Kansas COVID-19 Update, Week 6

 

As we add another week of COVID-19 updates, you may see a pattern developing in the good, bad and ugly trends. I see it too, but as much as I would like to mix things up, these are the directions the data are pointing. This week's update includes an intriguing proposal to ramp up testing, and a check-in on my home county, Johnson.

The Good: Hospital ICU capacity continues to hold steady, clocking in at 37% availability on Aug. 20, with 118 hospitals reporting. That's exactly what it was a week earlier and only one percentage point lower than it was the week before that. In fact, that number has held remarkably steady for about a month now. As I've said before, our COVID-19 cases in ICU seem to have settled in at a relatively high (compared to May/June), but manageable level of about 100 patients statewide. Manageable for now, that is. It might be a different story if hospitals are still treating that many critically ill COVID-19 patients when flu season hits.

The Bad: The infection reproduction rate, or Rt, ticked up again, to 1.06. It's the second straight week that has gone up, following several weeks of it trending down the way we'd like. That's discouraging, because I had hoped it was just a one-week blip. Remember: Rt below 1.0 means we're slowly choking off the virus. Rt above 1.0 means we're spreading it, and the farther above 1.0 we go, the faster it spreads. Social distancing, avoiding large gatherings and wearing masks are the best ways to lower it.

The Ugly: According to Johns Hopkins, the test positivity rate in Kansas took another jump last week, rising to 12.8%. It was 12.2% the week before and 11.8% the week before that. Not a good trend. To get that number lower we need more testing, and it appears there may be a plan developing to get it. Kansas health secretary Lee Norman acknowledged during a hearing this week that the state lab does not have enough capacity to do the necessary amount of testing (this is no surprise; very few states have the kind of public infrastructure required to handle current COVID levels, and Kansas budgets have been particularly tight for almost a decade). To increase capacity, Norman proposed that the state partner with private labs like Quest and LabCorp, which are currently running tests ordered by individual doctors (not public health departments). It's a good idea, and then Sen. Jim Denning added an element that made it much better: only paying the private labs if they get the test results done within 48 hours. That requirement should be written into any contract, in order to prevent the long delays that have plagued the private labs (Norman said the state lab returns results in about 1-3 days, while the private labs often take 7-14). I would also consider offering them a bonus if they get the results back in under 12 hours, or even 24.

Bonus: In Johnson County there has been an awful lot of talk about schools lately. Will they open up online-only, fully in-person, some combination of the two? Will there be sports? The county health department has developed a data-driven set of criteria for the school districts, but the actual decisions  are up to each school board.

Local journalist Kyle Palmer of the Shawnee Mission Post provided the health department's "gating criteria" recently on Twitter. 

BREAKING: @jcdhe says county is currently in "red" zone for school reopening, as part of its final guidance to JoCo schools before the start of classes this fall.

That would put @theSMSD in "remote only" learning for all students to start the year. But this is NOT official. pic.twitter.com/Ol138Jo1JD

— Kyle Palmer (@smpostkyle) August 18, 2020

As you can see, the criteria is based on a combination of test positivity and whether overall cases are increasing or not. According to the health department the test positivity rate in the county is currently about 11.5% and new cases are increasing (though slowly). That puts us in the "red zone." But we're not very far from the "yellow zone." After stay-home orders expired, new cases and test positivity rose quickly in Johnson County throughout June and early July. But the county adopted the state mask mandate that went into effect July 3 and after about one incubation period, case growth and positivity slowed considerably. 

That's similar to what we've seen in Douglas County and Sedgwick County, which also required masks. Douglas County has actually gotten its test positivity rate all the way down to 4% now, from a high of about 10%. But remember, Douglas County also closed bars. I don't know if there's any political will to do that in JoCo, or if it would reduce COVID-19 rates to the same degree it seems to have in Douglas County (I would guess there are more bars per capita in Douglas than there are in Johnson). Closing bars would obviously be controversial, and maybe it's not necessary. Maybe all JoCo needs to get that test positivity rate down is better adherence to mask wearing and social distancing and more testing. But with case rates and positivity rates where they are currently, there's a good chance of sports/school-related outbreaks. 

I will end on a hopeful note: last week I stopped into the Blue Moose in Prairie Village to pick up some takeout. The restaurant's outdoor patio was pretty full, but indoors there were hardly any patrons, and the few that were eating inside were very spread out, in a pretty well-ventilated space (the garage door leading to the patio was open). People seem to be getting the message: stay outdoors as much as possible. Doing so should only get easier in the months to come, as temperatures hopefully start to decrease. Perhaps in lieu of closing bars, the county could give them no-interest loans to rent tents and folding tables/chairs to set up outside, a la German beer gardens. That would help not only the bars, but also the party rental industry, which I assume is also hurting because of the pandemic.

