Kansas COVID-19 Update, Week 58

It's a rough time in Kansas City's hospitals. Our ICUs hit a new record for COVID-19 patients this week, 224. That's even more than during the winter surge. Exhausting. The good news is that new hospital admissions for COVID appear to be slowing. It will take time for that to provide relief, however, because COVID hospitalizations tend to last awhile. Other data this week is kind of hard to parse.

The Good: Test positivity fell from 38.8% to 34.4%, according to Johns Hopkins. That's obviously still too high (fourth-highest in the country behind Oklahoma, Iowa and Idaho) but at least moving in the right direction. 

The (maybe) Bad: The infection reproduction rate, Rt, rose from 1.0 to 1.3 this week... maybe. That's according to the Rt website I've been using, and I want to be consistent with my data sources, but I have my doubts about that number, because new cases in Kansas seem to have leveled off since hitting a high of about 1,600 on Aug. 16. If the Rt were really 1.3, we would expect new cases to be rising fairly steadily.  Another Rt calculating website has Kansas at 0.94, which seems more indicative of what new cases are doing. If Rt is really 1.3 (or even close to 1.3) that is obviously bad. If it's actually 0.94, that's mildly good.

The Ugly: Statewide ICU capacity numbers are a little hard to come by this week because the Kansas Hospital Association has blacked them out with a message that says "Reporting is paused on these elements to allow hospitals to review their data submissions." I don't know what that's about. The good news is that total COVID hospitalizations statewide only rose from 728 to 731 this week. The bad news is, that's still pretty high. Wichita's major hospitals are both still at ICU capacity and their COVID hospitalizations rose from 147 to 177.  Topeka's COVID hospitalizations have leveled off at about 74 or 75, which is high for them, but fortunately not still rising. As mentioned earlier, Kansas City's hospitals are in a bad spot, especially on the Missouri side of the state line. The metro's Kansas hospitals had about 21% of their ICU beds available as of Aug. 25, but its Missouri hospitals were down to about 11%, which is pretty dire. On the Missouri side, fully 41% of all ICU beds were being used by COVID patients, which is truly staggering for a single diagnosis. Hopefully this is the worst it's going to get for our hospitals.

Bonus: I penned this op-ed for the Kansas City Star. 

Kansas COVID-19 Update, Week 57

I skipped last week's blog because I was on vacation and, honestly, I needed a mental break from this stuff. Here's what you need to know this week: things are bad in Kansas, hospitals are pretty full in several key parts of the state, but there are indications that things could get better soon. After a month of rapid rise, new infections in the Kansas City area are starting to level off. They're leveling off at the second-highest level they've ever been, which is obviously bad, but at least they're not rising any more. The end of the rapid rise coincides with the reinstatement of mask orders. My guess is that masks have something to do with it, but don't entirely explain the change in trajectory. Rather, the mask orders themselves are a clear signal to the public to change behavior again: to reduce movement and public mixing, to keep their distance from people not in their "bubble" and, yes, to wear a mask in indoor public places. All of those, together, likely helped stem the tide. In any case, the leveling off of new cases means that if we can hold on a week or two, our hospitals may get some relief. But the beginning of school is a major wildcard in all of this.

The Good: The infection reproduction rate, Rt, fell from 1.3 to 1.0 over the past two weeks. That's consistent with new cases leveling off. Missouri's Rt is below 1 now (0.94) which could mean they're finally on the back end of the Delta variant wave, which has been just devastating there. We're a couple weeks behind them in Kansas, but we have a slightly higher vaccination rate, so maybe our wave will end up being less extreme.

The Bad: Hospital ICU capacity statewide rose from 22% to 24% over the past two weeks, according to the Kansas Hospital Association, but things were still fairly dire in Kansas' largest metro areas. The Kansas City area and southeast Kansas were down to 19% capacity, northeast Kansas (including Topeka) was down to 15%, and south-central Kansas (including Wichita) was down to 16%. Sedgwick County's ICUs hit their normal capacity on Aug. 9 and have been operating on "surge" plans since then.  In fact, according to the governor, six of the state's largest hospitals are now at their regular ICU capacity. Lots of health workers in this state need a break. Our total COVID-19 hospitalizations are still increasing at a rate of around 100 per week (up to 728 this week versus 526 two weeks ago). It's good that that rate is no longer accelerating, but we need to see it go down.

The Ugly: Test positivity rose from 21.8% to 38.8% in the past two weeks, according to Johns Hopkins. You may recall that I had doubts about the accuracy of that 21.8% figure, though, because it was such a steep drop from the week below. Take that week out, and it's up to 38.8% from 33.7% three weeks ago, which seems more likely than wild swings week-to-week. Either way, still not good. I do wonder, though, if the rise of at-home tests is making it harder to get a good handle on test positivity. People who test negative at home are unlikely to report that to their health care provider, while those who test positive will probably seek out a publicly recorded test in order to confirm the positive. 

Kansas COVID-19 Update, Week 56

Well, the badness that I had feared was coming last week has come this week instead. With the exception of test positivity, all of the trends are going the wrong direction. Delta-variant COVID is moving like a wave from Missouri and Oklahoma into Kansas, and hospitals in Kansas City and Wichita are already feeling it. I'm still hopeful that we will eventually see a steep drop in new infections, like India and the UK did after their Delta surges. But in those countries the drop didn't start until after about two months of rising infections. The Delta variant first started showing up in KC wastewater in late June (which is, not coincidentally, when the current surge started).  That means we could have several more weeks of rising infections ahead of us, and maybe another month of rising hospitalizations (because hospitalizations lag infections). That's daunting.

The Good: Test positivity fell from 33.7% to 21.8%, according to Johns Hopkins. That's a significant drop, and makes me suspicious it might be some sort of data error. The only other explanation I can think of is that more non-symptomatic people are getting tested now before they start school/college, but it seems a bit early for that. For whatever reason, we definitely are testing more now. According to Hopkins, Kansas is reporting more than twice as many average daily tests (almost 150 per 100,000 people) than we were on July 27 (68 per 100,000). 

The Bad: The infection reproduction rate, Rt, rose from 1.2 to 1.3 this week. Cases are not only continuing to grow, but they're growing faster now. However, if the test positivity numbers are right, part of the reason for the increase might be that we're identifying more infections than we were before because we're testing more. 

The Ugly: Hospital ICU capacity went from 25% to 22% statewide this week, according to the Kansas Hospital Association. A deeper dive into the data shows real danger zones. In the medical hubs of Wichita and Kansas City, ICU capacity was down to 16% and 17%, respectively, this week. The state's largest hospitals are already feeling crunched. If you look at the MARC website you can see that the problem is more acute on the Missouri side of the KC metro. On Wednesday (the most recent day that all of the area hospitals reported their data), the 10 facilities on the Kansas side had about 21% of their ICU beds available, with 20% taken up by COVID patients. The 17 facilities on the Missouri side had about 11% of ICU beds available with 35% occupied by COVID patients. The wave is moving westward from central Missouri and has already basically smothered the KCMO hospitals. The ripple effect is now moving through the KCK and Johnson County facilities. COVID patients in Kansas hospitals rose from 415 to 526 this week, an increase that was more than double that of the week before. 

Bonus: This video from a doctor in New Orleans (which is also being hit hard by Delta) is worth watching. If your hospitals are full, it's bad for everybody, vaccinated or not.