My family is camping this weekend and I have limited WiFi. As such, I need to postpone the Vaccine Q&A that was planned for today. As important as that effort is, it takes a considerable deep dive to find information and that’s not well suited to my remote setting. Instead, today’s newsletter will have two main areas of focus - making a case for expanded vaccine eligibility in Georgia and the latest COVID-19 numbers for Georgia.
Before I begin though, I want to thank those of you who nominated me for the Data Hero Award. You can read more about the award, my nomination and an interview that I did talking about this experience here. There is a great group of scientists and communications professionals on the Georgia page and I encourage you to read their stories also. Further, the organizers have created a map where you can find people like me, doing analysis and communication for other states. I wish we’d had this months ago!! I’ve been selected as one of 6 finalists for the award in the “Specialists” cohort and voting opens today. There are two of us in this category from Georgia (yay!). If you wish to vote you can do so here. The other people nominated are superstars and I feel lucky to be considered at all. To be abundantly clear, it is an enormous honor to have been nominated in the first place. I got to hear some of the things that you all wrote in your submissions and I just want to say that it means the world to me to know that I’ve helped you. Throughout all of this, my goal has been keeping as many of you safe as I can with clear and logical explanations of the data.
An argument for expanded vaccine eligibility in Georgia
There’s some exciting news today about expanded capacity for mass vaccinations at Mercedes-Benz Stadium in Atlanta. Previously this has been the site organized by the Fulton Board of Health (great job!). The Biden administration has announced that FEMA is going to expand operations there so that 6,000 doses can be administered per day and it will be open 7 days per week. Among the motivations for doing this is improving access for medically underserved communities and particularly to address the racial disparities in vaccine access. This is a big step forward and I hope that it helps. Still, it isn’t perfect, in that people still need to be able to get to Mercedes-Benz Stadium. There’s a MARTA station there so that will help, of course. I still think we need to see more community-oriented vaccine efforts rather than placing a large portion of the logistical burden on vaccine recipients. For those over 65, some of them don’t have reliable transportation, have difficulty scheduling appointments on the internet, etc.
We know that the deaths associated with the COVID-19 pandemic have been predominantly in people above the age of 65. So it makes sense that the state of Georgia prioritized this group for vaccination. But we also know that the pandemic has disproportionately impacted communities of color. As we think about addressing the racial disparities in vaccine uptake, I think it goes beyond a discussion (often a dismissal) based on vaccine hesitancy. I think access and eligibility are a big factor too. In fact, by setting the cutoff at 65, the state may be inadvertently perpetuating the health disparity caused by the pandemic.
Let’s consider those who have died so far across different race groups. The graph below uses data that are available for download each day from the Georgia Department of Public Health. It shows the median age of death for each race and ethnicity group. White populations have the highest median age of death from COVID-19, at 78. The youngest median age of death from COVID-19 is the “other” race (63), which includes the majority of people who identify as Hispanic (see section on the right) or Latinx. There is about an 11 year disparity between the median age for Hispanic and Non-Hispanic deaths from COVID-19. But generally, the deaths in all non-White, Hispanic groups are younger than those who are White and or non-Hispanic.
So this led me to wonder how much of these deaths were in people over the age of 65, or those who would currently be eligible for the vaccine. Does the 65+ cutoff for vaccine eligibility actually prevent the majority of deaths across racial lines? Those data are presented below, in the same order as was presented for median age of death.
What we can see here is that the logic for prioritizing those >65 years of age is correct for White and non-Hispanic populations. In those groups, 83% and 79% of the deaths occurred in those >65 years of age, respectively. However the proportion drops as you move to communities of color. In fact, for those in the “other” or Hispanic categories (and remember, there is some overlap in these two groups), only 47-50% of the deaths were in those >65 years of age.
Here’s the state dashboard for those who have received the vaccine by race and ethnicity. We can see that those who have received the vaccine are overwhelmingly White and non-Hispanic. Whereas Black / African Americans make up 32% of the Georgia population according to the US Census Bureau, they have only received 18% of the doses administered so far. Whereas Hispanic people make up 9.9% of the population in Georgia, they have received only 1.8% of the vaccine administered up to this point. It’s possible that some of this is due to poor data collection (see the “unknown” ethnicity bar).
So when the stated goal is to prevent as many of the deaths as possible, then we may need to adjust the age that we’re targeting for certain races. Setting the age cutoff at 65 is missing more than half of the deaths that are happening in Other and Hispanic populations. The graphs below show you the COVID-19 deaths in Georgia by age group and race. The orange line is meant to represent the 65+ cutoff for vaccine eligibility.
Looking at the data this way, it appears the current vaccine eligibility strategy is predominantly going to prevent White deaths. But there are a lot of younger deaths in the other race categories. We need to lower the age barrier to address some of the racial disparities in death that we’ve seen in the pandemic. We need to vaccinate essential workers, a large portion of which are people of color. According to CDC vaccine data from today, Georgia has 1,151,976 doses of the vaccine on hand (the difference between what has been delivered and what has been administered). Let’s get those doses out the door. Let’s save some lives and make sure that we are as equitable as possible in doing so.
Today Georgia reported a net increase of 35,861 new PCR test results through Electronic Laboratory Reporting. Of those, 4% were positive (yay!). There was a net increase of 12,193 new antigen test results and 5.8% of those were positive.
There was a net increase of 1313 newly reported PCR cases and 768 antigen cases for a combined total of 2081. This is a low day for Georgia based on recent trends. Of today’s newly reported cases, 34% came from nonrural counties outside of the Atlanta metro. The 7-day case rate decreased a bit today, but we still are in this noisy plateau. At present, the 7-day case rate for the state is 127% above the pre-winter surge baseline.
Today there was a net increase of 115 new confirmed COVID-19 admissions to the hospital and 15 admissions to the ICU. These are both low numbers for Georgia based on recent trends. Only two hospital regions are in the red zone for ICU bed usage (regions E and L) and statewide 81.3% of ICU beds are in use. For patient census, we have three regions in the green zone (hallelujah!) and they are regions G, J, and L. Statewide, COVID-19 patients make up 10.7% of the total hospitalized population.
Today there was a net increase of 64 confirmed and 1 probable COVID-19 death that were newly reported today. These are low numbers for Georgia based on recent trends. Of today’s newly reported confirmed deaths, 31% came from nonrural counties outside of the Atlanta metro. The 7-day death rate is 182% above the pre-winter surge baseline. The death rate is highest in rural counties and lowest in the Atlanta metro (Atlanta counties and suburb counties are equal today).
Have a great weekend!
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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.