Kansas COVID-19 Update, Week 69

It looks like the beginning of the winter surge is upon us. New cases are up, and hospitalizations are up too. For now, deaths still seem to be trending down from September/October levels, but deaths are of course a lagging indicator. This year's winter surge is not likely to be as bad as last year's, especially in terms of hospitalizations and deaths, because of the vaccines. But this year we also seem to have more people in hospital beds for non-COVID reasons. So, a friendly reminder: you can get your annual flu shot and a COVID booster at the same time.  

The Good: The infection reproduction rate, Rt, rose from 0.96 to 1.0 in Kansas this week. That qualifies as good news this week because the rest of the news is worse and also because, if you read last week's blog, you know that I wasn't super confident in that 0.96 figure anyway. In fact, given our lack of testing, I'm guessing 1.0 might be artificially low too. 

The Bad: COVID hospitalizations statewide rose from 393 to 443, according to the Kansas Hospital Association. Of those, 114 are in ICU. Hospitalizations in the Wichita area fell from 102 to 97, but the number of cases in ICU remained at 51.  ICU availability in KC area hospitals fell from 18% to 17%. 

The Ugly: Test positivity rose from 37% to 37.6%, according to Johns Hopkins. That's still fourth-worst in the country behind Iowa, Oklahoma and Idaho. And Kansas is still running the fifth-least tests per capita in the U.S. One caveat: these numbers, for the most part, don't include at-home tests. The news this week that Lee Norman is stepping down as KDHE secretary spurred me to go back and listen to an interview he did for the Kansas Reflector podcast in May. In it he predicted that the rise in at-home tests would skew test positivity numbers because negative at-home test results are almost never going to be reported, while most positive results probably will be eventually (when a patient gets a PCR test to confirm the positive). I can confirm that this has happened in my house. My wife and I have run several at-home tests, they've all been negative, and those negatives weren't figured into any official test positivity data. That could be playing a role in keeping Kansas' test positivity stubbornly high, especially if Kansans are relying on at-home tests more than residents of other states. 

Bonus: Throughout the pandemic I have found Eric Topol's Twitter feed to be invaluable. He's a physician-researcher with a "just the facts" style who does a really good job of spotlighting important, reliable studies and then putting their results in context. This week he spotlighted the first randomized, controlled trial to show the effect of COVID boosters. All 10,000 participants in the study had gotten two doses of the Pfizer vaccine earlier this year. One group was given a real booster, and the control group was given a placebo "booster." Both groups were then watched for two months. The results were striking: the group that got the actual booster saw their protection against symptomatic infection rise to 95% within seven days. And the best part? There were actually more adverse events reported by the placebo group than by the group that got the actual booster, suggesting it's extremely safe. Now, the people in the placebo group remained well-protected against severe illness from their first two shots — none were hospitalized for COVID and only two suffered a "severe" case (determined by an oxygen saturation level of 93% or below). But they were more likely to get an infection (which can still be pretty crummy, if not life-threatening) and therefore more likely to pass the virus along to others. Boosters are now open to all adults, and the data shows they can really help our communities stem the spread.