Kansas COVID-19 Update, Week 37

 

The next COVID-19 surge is coming. About half the states are now reporting rising case numbers, and overall cases are now rising nationwide again for the first time in months. In the states that have it worst right now, like Michigan, it seems pretty clear that new variants are driving the surge. We know those variants have already appeared in the metro areas of Kansas: Wichita, Kansas City, and now Lawrence. We don't know how much they've spread yet. Last week's metrics looked really good. But there are signs in the data this week that we're losing those gains.

The Good: The infection reproduction rate rose from 0.86 to 0.92 this week. That's not a good trend, but I'm sort of grasping for good signs this week and 0.92 is still a pretty encouraging number, if we can keep it there (or lower). Right now we're in a sustainable position in terms of our health care system and as long as we keep Rt below 1.0, it should stay sustainable. 

The Bad: Hospital ICU capacity fell from 34% to 28% statewide this week, according to the Kansas Hospital Association. Every region is still at 17% or more capacity, so it's not critical, but the cushion is not huge and it appears to be getting smaller. The number of Kansans currently hospitalized with COVID, is still relatively low (about 280, compared to well over 1,000 throughout most of November, December and January). But it appears to be increasing again.

The Ugly: Test positivity rose from 11.6% to 15.5% this week, according to Johns Hopkins. That's a pretty big jump, and Kansas is now third-highest in the country, behind Idaho and Iowa. We're not getting tested enough. That's makes it harder to recognize the surge when it comes, and delays any response to it. 

Kansas COVID-19 Update, Week 36

This week's post is going to be brief because, well, there's a lot of college basketball on TV and everything looks pretty good in Kansas right now. That's not to say we should get complacent — COVID-19 cases are actually rising in 14 other states (including my home state of MN) right now and the new, more contagious variants are showing up more and more often in the U.S. (meanwhile COVID is still absolutely ravaging other countries, like Brazil and parts of Europe, which raises the specter of even more variants emerging because every infection is a chance for more mutations). But every week like this buys us more time to get more shots in arms and keep Kansas from experiencing another month like December or January.

The Good: The infection reproduction rate ticked down again, from 0.87 to 0.86. Not a huge drop, but it's moving the right direction and plenty low enough to keep the number of active cases from rising. Hospital ICU capacity was up significantly, from 28% to 34% statewide (with 92% of hospitals reporting), according to the Kansas Hospital Association. The fullest region was south-central Kansas, at 22% capacity available. The statewide test positivity rate dropped from 13.6% to 11.6%, according to Johns Hopkins. That's still fourth-worst in the country, but an encouraging week-to-week improvement. When new cases and test positivity are both declining at the same time, we can be pretty confident that we're truly reducing the number of infectious people out there in our state (and not just testing less). 

The Bad and/or Ugly: There is none! Let's watch some hoops. 

Kansas COVID-19 Update, Week 35

Well, we know the coronavirus is still with us here in Kansas... because it seems to be circulating within the KU men's basketball team at the worst possible time. But overall things are still looking pretty good. New cases continue to trend downward. We're now averaging about 250 a day statewide, which is a level not seen since last June. We were recording about ten times more than that in January. So we've come a long way.

The Good: After jumping up last week, the infection reproduction rate (Rt) appears to have stabilized, even dropping a tick from 0.88 to 0.87 this week. There's always some uncertainty about this metric because it depends on testing, but unless we're at the uppermost range of potential missed cases, the true number is still below 1.0, and that means the pandemic is losing.

The Bad: After dropping steadily for several weeks, test positivity barely moved this week, falling only from 13.7% to 13.6%, according to Johns Hopkins. It's still a major improvement from where we were a month ago, but Kansas remains among the bottom five states in this metric and that hampers our ability to get a handle on how much virus is really circulating (and nail down precise measures for things like Rt).   

The (Maybe) Ugly: Hospital ICU capacity dropped again, from 30% to 28%, according to the Kansas Hospital Association. But I have some reasons to doubt the accuracy of that. For one thing, the percentage of hospitals reporting, which had been at or close to 100% since November dropped to 91% this week. So we're missing some data, but it's probably a good sign that some hospitals are now so unconcerned that they aren't even reporting any more. And the data that is there suggests that the number of ICU beds taken up by COVID-19 patients is quite low right now (only 48 statewide). 

