Kansas COVID-19 Update, Week 29

 

The website that I use to track the infection reproduction, or Rt, has now stopped updating.  So I'm going to start using a different site this week, which is going to temporarily throw the trend data for a bit of a loop. But overall, things are looking pretty good. New cases in Kansas keep declining steadily and the test positivity rate is also down this week, which means the decline in new cases isn't due to less testing. There are still dangers out there — the amount of COVID circulating in some parts of the state is still too high for comfort, and new variants that are more contagious (and maybe more deadly) could still come here and cause significant pain. But the trends are good. It's looking more and more like we have weathered the fall surge and we now have an opportunity, if we can get a lot of people vaccinated, to make sure we don't ever have another wave like that. Which would be great, because we're still averaging 500 deaths every two or three weeks because of the fall surge (we topped 3,500 total this week). 

The Good: Hospital ICU capacity improved to 22% statewide, according to the Kansas Hospital Association. That's only a single percentage point better than last week, but every region of the state was at 12% or better this week, so the beds seem better distributed.

The Neutral: According to this new site I'm using, Kansas' Rt is right at 1.0. That would be worse than last week, but this site calculates Rt in a slightly different way, so it's an imperfect comparison. Let's wait and see what the next few weeks bring. Based on the falling new cases/test positivity, I think we'll be below 1.0 soon.

The Bad: Test positivity dropped from 28.4% to 25.7%, according to Johns Hopkins. The trend is good, but the number's still way too high and I wish it was dropping faster. The more testing we do, the easier it will be to nail down a solid Rt number. As it is, we're not testing enough, which is why we end up with a range of different Rt estimates from different sources. 

Bonus:

This week's bonus is a series of heat maps that show where the virus has been spreading most lately, and where it's been most prevalent/deadly throughout the pandemic. All of them are based on cases/deaths per capita.

This one shows which counties had the most new cases per capita from Jan. 13-27. As you can see, things are looking pretty good, with the exception of a few troublesome counties. 

This one shows which counties had the most new deaths per capita from Jan. 13-27. It looks a lot worse, because deaths are a lagging indicator. Even though new cases are slowing down, lots of Kansans who contracted the coronavirus weeks or even months ago are still dying. 

This one shows which counties have had the most cases per capita since the start of the pandemic. Although cases first started showing up last spring in the Kansas City area, as you can see it's since been western Kansas that has really taken the brunt of things. And this only reflects confirmed cases. 

This one shows which counties have had the most COVID deaths per capita since the start of the pandemic. Again, western Kansas has been absolutely ravaged. When you look at the raw death numbers from those counties they don't look like much, but based on their total populations they're devastating. Indeed, as of mid-January, the top 10 counties for per capita COVID deaths in Kansas all had fewer than 11,000 residents. The pandemic's been bad everywhere, but it's been a nightmare for rural Kansas. 

Kansas COVID-19 Update, Week 28

After a lot of good news last week, this week is more mixed in Kansas. It still appears that we're doing a good job of cutting down new cases, but the downward momentum of test positivity has stalled and our hospital ICUs are actually a bit more full than last week. Could be a result of the ebbs and flows caused by the holiday surge, but it should be a warning not to let our collective guard down. 

The Good: The infection reproduction rate, or Rt, is down yet again, now at 0.95. That's a good number, and the first time it's been that low since Christmas. It's been more than three weeks now since New Year's, so we should have absorbed all the new infections from the holiday surge now, and it doesn't appear that the ripple effect will be long-lasting.

The Bad: Hospital ICU capacity dropped from 25% to 21% this week, according to the Kansas Hospital Association. That may seem counterintuitive, given that the number of new infections is going down now. But remember, there's usually a lag between when a case is diagnosed, and when it results in hospitalization. So this dip in ICU availability, given the timing, could very well reflect the holiday surge. People were exposed to the coronavirus Dec. 25-Jan 1, they started to get sick (and test positive) about a week later and a week or two after that they ended up in the ICU. Fortunately, we have enough of a cushion to be able to absorb that surge and so far stay above 20% capacity statewide, which is a good mark. There are still trouble spots, though. Southwest Kansas was down to 9% capacity, for instance, with only two ICU beds available as of Jan. 22. And there's not a lot of room to transfer patients to Wichita's ICUs, which are still over capacity (although the number of COVID patients in ICUs there is now as low as it's been since the beginning of November).

The Ugly: Test positivity rose from 28.1% to 28.4% this week, according to Johns Hopkins. That's not a huge jump, but it was already quite high. We would like to see some sustained decline in this metric to be sure we're identifying most of our active infections. 

Kansas COVID-19 Update, Week 27

Things are really looking up this week! Any new infections from Christmas and/or New Year's gatherings should have shown up by now, and this week's metrics suggest that the ripple effect from those holiday infections may not be long-lasting. Things could still go bad again, especially with new, more contagious variants of COVID-19 out there and some rural counties deciding to lift their mask rules. But right now, there's reason for optimism. All of our measures except deaths are improving, and deaths are always the last trend to change.

The Good: The infection reproduction rate, or Rt, fell from 1.04 all the way to 0.97. That's excellent. We still have a relatively high number of infections floating around in the state, but if we can keep the Rt at that level (or even lower), we could soon get it back down to where it was in July, or at least September. 