Kansas COVID-19 Update, Week 3

Updated Aug 3: The test positivity rate cited below (18.6%) appears to be an error. After taking a deeper look at the Johns Hopkins data, it includes one day (July 27) in which test positivity was reported to be 109.7%. This is obviously impossible (you can't have more than 100% of tests come back positive), so there's something wrong with the data on that day. Test positivity on the other days in the rolling average are 11.2%, 10.8%, 10.8%, 11.6% and 12.5%. So the true number is probably somewhere between 10.8% and 12.5%, which is closer to what it was last week. Still not good, but much better than 18.6%.

The format has changed a bit with this week's Kansas COVID-19 update. Only one of my key stats was "bad" compared to the week before, but it was SO bad that it has skipped right to the "ugly" category. It is a truly shocking number, and one I hope is a fluke, or a data error. As a palate cleanser, I've included another "bonus" section on a single county.

The Good: Once again, Kansas' reproduction rate, or Rt, has ticked down a bit, now to 1.07. Until there is a vaccine or an effective treatment, getting that Rt below 1.0 remains our best chance of containing the virus. (Rt below 1.0 means every infected person spreads the virus to fewer than one other person, on average, which would cause COVID-19 to slowly die out for lack of new hosts. Rt above 1.0 means the virus' spread is increasing). If Rt is decreasing, that probably means more people are wearing masks and social distancing. 

The Neutral: ICU admissions were stable this week, with at least 98 COVID-19 patients in intensive care and 36% of beds available on July 30 (the same numbers as on July 23).

The Ugly: According to Johns Hopkins, the percentage of COVID-19 tests that came back positive in Kansas jumped from 11% last week to 18.6% this week. If that's accurate it means Kansas is not only far from the World Health Organization's standard of 5% or less, but it's tied with Arizona for the fifth-highest test positivity rate in the country. It's also disheartening in that it means we're probably missing a lot of cases and that drop in the Rt might be a mirage caused by hidden infections. 

A quick clarifying note: many Kansas media outlets, when they report test positivity rate, use the figure reported by the Kansas Department of Health and Environment, which is much lower (9.5%). But KDHE appears to be calculating test positivity based on the cumulative number of all tests in the state since the beginning of the pandemic (now almost 300,000). That's not wrong, but it does mean that the percentage isn't going to move much from week-to-week. I prefer to look at Johns Hopkins' number because they're calculating test positivity based on a rolling average of the last seven days of testing. That provides a more current snapshot of the situation, but it also makes the positivity rate more susceptible to weekly fluctuations in testing. 

For example, there has been a lot of press lately about long wait times for outpatient testing done at private labs (mostly Quest and LabCorp). Kansas depends heavily on those labs (they've recorded 70% of the state's positive cases, so far). If their results were really backed up last week and most of what was actually reported were results from hospital inpatient labs, that might skew the test positivity number higher (because patients sick enough to be hospitalized are more likely to have COVID than outpatients). But still, 18.6% is a number that should cause all of us to sit up and take notice. We need more testing in Kansas.

Bonus: At the end of May, Sedgwick County had its test positivity rate down to about 1%. But then the shops, restaurants and bars opened back up and the rate quickly ballooned to about 14% by July 23. Things were going the wrong direction. At one point in mid-July, Wichita's hospitals estimated they had only eight ICU beds available. But since July 23, the test positivity rate has made an abrupt downward turn and is below 12% and falling. What happened? Here's one theory: on July 8, the Sedgwick County health officer ordered residents to wear masks in public areas. Almost exactly two weeks later (the maximum incubation period of the novel coronavirus) the county's test positivity rate began to go down. It's impossible to prove that the mask order caused the downturn, but the timing matches up. Sedgwick County still has a long ways to go, but it's now trending in the right direction, and, as I wrote last week, trends are everything with outbreaks of infectious disease.

Sometimes it's good to get left out of the NCAA tourney

Missing out on the NCAA tournament this year may end up being the best thing that could have happened to the Kansas women's basketball team. Everybody wants to play in the Big Dance, of course, but the Jayhawks' run to the WNIT championship felt like the start of something special. I was at the title game at Allen Fieldhouse, one of the 16,113 fans who set a Big 12 women's basketball attendance record.

I was also at the semifinal game three days earlier. It was the first time I'd been to consecutive women's games, but it probably won't be the last. The Jayhawks lost in the championship to a poised, veteran South Florida squad 75-71, but the experience was well worth the $8 price of admission. When Kansas cut a big deficit to one possession late in the game, the near-capacity crowd was on its feet and the scoreboard's decibel meter briefly topped 100 – a noise level comparable to a rock concert.

