The COVID Digest, 27Apr2021

Georgia COVID-19 Updates

Vaccine Update

The data provided in the table below are publicly available from the CDC update as of the morning of 27Apr2021. The table compares Georgia’s data to the US average. CDC indicates that 8,793,835 doses have been delivered in the state of Georgia and 6,011,504 have been administered in the state of Georgia. That leaves an inventory of 2,782,331 doses on hand. Last week, Georgia moved up in the rankings for several of the items below. This week, the state moved up for adults with 1+ dose of vaccine and for total population and adults who are fully vaccinated.

We have new data on where the doses delivered to Georgia have gone, as of 25Apr. In the past three weeks, the doses sent to the state government have made up a shrinking proportion of the doses delivered. Meanwhile, doses shipped to federal retail pharmacy program and the FEMA CVC Pilot Program have taken up a bigger share of the pie.

If we look at how the dose supply has increased for different providers in the state, this is the percent change in about 3 weeks time.

What does this mean? I can think of at least a couple possibilities: (1) state vaccine providers are ordering less vaccine and this might make sense with the closing of GEMA mass vaccination sites in May, (2) the federal government is going all in on community-oriented vaccination efforts including the HRSA federally qualified health center program and the FEMA CVC Pilot program.

For people who have received at least one dose of the vaccine, the rate of increase has started to level off, first for the state of Georgia and then for the nation. This is likely part of the reason why the GEMA Mass Vaccination sites are being closed next month.

It took Georgia a long time to figure out mass vaccination sites, but they have now served their purpose. The people who could be served through one of these sites have likely been served and now the state needs to pivot to community-oriented vaccination efforts that meet the population where they're likely to gather. This could include schools, workplaces, churches, grocery stores, government buildings, or even mobile clinics that go from neighborhood to neighborhood. As logistically complex as the mass vaccination sites might have been to put together, that was actually the "easy" phase of the vaccination effort. The pivot to community-oriented vaccination is less efficient, more time consuming and resource intensive. But it's the critical work that needs to be done to facilitate Georgia's safe return to post-pandemic normal. There are still a lot of people who want to be vaccinated but couldn't be served for whatever reason at a mass vaccination site. I hope that GEMA and the Georgia National Guard will continue to participate in vaccination efforts on a community level. Because the workforce to administer vaccines is the rate-limiting issue a lot of the time.


The United States

The map above comes from the CDC COVID-19 Tracker on the Community tab, county view. The map above looks at the combined community transmission indicators that looks at both case rate and test positivity. Red and orange are considered the danger zone, yellow is safer and blue is safest. The northeast corner of the country and upper Midwest continue to be areas of intensity. Closer to Georgia, many of its neighbors majority red/orange including Tennessee, the Carolinas and Florida.

According to data from the 25Apr2021 HHS Community Profile Report (the source document for the White House Coronavirus Task Force reports), the top five states in the nation for new case rate per 100,000 residents are Michigan, New Jersey, Delaware, Minnesota and Pennsylvania. The top five states in the nation for new death rate per 100,000 in the past 7 days are Michigan, New Jersey, Pennsylvania, New York and West Virginia.

The table below tells you where we are this week and how that compares to the previous week (in parentheses). The data for everything comes from the HHS Community Profile Report from 25Apr2021.

Georgia has just one county in the top 20 counties in the US for new case rate, Chattahoochee county at #4, the same as the previous week.

The table below shows the highest and lowest ranking states and territories from the latest HHS State Reports (formerly known as the White House Coronavirus Task Force Reports). You can find the most recent report here.

I’m not sure what has happened to West Virginia. They were an early success story in the effort to vaccinate. But now it is the worst state in the nation for administering vaccine doses to its senior population.


Georgia

We can zoom in on a current view of Georgia using the CDC community transmission criteria. Last week, there were 14 counties in the blue category and 49 counties in the yellow category, with 60% of Georgia’s counties in the substantial or high transmission categories. This week, there are 4 blue counties and 50 counties in the yellow category. That leaves 66% of the state’s counties in the substantial or high transmission categories. Nationally, 69% of US counties are in the red or orange zone. So Georgia is performing slightly below the national average, in a good way.

This week, more of the Atlanta metro has shifted from red to orange. Things are getting better along the border with South Carolina. But there are more red and orange counties in the southern half of the state than there were last week.

