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.