The Daily Digest, 10Aug2020

Georgia COVID-19 Updates

Hello and welcome! On Mondays each week, I take a look at national data for COVID-19 and see how Georgia fits into that larger context. Briefly, here are the “new” data for today in Georgia.

Testing: there were 26,914 new tests reported today (an average day for us) and 8.3% were positive.

Cases: there was a net increase of 2429 cases today, resulting in a new statewide total of 219,025. The largest contribution of new cases was 648 from nonrural counties that aren’t part of the Atlanta metro.

Hospitalizations: GEMA is reporting that the current number of hospitalized patients is 2871, a small increase over yesterday’s number (2865). As of yesterday’s situation report, Region H was down to 1 ICU bed available and Region L was down to five.

Deaths: there was a net increase of 30 deaths today compared to yesterday’s total. The new statewide total is 4229. Ten of these deaths came from nonrural counties (not affiliated with the Atlanta metro) and another ten came from rural counties.


Research

There’s a new report from the American Academy of Pediatrics and the Children’s Hospital Association. The summary can be found here and the full report here.

Some highlights:

  • There have been 338,982 COVID-19 cases in children to date across the United States, representing 8.8% of all the cases recorded so far (across all age groups). This corresponds to a case rate of 447 per 100,000 children in the US. Georgia is above that national average, at a rate of 570.9 per 100,000 children.

  • In a recent two week period, between July 16 - 30th, there were 97,078 cases reported in children, representing 28.6% of the cases reported in children to date. That’s pretty explosive growth in a short period of time.

  • Georgia is 6th in the nation for cumulative pediatric COVID-19 cases (total counts). When adjusted for population, we are 12th in the nation for pediatric cases.

Here’s how pediatric cases per 100,000 children have accumulated over time, nationwide, using the AAP report data.

Below I’ve provided a map that shows the pediatric cases per 100,000 children since the start of the pandemic, using the data provided in the AAP report.

As a reminder, the national average is 447. So anything in the top three color tiers is above the national average. Notes: only New York City provided age data, so despite the map coloring in the whole state, the data are just for New York City. Alabama classifies their children as any person 0-24 years of age, so their data were omitted by AAP. Texas only had age breakdown for 8% of the total cumulative cases to date, and was therefore omitted from the analysis by AAP.

Another important finding is the mortality data for children. There have been 86 pediatric deaths as of July 30th and 338,982 pediatric infections. Therefore, the child mortality rate is 0.03%. It is a relief to see such a tiny percentage, for sure. To compare that to influenza (see table below), in the 2018 - 2019 season there were and estimated 477 pediatric deaths out of 11,296,414 illnesses. That would mean a mortality rate of 0.004%. Compared to seasonal influenza, the COVID-19 mortality rate among children is 7.5 times higher. So it is incorrect to say that COVID-19 kills fewer children than influenza - it just hasn’t had the chance to spread to kids at the same rate as influenza due to existing public health recommendations, thankfully. This isn’t the time to let our guard up.

Thankfully, most cases in children are mild. But in adults, we’ve seen long lasting damage in their hearts and other areas. We don’t know what the mid and long-term impacts are for kids. But it’s important to remember that COVID-19 isn’t a benign infection for everyone and survival and death aren’t the only outcomes.


Cases

According to CDC’s COVID Tracker, the US stands at just under 5 million cases as of 09Aug for a case rate of 1,518 per 100,000 people. Comparatively, Georgia has a case rate of 2,029 per 100,000 people and we rank as the 7th highest state in the nation for this metric. When considering cases just within the past 7 days, Georgia has recorded 23,415 and that puts us in 4th place after Texas, Florida and California.

For recent trends I’d like to turn to Harvard’s Global Health Institute tool. This features really intuitive stoplight-inspired color coding where green means good, red means bad and yellow and orange are varying levels of caution.

Based on the daily new cases per 100,000 people (7-day moving average), Georgia is fourth in the nation and just one of ten states that are classified as red. More on their color coding below:

If we look at just the state of Georgia, just 7 of the state’s counties fall into the green or yellow categories, showing that they are on track for containment or have manageable levels of community transmission. This resource considers any state in red to require a stay at home order to bring transmission back under manageable levels. Eighty nine of Georgia’s 159 counties are classified as red at this time, including many of our most populated counties.


Testing

For testing, Georgia ranks 9th in the nation for total tests performed, but still has a percent positive rate that ranges between 11-20%.


Hospitalizations

The Health and Human Services dashboard for hospitalizations data hasn’t been updated since 03Aug. So it’s kind of useless right now. Unfortunately, that’s the best resource we have for current hospital capacity and usage right now at a national level. So the bottom line is we really don’t know what’s happening at a national level or even state by state level for hospitalizations.

Among those who are hospitalized, these are the most common underlying conditions noted by CDC.

It’s hard to read, but the top three conditions for adults are hypertension (52.6%), obesity (50.2%), and metabolic disease (includes diabetes, 40.4%). Among pediatric patients, the top three conditions are no known condition (in other words, healthy kids, 48.3%), obesity (38.4%), and neurologic disease (13.6%). These data also haven’t been updated since 01Aug2020.


Deaths

When we look at deaths across the US, Georgia ranks 16th in the nation for deaths per 100,000 residents. Our death rate is 40 per 100,000 people. The national rate of death per 100,000 residents is 48.9. So we are below the national average for deaths.

Lastly, I wanted to touch on a model that is making headlines right now from IHME. Among some of my colleagues, this is a prediction model for coronavirus that has tended to have an overly optimistic view on the pandemic. So it has been interesting, but my colleagues tend to favor other models. Most recently, they’ve made news for estimating that a nationwide mask mandate would save 66,739 lives by December 1st compared to our current plan that doesn’t include a nationwide mask mandate. However, I saw something even more interesting in their assumptions page:

I mean, if even the rosiest of COVID-19 projection models is saying that Georgia needs to consider a statewide stay at home order, then that’s saying something. That’s it for today. I’ll be back on Wednesday!


References

https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/children-and-covid-19-state-level-data-report/

https://downloads.aap.org/AAP/PDF/AAP%20and%20CHA%20-%20Children%20and%20COVID-19%20State%20Data%20Report%207.30.20%20FINAL.pdf

https://www.cdc.gov/flu/about/burden/2018-2019.html

https://jamanetwork.com/journals/jamacardiology/fullarticle/2768916

https://www.cdc.gov/covid-data-tracker/#cases

https://covid19.healthdata.org/united-states-of-america


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