Kansas COVID-19 Update, Week 33

Last week I said I was cautiously optimistic about where we were in Kansas, but still saw several pitfalls that could cause another COVID-19 wave here (re-openings, coronavirus variants and March Madness gatherings). This week I'm re-upping those concerns. The steep decline in new cases seems to be leveling off, not only in Kansas but nationwide (this New York Times article is a really good explainer of where we're at and what it could mean for the immediate future). If we can stay at this level we're probably OK in a macro sense — there will be more deaths but our health care system will be able to handle the flow of patients. But as we've seen, the coronavirus doesn't usually stay at one level for long. It spreads in waves, and if you're not on the downswing, you're probably not far from the upswing (unless you can get cases to a low enough level that you can test, trace and isolate everyone who's exposed, and we're definitely not there yet).

The Good: Test positivity in Kansas is down! It's below 20% for the first time in months, according to Johns Hopkins, clocking in at 17.6%. Last week it was 22.1%, the worst mark in the country. This week's number is better than four other states (Idaho, South Dakota, Iowa and Alabama). We must be doing a better job of testing. It's possible this coincides with more schools and colleges opening for in-person instruction. Education has generally been among the most diligent industries when it comes to testing. 

The Bad: The infection reproduction rate is up a bit this week, from 0.82 to 0.83. This is not a big jump, and 0.83 is still a really good number. The question is, will it stay there? The lifting of restrictions on bars, restaurants and general gatherings, in addition to new, more contagious variants means the number is likely to rise. What will help keep it down? The same things we've been doing (avoiding gatherings, especially indoors; wearing masks, especially multi-layered well-fitting ones) as well as vaccinations, vaccinations, vaccinations. The data is still preliminary, but so far it looks like several vaccine reduce transmission of the virus as well as reducing illness.

The Ugly: Hospital ICU capacity was down again this week, from 31% to 30%, according to the Kansas Hospital Association. Again, not a huge drop, but the trend is bad. And when you look deeper into the data there's a regional trouble spot: south-central Kansas, aka the Wichita area, which was down to 14% availability this week. That's a little concerning. Just last week Wichita's ICUs dropped below capacity (208 beds) for the first time in months. This week they're trending back toward full, going from 190 patients to 193.  Health care workers there must be exhausted and we haven't left much of a cushion to protect against another wave.  

Kansas COVID-19 Update, Week 32

 

There is still a lot to be optimistic about in this week's numbers. New cases continued to fall to levels not seen since early July. Wichita's ICUs were below capacity for the first time in 15 weeks (yes, you read that right). COVID deaths are tailing off considerably now. But there are still a few reasons to believe another wave could happen before we get enough people vaccinated to end the pandemic. 

The Good: The infection reproduction rate in Kansas continued to fall, from 0.87 last week to 0.82 this week. It's dropping a little more slowly now, but 0.82 is a really good number and means the total number of active cases should continue decreasing steadily. 

The Bad: Despite the good news from Wichita, overall ICU capacity statewide dropped from 34% to 31%, according to the Kansas Hospital Association. Every region of the state remains above 20% availability, so there is nothing critical here, but clearly some hospitals were more full this week, including the University of Kansas Hospital, which added five new COVID-19 patients Friday alone. That led KU's top infectious disease doctor to say the numbers were making him "a little uneasy," and when Dana Hawkinson talks about the pandemic, I listen. What would cause hospitalizations to go up even as overall cases go down? Two possibilities: a lack of testing (we're missing cases) or new variants of the coronavirus that are more likely to cause severe illness (we should probably be testing more for these mutations). 

The Ugly: Test positivity rose from 22.1% last week to 22.7% this week, according to Johns Hopkins. It's not a big jump, but this number really should be going down every week. When it's this persistently high, there are better odds that we're missing lots of cases, which makes it harder for us to stay ahead of surges that lead to lots of hospitalizations and deaths. Kansas now ranks dead last among all of the states in test positivity, at least as calculated by Hopkins. 

Bonus: A Johns Hopkins doctor made headlines Friday when he said that COVID-19 could be "mostly gone" in the USA by April, because new cases keep declining and the number of vaccinated people keeps rising. He might be right. I certainly hope so. But there are a few reasons that I think yet another surge could hit before we have vaccinated enough people to achieve herd immunity.

