64 to 0.69 this week. The Rt seems to be fluctuating a lot in the past couple weeks as the surge dissipates. I think it's very possible that last week's number was a bit artificially low and 0.69 represents a data correction more than a trend toward more transmission. In any case, both 0.64 and 0.69 are good numbers that will continue the rapid downward trend of total cases. 

Saturday, February 12, 2022

Kansas COVID-19 Update, Week 80

 

coronavirus

Another good week. New cases continue to fall rapidly and test positivity is also declining, which means we can be quite certain the dip in cases is real. Hospitalizations are also trending down for the second straight week, though they're still at kind of unmanageable levels. We are on the back end of the omicron surge, but hospitalizations and deaths will likely remain stubbornly high for another couple weeks as the effects of the surge dissipate.

The Good: The infection reproduction rate, Rt, plummeted from 1.0 to 0.64 in Kansas this week. I have trouble believing that such a drastic change really happened in one week, so I think last week's number was probably overinflated and the website I use to find Rt is finally catching up with the declining case counts. In any case, this is really good news.

The Not-Bad: Test positivity fell again, from 29.8% to 22.1%, according to Johns Hopkins. That's still sixth-highest in the nation, but we're definitely trending in the right direction.

The Still-Bad-But-Getting-Better: Hospitalizations are headed down for sure, but they're still quite high and hospital capacity is still quite tight. It may be that people who had their non-COVID medical care delayed during the surge are now getting in for their procedures. That's good, but it's going to take weeks or even months for us to catch up.   

  • Statewide COVID hospitalizations fell from 1,091 to 889 this week, according to the Kansas Hospital Association.
  • Statewide cases in ICU fell from 236 to 203. 
  • COVID hospitalizations in the Wichita area fell from 272 to 218, and cases in ICU fell from 67 to 54. Both Wichita hospitals are still managing through contingency plans, but hopefully should be able to resume normal operations soon. 
  • COVID hospitalizations in the KC area (bistate) fell from 1,116 to 922 and cases in ICU fell from 211 to 179. 
  • Overall ICU availability in the KC area rose from about 14.3% to 14.7%. But regular hospital bed availability actually dropped a bit, from 16% capacity available to about 15%. It seems like a lot of people are ready to move past the pandemic, but if you work in a hospital it's not really possible to do so. It's still dominating every work day.


Sunday, February 6, 2022

Kansas COVID-19 Update, Week 79

 

coronavirus

Things continue to trend in the right direction, increasing my confidence that we're now on the back end of the omicron surge. New cases are trending down, and we saw our first real dip in hospitalizations in a long time this week. But overall hospitalizations remain high, so it's not time to declare victory yet.

The Good: Test positivity dropped again this week, from 36.8% to 29.8%, according to Johns Hopkins. Kansas remains sixth-worst in the country in this metric, but that's two straight weeks of substantial decline. 

The Not Bad: The infection reproduction rate, Rt, fell from 1.1 to 1.0 this week. I would love to see a bigger decline, but if this is accurate, it at least means that we're stable now. I still expect to see this number below 1.0 soon, given that both new cases and test positivity are declining.

The Still-Bad-But-Getting-Better: COVID-19 hospitalizations have fallen in Kansas, but they've only fallen from about as high as they've ever been (1,250) to almost as high as they've ever been. I doubt hospital workers are feeling much relief yet. Here's the breakdown:

  • Statewide COVID hospitalizations fell from 1,243 to 1,091 this week, according to the Kansas Hospital Association.
  • Statewide cases in ICU fell from 250 to 236. 
  • COVID hospitalizations in the Wichita area fell from 294 to 272, and cases in ICU fell from 72 to 67.
  • COVID hospitalizations in the KC area (bistate) fell from 1,224 to 1,116 and cases in ICU fell from 220 to 211. 
  • Overall ICU availability in the KC area rose from about 13.7%, to about 14.3%.  Regular hospital beds were at about 16% capacity available, which is also only a very slight increase from last week. Bed space is still pretty tight. Need to get above 20% before hospitals have any real breathing room.