South Florida called timeout, and the P.A. system started blaring ACDC's “Thunderstruck,” with thousands of people chanting along. It was a spine-tingling, goosebump-raising moment usually reserved for football or men's basketball games against big rivals. As we trudged back to the parking lot after South Florida hung on, any disappointment soon faded.

“That was the most fun I've ever had at a women's basketball game,” my younger brother, Dan, said. “And they lost.”

No doubt many other people who were there felt the same way. The KU women came close to duplicating the men's basketball atmosphere, and for a fraction of the cost to the fans. At least some of those fans are likely to come back for more next fall, and there's reason to believe the women can win enough games keep them coming.

This year's squad loses just three seniors: Katie Smith, Marija Zinic and Ivana Catic. Smith and Zinic rarely got off the bench. Catic was a starter, but probably only because highly-touted freshman Angel Goodrich tore her ACL in October, just before the season opener. Catic was a heady point guard with a big heart, but Goodrich, a high school All-American from Oklahoma, should have little problem replacing her athletically and statistically. She was cleared for full participation April 15 after knee surgery and six months of physical therapy.

The Jayhawks should be able to bring Goodrich along slowly next year, considering the veteran group they've got coming back. Two returning starters, Danielle McCray and Sade Morris, will be seniors. The other two, Nicollette Smith and Krysten Boogaard, will be juniors.

Boogaard is a 6-foot-5 center who can be a dominant force on the occasions when she decides to hit the glass hard and go up strong around the basket. Smith is the rare 6-foot-2 women's player who can light it up from 3-point range, though she's been streaky her first two seasons. Both may find it hard to hold on to their starting spots with freshman Aishah Sutherland, an irrepressible 6-foot-2 uber-athlete, coming on strong. Sutherland runs like a gazelle, consistently makes 15-foot jumpers and reportedly can dunk. She had 12 points and 9 rebounds in the WNIT championship.

Morris and McCray – known somewhat confusingly as 'De and 'D' to their teammates – may be the best tandem in the Big 12 next year. Morris is a long, lean guard with sweet mid-range shooting touch who averaged 12.7 points and was the Jayhawks' top perimeter defender this season. McCray has established herself as quite simply one of the best college players in the country. She averaged 21.6 points and 7.7 rebounds on the season, set the WNIT scoring record, was named First Team All-Big 12 and honorable mention All-America.

McCray is 5-foot-11, muscular and can shoot the 3. Too quick for most interior defenders and too strong for most perimeter defenders, she's a match-up nightmare and should be on everyone's short list for 2009-2010 Big 12 Conference Player of the Year.

Aside from Morris, McCray and Goodrich, the Jayhawks will also have athletic point guard LaChelda Jacobs and capable outside shooter Kelly Kohn to provide backcourt depth. With seven of their top eight players set to return, the Jayhawks will bring back as much talent as any of the six teams that finished ahead of them in the conference this year. Competing for a Big 12 championship doesn't seem out of the question.

It will be a crucial season for coach Bonnie Henrickson. She's taken some heat for having a big contract and not getting the team into the NCAA tourney, but it's still only her fifth year, which means she's only recently gotten to work with players who were all recruited by her. It's been two steps forward and one step back for much of her tenure, but some of the hardships, like Goodrich's injury, have been out of her hands.

Henrickson is building a strong recruiting presence in eastern Kansas, finally drawing some of the state's top talent away from Kansas State. McCray was a product of Olathe East and high-potential Lawrence High forward Tania Jackson will be a KU freshman next year. Henrickson is also a solid game coach. Her three top scorers – McCray, Morris and Boogaard – were in serious foul trouble against South Florida, but Henrickson juggled her line-up and had them all available to make that thrilling run late in the game.

Even though that run came up short, it's hard to overstate how important it was. Getting blown out at home in front of 16,000 fans would have been devastating. Instead those fans got a little taste of what it's like to watch a close, hard-fought, meaningful women's game. For many of them, it might be just an appetizer.

It's doubtful this new fan support would have materialized if Kansas had climbed out of the bubble and crept into the NCAA tournament. Realistically, the Jayhawks might have won one game in the NCAAs, maybe two if everything aligned in their favor. They really weren't ready, as their struggles against ranked teams showed. Instead they got the experience of playing five must-win games in 12 days. They got to play four of those games at home, which would not have happened in the NCAAs.

The Kansas women still have to follow up on it next year. But the stage is set, and it's all because the Jayhawks got left out of the NCAA tournament. They may be the best advertisement for the WNIT in that tournament's history.