Kansas COVID-19 Update, Week 16

 We're in trouble. The U.S. is setting records for new infections almost daily, creeping up on 100,000 a day. The Midwest has been at the center of the surge and Kansas has not been spared. Public health officials have warned us for months that this would happen – that infections would spread rapidly in the fall and winter, when respiratory illnesses always tend to be worse. They urged us to use the summer months to drive down case counts so that we'd be better prepared. States like Michigan and Minnesota, and certain counties within Kansas, that pursued phased reopening and required residents to wear masks have fared slightly better, with the surge coming later and less dramatically than in places like Wisconsin, Iowa, the Dakotas and western Kansas. But now it's basically a wildfire burning out of control and even people who cleared the brush around their own houses are in danger. Hospitals are filling up in several parts of Kansas and western Missouri, and it's having spillover effects on hospitals in others parts of the state. We could be in for a rough winter.

The Not-yet-bad: ICU availability clocked in at 36% in Kansas on Oct. 29, which isn't bad. But it's a bit of a mirage. Hospitals reported 145 COVID-19 patients in ICU that day, which would have been a record except that they reported 153 the day before. Our previous high was 128 two weeks ago. We blew past that three times this week. So why isn't the percentage of available capacity lower? A couple reasons. There are fewer people in ICU for non-COVID reasons than there were a couple weeks ago, but we can't expect that to last, given that flu season is just starting. And some hospitals, including the largest one in the state, The University of Kansas Hospital, are adding capacity by opening up overflow ICU units. It's obviously good that they're doing that, but staffing overflow units for extended periods of time can mean quality of care suffers. It requires a lot of overtime hours and people get burned out. 

The Bad: The infection reproduction rate is way up, to 1.22. This is not surprising. It's up almost all over the country. Last week I wrote that the actual rate was probably closer to the high end of the estimated range (1.29) than it was to the exact estimate of 1.06. Now the top end of the estimated range for Kansas is a dismal 1.45. Even if 1.22 is accurate, that means that every infection, on average, causes 1.22 more. When you're starting from about 1,000 new cases per day (where Kansas is now) you can see how quickly this thing spreads.

The Ugly: Test positivity in Kansas was 33.8% last week according to Johns Hopkins. That is just stunningly high, but somehow only fourth-highest in the country behind South Dakota, Wyoming and Iowa. In summary, we're setting records in Kansas for new confirmed cases, new hospitalizations and new ICU admissions, and we're still missing a significant number of infections based on our test positivity. All the trends are bad.

Bonus: A couple weeks ago Via Christi's hospital in southeast Kansas reached capacity and said it would be reaching out to the chain's other hospitals in Wichita and Manhattan for support and resources. Last week Via Christi's hospital in Wichita said it was nearing capacity and could take no more COVID-19 patients (Wichita's other major hospital, Wesley Medical Center, was 90% full). Wichita is a hospital catchment area for most of western Kansas, where ICU beds are scarce to begin with. Which is how you get this KCUR story about a patient in Kearny County, the far southwest corner of Kansas, who was rapidly dying of COVID-19 and needed an ICU bed and a ventilator, but the nearest available was in Kansas City, a seven-hour drive. 

We are all connected, whether we want to be or not, and the actions we take (or don't take) affect the people around us, and then ripple out to the people around them, and so on and so forth. So, please, wear a mask, don't gather in groups, try to keep things ventilated indoors as much as possible, and avoid unnecessary close contact with other people, even if you are wearing masks. Oh, and get a flu shot. It might keep you out of a hospital bed, and there's even some evidence it might reduce your risk of a severe COVID-19 infection. 

If 1,000 Americans were dying every day in a war, it would be all any of us were talking about and we would be desperate to change course. We are there now with COVID-19.