Plus, the University of Kansas Hospital reported this week that it was down to five patients with active COVID-19 infections, including just one in ICU (another 18 COVID patients were still recovering in the hospital, but were no longer contagious). That's down from 167 infectious patients in December, which is remarkable progress. KU is the state's biggest hospital, so this indicates that it's unlikely other hospitals are facing capacity issues due to COVID. It also indicates that at this point the pandemic is probably mainly circulating among young people (like the KU basketball players) who are less likely to be hospitalized. Which makes sense, given that a significant percentage of our seniors are now vaccinated. 

In short, I'm not too worried about the hospitals right now. But that could still change if we have a major surge. A study just published by the Mayo Clinic showed that even middle-aged adults are at significant risk of hospitalization if they get COVID. Only about 3.5% of those 18-34 who caught it had to be hospitalized, but that number rose to almost 10% among those 35-49 and 18% among those 50-64 (who, by and large, aren't vaccinated yet in most states). So if the pandemic wave turns upward again, we could still need a significant number of hospital beds. And that risk will probably remain until we get vaccines to everybody 35 and up.  

Bonus: Want to see how well your county has done at keeping the virus in check? The Wichita Eagle published a county-by-county breakdown of per capita cases and deaths this week to coincide with the one-year anniversary of the pandemic. The standout counties in terms of fewest confirmed cases were Woodson, Riley, Douglas and Jewell. Riley and Douglas are pretty remarkable success stories, given that they're home to large universities that were doing a lot of testing and therefore would be expected to find more cases than other counties. The lowest per capita COVID death rates belong to Hamilton, Riley, Smith, Douglas, Atchison, Greeley and Linn counties. That's also an important metric, obviously, but it's more subject to being skewed by things that aren't directly related to mitigating transmission of the virus — like the age of the county's population and the access to medical care.

Kansas COVID-19 Update, Week 34

Again this week the metrics themselves are overall pretty good, but the trends are mixed. Some numbers are moving in the right direction, some are stagnant and some are going the wrong way. I still think it's possible we will see another spike in cases in the next couple months, but I remain optimistic that vaccines and acquired immunity from prior infections will blunt it (more on that below).

The Good: Test positivity continues to fall steadily in Kansas, from 17.6% last week to 13.7% this week, according to Johns Hopkins. After months of watching this metric stick stubbornly above 20% (or even 30%), the recent multi-week decline has been really good to see. Kansas is still fourth-highest in the country in this metric, but the three states that are worse (Idaho, Alabama, Iowa) are all significantly worse (18% or more). Kansas is finally headed in the right direction. 

The Bad: Hospital ICU capacity remained unchanged at 30% this week, according to the Kansas Hospital Association. The number itself is not bad — 30% capacity is plenty manageable if it stays there. But it's not a huge cushion in the event that we do face another surge. The south-central Kansas region remains the foremost potential trouble spot, at 14% capacity. 

The Ugly: The infection reproduction rate rose from 0.83 to 0.88. Again, 0.88 is not a bad number, but it's the trend that's ugly. This is now several straight weeks that this number has gone up. Here's the thing, though: based on the decreasing test positivity rate, it could be that previous estimates of Rt in Kansas were artificially low because we weren't testing enough to identify most cases. It's likely that we were never really as low as 0.82 and we're now getting closer to an accurate picture of how much infection we're truly spreading. As long as it stays below 1.0, and the test positivity rate keeps going down, we can feel good about where we're heading. 

Bonus: About 8.5% of Kansans are now fully vaccinated against COVID-19, according to the New York Times. About 17% of residents are partially vaccinated, which provides at least some protection against infection. This is not nearly enough to convey herd immunity (probably need at least 70%), but when you consider that in some parts of the state close to 50% of people have some measure of acquired immunity from getting COVID in the past year, we may be getting close in some regions. And the people not yet vaccinated right now skew younger, which means they're less likely to end up in the hospital if they do get COVID-19. All of this should hopefully prevent a repeat of November/December, when hospitals were full and desperately seeking transfers for dying patients.