The Not-bad: Kansas had 25% of its ICU beds available as of Jan. 15, according to the Kansas Hospital Association. That's manageable, especially compared to last week's 19%. Getting it to a stable 30% would give us some cushion in case one of the new variants makes its way here (which is likely at some point, given the prevalence of interstate travel). The Wichita area still has a stubbornly high number of COVID cases in its ICUs, however, and there are signs of increasing spread in southeast Kansas as well.

The Ugly: Test positivity in Kansas was 28.1% this week, according to Johns Hopkins. Let's be real, that's still ugly (sixth-worst in the country behind Idaho, Pennsylvania, Iowa, Alabama and South Dakota). But it's a big step up from where we were a week earlier (37.8%). Fewer confirmed cases + lower test positivity = reduction in overall caseloads.

Bonus: We've all seen dire news reports about COVID in California lately. And it certainly is bad there. But as bad as it's been there, on a per capita basis Kansas has still been experiencing more COVID-19 deaths. Over the seven-day period that ended Jan. 15, California averaged 14 deaths per 1 million population, per day. Kansas averaged 16. Like I said, deaths always lag new cases and hospitalizations. But how is it possible that hospitals in Los Angeles are totally overwhelmed, but a greater proportion of Kansans are dying of COVID-19?  

The answer may have to do with hospital beds, both the number and the type. Kansas ranks near the top of all states in hospital beds per capita. California ranks near the bottom. Which means that when COVID comes to each state, one (Kansas), has a lot more capacity to hospitalize patients than the other (California). California's hospitals run out of space faster. But all hospital beds aren't the same. Many of Kansas' beds are in small, rural hospitals with no ICUs and minimal staff trained to handle critical care. This means that even during the worst of the pandemic, EMS could probably can find a bed for you somewhere, if they call around enough. But it may not be a bed that comes with the level of care that your condition requires. Which may be how we end up with more people dying, per capita, even if we don't have ambulances circling for hours and people setting up tents to treat patients in hospital parking lots. It's a complicated web of resources, and the best thing we can do is just try not to overtax it. 

Kansas COVID-19 Update, Week 26

We're still experiencing about 500 COVID-19 deaths every two weeks in Kansas. That rate, sadly, has not slowed, even as the rate of new cases has tailed off. The state topped 3,000 deaths this week (3,148 as of Jan. 8). A little more than 0.1% of all Kansans have now died of COVID-19. The fatality rate of influenza is about 0.1%. Which means that even if every single man, woman and child in the state got the flu in a given year, it still wouldn't kill as many Kansans as COVID has in just about nine months. All of which is to say, COVID is not the flu. Is it much deadlier (probably 5-10 times deadlier). And at this point anyone who tells you it's only about as deadly as the flu has no credibility.

The Not-so-bad: The infection reproduction rate, or Rt, rose only a tiny bit, from 1.03 to 1.04. Obviously it's not good that it rose, but everything else is bad this week, so this is as close as we get to good news. At least it didn't rise as fast as last week. She still have to be concerned about a holiday surge, though. Last week we saw a day of near-record new cases in the KC area, and this week the Topeka area set a new record.  

The Bad: Hospital ICU capacity is trending down again. It was 19% on Jan. 8, according to the Kansas Hospital Association. It was 21% the week before. The most strained part of the state continues to be south-central Kansas, at 11% availability. Wichita's ICUs remained over capacity, for the 10th straight week. 

The Ugly: Test positivity is super high and still rising. It's now 37.7%, according to Johns Hopkins. It was 35.9% last week. That's not a big increase, but once you're in the 30s it's honestly pretty hard to get higher. Unless you're Idaho. 

There's a lot to be concerned about in these numbers. But the vaccines continue to be delivered and soon everyone in nursing homes should have at least some protection. That should help with the death rate. 

Kansas COVID-19 Update, Week 25

 

Last week all of the metrics were looking pretty decent. But this week we're already seeing evidence of the holiday surge that public health officials predicted. For example, the Kansas City area recorded a near-record number of new cases Friday. That's about one incubation period after Christmas, so this is to be expected. Hopefully it will be temporary.

The Good: Hospital ICU capacity remained at 21% as of Jan. 1, according to the Kansas Hospital Association. One would hope we could gain a little capacity to give us more cushion heading into the holiday surge, but an unchanged rate is what qualifies as good news this week. Wichita's ICUs have now been over capacity for two full months, but they have their lowest number of COVID-19 patients since Nov. 2.

The Bad: The infection reproduction rate, or Rt, rose from 0.95 to 1.03. Not good. Anything above 1.0 means more cases, more hospitalizations and more deaths. This week's rise might reflect the holiday surge, but it didn't have to happen. Three other midwestern states, Minnesota, Wisconsin and North Dakota (which all now have statewide mask mandates and other restrictions), are still below 1.0.

The Ugly: Test positivity rose to 35.9%, according to Johns Hopkins. We'd been making some modest gains in that area over the last few weeks, getting the rate below 30% (still way too high). Now that's all gone. We've never tested enough in this state, since the beginning of the pandemic. And we still aren't. Not even close.