From the most recent HHS State Report (formerly known as the White House Coronavirus Task Force reports), the graph below shows how the proportion of Georgia counties in each color class has shifted over time. It’s been a bouncy trajectory, but the trend has been a decreasing proportion of counties in the red zone since mid-March and an expansion of yellow or blue counties.

Testing

According to the most recent HHS Community Profile report, Georgia is ranked #33 in the nation for test positivity (yellow zone) and #46 in the nation for tests performed per 100,000 (with 1 best best for both), in the orange zone.

The graphs below come from the executive summary of the HHS Community Profile Report for 25Apr2021 (PDF). The top graph shows test positivity (nationally) for age groups. The test positivity is highest for 12-17 year olds (middle school and high school aged children) and lowest for 65+. That means we’re doing a good job of testing 65+ but are likely missing cases among teenagers.

The bottom graph looks at tests performed per 100,000 residents, or testing output. Part of the reason why test positivity is low among 18-24 year olds is because we test them the most. When you’re testing widely in a population, you’re less likely to miss cases in that group. For most age groups, testing output is relatively flat since the beginning of March. But testing is increasing among all children. That’s really important since many areas around the country have returned to some version of in-person learning at school. Part of doing so safely is having a strong safety culture inside the building, including universal and appropriate mask wear, distancing, ventilation, etc. But another big part of it is making sure we’re testing children more frequently also. When humans gather, the virus has the chance to spread. Schools are a big human gathering point.

If we drill down to Georgia, we can see the following test positivity rate by age group in the chart below. Only children <5 and adults 65+ are under 5% test positivity. We are undercounting disease in all other age groups, and especially among K-12 aged children, 5-17.

It was a low day for PCR testing volume day for Georgia but not for antigen testing. There were 16,951 newly reported PCR tests and 4.4% were positive. There were 10,221 newly reported antigen tests and 5% were positive.

Cases

Cases are flat for Georgia and decreasing for the nation. Georgia is ranked #23 (with 1 being best) for new case rate, in the orange zone, according to the 25Apr2021 HHS Community Profile Reports.

Today there was a net increase of 1299 newly reported cases for Georgia, with 787 identified by PCR and 512 by antigen testing. The state’s case rate is relatively flat, about 13.5% higher than the post-winter surge low point, set on 06Apr.

Something to pay attention to is a substantial increase in the number of school-associated clusters of COVID-19 disease. In the most recent week reported, there was a new record that was a little under twice as high as previously recorded. The Georgia Department of Public Health generates these reports on Fridays and usually posts them the following Monday. The timing of this really large increase is compatible with people picking up disease during spring break and then bringing it to school. DPH doesn’t tell us how many cases are associated with each cluster or the breakdown of students, faculty/staff, family members, etc. It’s a good reminder that we need to encourage good public health habits inside the school building to make it a safe environment for everyone until vaccines are widely available for all ages.

Hospitalizations

Today there were 117 newly reported COVID-19 hospital admissions and 25 admissions to the ICU. These are typical numbers for a Tuesday.

For confirmed COVID-19 hospital admissions per 100 beds, Georgia is ranked #45 in the country (with #1 being best), in the orange zone.

Deaths

Death rate is flat for the US and decreasing for Georgia. Georgia is ranked #45 in the US (with 1 being best) for new death rate per 100,000, in the red zone.

Today Georgia reported a net increase of 4 newly reported confirmed COVID-19 deaths and 14 probable deaths. This is a low day, thank goodness. The state’s death rate per 100,000 is now 5.8% below the pre-winter surge baseline, a very good place to be. Let’s keep that going. Get vaccinated or help those around you to get vaccinated.


References

https://covid.cdc.gov/covid-data-tracker/#vaccinations

https://dph.georgia.gov/covid-19-daily-status-report

https://covid-gagio.hub.arcgis.com/

https://covid.cdc.gov/covid-data-tracker/#county-view

https://beta.healthdata.gov/Health/COVID-19-Community-Profile-Report/gqxm-d9w9

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/distributing/jurisdiction-portfolios.html

https://dph.georgia.gov/school-aged-covid-19-surveillance-data

https://www.ajc.com/news/georgia-to-wind-down-state-run-mass-vaccination-sites-by-may-21/3IKFIIYO75CJFOCZHIQR3C56IQ/


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My Ph.D. is in Medical Microbiology and Immunology. I've worked at places like Creighton University, the Centers for Disease Control & Prevention and Mercer University School of Medicine. All thoughts are my professional opinion and should not be considered medical advice.