1. Reopenings (including schools): Bars, restaurants, entertainment venues, they're all opening back up, even in places like the Kansas City area that have been more aggressive about containing COVID-19 than the rest of the state. And state leaders want nearly all kids back in the classroom by next month. This is understandable, given that cases keep declining and businesses have been struggling. But the virus is still circulating, and although it's circulating at a lower level than a month ago, it's still a high enough level that our contact tracing won't be able to keep up. That means untraced transmissions, community spread, and unidentified infectious people who will be increasingly congregating with other people. That's a recipe for another surge.

2. Variants: The UK variant, the South Africa variant, the Brazilian variant — all spread more easily than the traditional COVID-19 coronavirus we've come to know and loathe. And they're making their way to Kansas, slowly but surely. To protect yourself from these mutant viruses, make sure your mask is multi-layered and fits well if you're going to be in close contact with other people, especially indoors. 

3. March Madness: In addition to the mega-spike in the fall caused by the seasonal nature of upper respiratory viruses, we also quite clearly saw mini-spikes of COVID-19 about a week after Thanksgiving and Christmas/New Year's. Which is extremely predictable. Those are times when people gather and when people gather, COVID-19 spreads. The next gathering is March Madness. Even if there will be few fans allowed at the games this year, you can bet they're still going to get together in bars and houses to watch their teams together. And unlike Thanksgiving and Christmas, those games will be happening every weekend for about five straight weeks (more, if you count the conference tournaments leading up to it). With bars open again and new variants floating around, March Madness could very well cause yet another spike. 

Kansas COVID-19 Update, Week 31

We continued on a really good trajectory this week. New COVID cases in the Kansas City area have dropped to their lowest levels since July, and the rest of the state is also declining, though not as quickly in some areas. With any luck, the recent snap of ultra-cold weather will help by keeping people in their homes for another week or so. We don't know when the next COVID wave is coming, but this trough right now is our opportunity to get as many people vaccinated as possible to blunt that wave when it arrives.

The Good: The infection reproduction rate dropped from 0.98 to 0.87 this week. That's huge. This is why cases are dropping so fast. Each infection is now causing only 0.87 subsequent infections, on average. That means a solid portion of people who are getting infected now aren't infecting even a single other person. And that should only continue as the number of vaccinated Kansans increases. 

The Also-Good: Available ICU capacity increased from 29% to 34% this week, according to the Kansas Hospital Association. Every region of the state had at least 22% capacity available. That's a robust number, and should ensure that everybody who enters ICU now has the best chance possible to get out alive. It also means that our health care workers can finally take a breath and some can maybe even take a well-deserved vacation. 

The Bad: Test positivity is still going down in Kansas, but slowwwwwwwly. It dropped from 24.3% to 22.1% this week, according to Johns Hopkins. That's still third-worst in the country, behind only Iowa and Idaho. It's perplexing that this number isn't improving more quickly, given how good the other numbers look. High test positivity means we may be missing lots of infections. But the fact that it continues to go down — however slowly — even as new confirmed cases also go down, signals that we can be confident the steady downward trajectory of new infections is real. 

Kansas COVID-19 Update, Week 30

 

Kansas passed 4,000 COVID-19 deaths this week (the state has confirmed 4,101 as of Feb. 5). The new deaths include, especially tragically, a 6-year-old. We passed 1,000 deaths in late October, we passed 2,000 by Dec. 12, and we passed 3,000 the week of Jan. 9. So the pace of deaths has leveled off, but we're barely at the downturn. Still, there are several signs that a precipitous drop is finally coming.

The Good: Hospital ICU capacity improved from 22% to 29% this week, according to the Kansas Hospital Association. That's an excellent jump. This is the last step before deaths start to really drop: more empty ICU beds. 

The Not-bad: The reproduction rate, or Rt, dropped from 1.0 to 0.98. I'd like to see a bigger decrease, but this new site where I'm pulling the data from seems fairly conservative in its estimates, and an 0.98 still means that total infections are decreasing.  

The Bad: Test positivity in Kansas dropped from 25.7% to 24.3% this week, according to Johns Hopkins. It's barely moving, which gives us some room to doubt just how much new cases are really decreasing (we're clearly missing a lot of cases, we just don't know how many. This is why it's hard to pin down an Rt). However, based on our improving hospitalization figures, they clearly are decreasing. Only Alabama and Idaho currently have worse test positivity numbers than Kansas.