Kansas COVID-19 update, Week 1

Kansas is at an inflection point in the novel coronavirus pandemic. Our state weathered the first wave relatively well, and currently has one of the lowest COVID-19 death rates in the country.

But after an uneven county-by-county reopening of the economy in late May and early June, case numbers have been ticking up. This week we found out that Kansas was one of 18 states designated as "red zones" for COVID on an internal White House document based on the growth in new cases.

Raw case numbers are far from a perfect metric, because they can fluctuate a lot based on the amount of testing you do. So, every week (for an indeterminate number of weeks), I'm going to highlight some other metrics on this blog that hopefully will give us a better idea of just how we're doing in Kansas, and help people make decisions about how much they should be going out and exposing themselves to other people's germs. I promise to provide links to every number I cite, so you can go back and see the data for yourself. Here goes:

The Good:
Hospital capacity in the state is in good shape, overall. As of July 14, the CDC estimated that only about half of Kansas' regular inpatient beds and ICU beds were full. But this good news comes with a caveat: COVID-related hospitalizations have recently begun rising in the Kansas City area and in Wichita. Hospitalizations are a "lagging indicator" (they don't go up until cases have been rising for several weeks). Once they start to rise it takes at least two weeks for any behavioral changes to stop that rise. In other words, if you wait until hospitals are almost full to act, you've waited too long.

The Bad:
Our infection reproduction rate of approximately 1.12, shows that Kansans are spreading COVID to each other too much. The reproduction rate, often abbreviated "Rt" or "R0," is the number of new infections that each infected person creates. If the rate is at exactly 1.0, then every infected person only infects one other person and the outbreak doesn't get worse or better. The higher above 1.0 Rt goes, the faster the outbreak spreads. If you hold it below 1.0, you can starve the virus of the new hosts it needs to survive and slowly choke off the outbreak altogether. Germany has had good results tamping down COVID by focusing on this number: when reproduction rates rise above 1.0 in a given region, they put restrictions in place in that region. When it goes back below 1.0, they relax them. It's a proactive approach that helps them get ahead of outbreaks before they become problematic. What factors reduce the COVID reproduction rate? Avoiding crowds, social distancing, and wearing masks, especially when indoors. The Rt rate is notoriously hard to estimate, but multiple sources now peg Kansas' rate above 1.0. As long as it stays there, the outbreak will continue to grow.

The Ugly:
Our test positivity rate in Kansas is too high. Test positivity is the percentage of COVID tests that come back positive. It's a better measure than raw case numbers because it doesn't "penalize" you with higher numbers if you do more testing. In fact, the more testing you do, the lower the test positivity rate should be. In Kansas, however, it has climbed to 10.7%, the 11th highest rate in the nation. Anything over 10% is generally considered a "red flag" that means you're not testing enough to be reasonably confident you're identifying most cases. The World Health Organization recommends governments maintain a test positivity rate of 5% or less before reopening their economies. Data from some of the European countries that have been most successful at reopening without seeing a surge in cases suggests that the optimal threshold may be even lower — more like 1.5%. Kansas obviously has a long ways to go to reach either threshold.