Kansas COVID-19 Update, Week 38

 

We're still looking good in Kansas. Nothing "ugly" this week, but there are reasons for watchfulness. Cases are still decreasing here, but the decrease is slowing (and cases now appear to be increasing in several states near us, which will have spillover effects). 

Michigan is fast becoming a cautionary tale about letting our guard down too early. Hospital ICUs are filling again in places like Detroit and Flint after COVID hospitalizations statewide doubled in March, driven mainly by variants infecting people in their 50s. Like other states, Michigan has now successfully vaccinated most of its seniors. But remember, according to the Mayo Clinic study cited in Week 35, almost 20% of people age 50-64 who get the coronavirus require hospitalization. That is very high compared to illnesses like the flu, and it means that hospitals can still fill up fast if thousands of people in that age demographic (which is largely still waiting on immunization) get infected in a short period of time. So for now, the prescriptions remain the same: wear a snug-fitting mask, maintain some distance from other people if at all possible, wash your hands, etc. At least until two weeks after your second shot. 

The Good: Test positivity dropped from 15.5% to 11.4% this week in Kansas, according to Johns Hopkins. That's almost exactly where it was two weeks ago, which makes me wonder if last week's spike was some sort of fluke or data reporting issue. Either way, it's good news. But Kansas is still sixth-highest in this metric nationally (behind Idaho, Iowa, Michigan, Alabama and South Dakota).

The Neutral: Hospital ICU capacity stayed the same, at 28%, according to the Kansas Hospital Association. It is now 16% in the south-central (i.e., Wichita) region, which is a little concerning, especially with new variants continuing to show up in Kansas. But every week that ICU capacity stays the same statewide is a win for us right now because it gives us more time to get vaccines in arms. About 30% of all Kansans (including yours truly) have now gotten at least one shot, and there's mounting evidence that even one shot significantly reduces your risk of carrying or transmitting the virus. States like Michigan that are experiencing rapid surges of cases would probably be well-advised to focus their vaccine doses on first shots right now, as England has done, even if it means delaying second doses for the time being. 

The Bad: The infection reproduction rate rose again, from 0.92 to 0.94. It's not time to panic, but the trend here is bad. This is two weeks in a row that this number has gone up, and we're creeping awfully close to that 1.0 threshold of where total case numbers will start to increase again. 

Bonus: Masks are in the news again in Kansas, as the Republican-led legislature has decided to overturn the Democratic governor's attempt to get everyone to wear them in public places. Someone asked me on Twitter recently how long states should really be expected to keep public health measures like mask mandates in place, now that vaccines are rolling out. I personally think there are two scenarios that should make us comfortable lifting the mask rules: 1. We reach herd immunity via vaccines (experts believe this will require about 75-80% of the population to be immunized), or 2. We drive case numbers so low that public health officials can identify the sources of all (or nearly all) infections, isolate positive cases and quarantine their contacts. This is what we already do with other contagious illnesses, like measles. We halt infection chains and keep epidemics localized. Unfortunately with COVID, our case numbers quickly overwhelmed our ability to do that last year, and we've never really gotten them low enough to do it since then. That has kept us in a state of "community spread," which is when public health officials can't identify the source of infections and instead have to advise us to treat everyone we come into contact with as a potential source. When you have community spread of COVID, requiring masks in indoor public places remains the easiest, lowest-cost way to reduce infections. There's evidence that after the initial wave last year (when masks were not really in wide use anywhere in the U.S.), the states that adopted mask rules generally suppressed the spread of the virus better than the states that didn't. So if it were up to me, I would stick with the mask mandates until we no longer have community spread, our we've reached herd immunity, whichever comes first.