Kansas COVID-19, Week 11

 

Last week we saw a dip in ICU capacity that was NOT due to more COVID-19 cases, but to other types of hospitalizations. This week the capacity is nearly unchanged, but the amount taken up by COVID-19 cases is up sharply. That's not only disturbing, but a good reminder to look at the data behind the data whenever possible.

The Good: The infection reproduction rate, or Rt, has dropped to 1.01, which is just barely above the level at which the raw number of infections should start trending downwards — if that number is accurate. Unfortunately, due to the lack of testing in Kansas, it's hard to tell how accurate it is. The site  I use to track Rt says its best estimate for Kansas is 1.01, it also says that the true number could be anywhere between 0.80 to 1.21. More testing would help narrow that range.

The Bad: As of Sept. 17, the state's hospitals had 36% of their ICU capacity free (with 130 hospitals reporting data). Of the 623 patients in ICU on that day, only 80 were in because of COVID-19. As of Sept. 24, the state again had 36% ICU capacity remaining (with 128 hospitals reporting). But — and here's where the bad part comes in — of the 632 total ICU patients on that day, 121 were in because of COVID-19. That's the largest number since the state started keeping track (the previous high was 112 on July 21). That doesn't bode well. Let's hope it's a blip and not a trend.

The Ugly: Test positivity in Kansas was 15.4% over the last two weeks. That's up a tad from last week (15.1%). This is way too high and it means we're probably missing a significant number of cases. It also means that if the Rt above is off, then the actual number is probably higher.

Bonus: The bonus section is back this week because I want to share another useful website. It's called the Daily Yonder and it's published by the Center for Rural Strategies. The cool part is a county-by-county map that controls for population to show which counties have more than 100 new  COVID-19 cases a week per 100,000 people — the White House Coronavirus Task Force's "red zone" threshold. It shows that in Kansas, as in most states, rural areas have not been entirely spared. Some rural areas, like a strip of counties along the northeast border with Nebraska and another strip along the south-central border with Oklahoma, have little COVID-19 per capita. But rural counties in the southwest corner, southeast corner and the center of the state around Hays are all in the red zone. Urban counties are a similarly mixed bag, with low levels of COVID-19 per capita around the Topeka and Wichita metro areas, but relatively high levels around the Kansas City metro. There's nothing magical about the 100 new cases per 100,000 threshold, but the map is a good way to visualize which parts of the site have more than their share of COVID-19, and are therefore disproportionately driving the statewide numbers. 

Kansas COVID-19 Update, Week 10

 

Kansas lawmakers are talking about using tens of millions of dollars in federal funding to dramatically increase COVID-19 testing in the state. This would be helpful not only for diagnosing more COVID-19 and isolating people to keep from spreading, but also for creating more robust data to show how we're doing at controlling the spread. Until then, here are the numbers as best we know them.

The Good: The infection reproduction rate (Rt) ticked down a notch from 1.03 to 1.02. It's looking more and more like the Week 8 spike up to 1.10 was an anomaly. But we're still just a bit short of getting Rt below 1.0, which would transition us from an outbreak in which cases are slowly increasing, to one in which cases are slowly tapering off. 

The Bad: Hospital ICU capacity in Kansas, which had been slowly growing for several weeks, dropped down from 39% on Sept. 9 to 35% on Sept. 17. Interestingly, though, it looks like the loss of capacity was not due to COVID-19 cases, which were steady. People must have been ending up in ICU beds for other reasons. It's too early for flu season, and I can't think of any other cyclical or systemic event that would lead to an increase in ICU admissions. So my guess is this is another anomaly and probably not too worrisome.

The Ugly: Test positivity. It just stays stubbornly, discouragingly high. In Week 9 it was 14.6%, which was actually an improvement from the ghastly 17.3% the week before. This week it ticked back up to 15.1%. Remember, we're shooting for 5% or less, which is very possible. Half the states are there already.  But Kansas tied Alabama this week for the fifth-highest positivity rate in the country. Only South Dakota, Wisconsin, Idaho and Mississippi were worse. We need lots more testing, including regular surveillance testing at nursing homes, schools and workplaces, which is supposed to be part of the aforementioned ramp-up effort using federal funds. That effort can't come soon enough. 

Kansas COVID-19 Update, Week 9

 

The key metrics are starting to show some serious fluctuation from week to week, which makes one wonder which weeks are the anomalies and which are the trend. All we can do is keep tracking and trust the trend will become more clear as we get more data.

The Good: Hospital ICU availability remains stable, at 39% on Sept. 9 with 124 hospitals reporting. It's important to remember that this is a lagging indicator, which means spikes in COVID-19 cases won't show up in hospitals until weeks later. But right now this is going the right direction, but slowly.

The Bad: The infection reproduction rate, or Rt, was 1.03 last week. That's not good, because it's still above 1.0. But it could be a lot worse. The week before it was 1.10, so it's trending the right direction.

The Ugly: The test positivity rate in Kansas was 14.6% last week, according to Johns Hopkins. That's quite bad — it's nowhere near the 5% or less that we want — but again it's better than the week before, when it was a whopping 17.3%. We still have a long ways to go. Hopefully this week was the start of a good trend on both Rt and test positivity.

Kansas COVID-19 Update, Week 8

 

Not a lot of good news this week. A surge of COVID-19 throughout the Midwest has affected Kansas (though not quite as bad as Iowa and the Dakotas), and the state is now 11th nationally in per capita new cases. Let's hope Labor Day doesn't make things worse.

The Good: Hospital ICU capacity still holding steady at 38% availability as of Sept. 3 with 122 hospitals reporting. Again, that number hasn't changed much in the last month or two. But hospitalizations are a lagging indicator, which means if we have a surge of cases it won't show up in the hospitalization numbers until a couple weeks later. 

The Bad: The infection reproduction rate, Rt, is up... substantially. It went from 1.06 to 1.10 last week. Which means each infection is causing more subsequent infections than before. We're spreading COVID-19 too much in Kansas. That doesn't bode well as kids prepare to go back to school.

The Ugly: Last week's drop in test positivity appears to have been a blip, as I feared. Possibly caused by widespread surveillance testing at colleges, in particular KU, which tested more than 20,000. This week, as we returned to our normal volume of testing, the test positivity rate jumped from 11.4 to 17.3. That's the fifth-worst nationwide and a truly discouraging number. I know it seems like a broken record, but we need more testing.