The Daily Digest, 14Sep2020

Georgia COVID-19 Updates

The World

Globally, the SARS-CoV-2 virus that causes COVID-19 disease has sickened >29 million people and killed 924,213 (+35,312 in the past week) as of this morning.

The US is a warm spot (not red hot as before), as is much of the Western hemisphere. Our weekly case rate per 100,000 is 75 (down from 87) and we are ranked 26th in the world with this case rate. Some of the hottest areas for disease right now are in Central and South America, France and Spain.

For deaths, our weekly death rate per 100,000 is 1.6 (down from 2) and we are ranked #15 in the world for this (the same as last week).


The United States

As hot spots go, the South is cooling off for now and disease hot spots are cropping up throughout the Midwest. In fact, my new state (Kansas) has a higher disease rate in the past 7 days than Georgia. Georgia is ranked #14 in the nation for 7-day case rate per 100,000, a drop from #13 last week. Of the top 10 states, only 2 are in the South. So it’s definitely encouraging news to see that for the state and the region, although there may be more to worry about on a local level.

When I mentioned that there more to worry about at the local level, the table below is what I mean.

In the past week, Georgia has 4 of the top 20 counties in the US for 7 day case rate per 100,000 and Wheeler county in southeast Georgia is number 1. Chattahoochee county also has a high case rate (ranked #3 county in the nation) and much of this is probably associated with Fort Benning. Clarke county is ranked #12 in the nation and its increases are most likely due to the return of college students to the University of Georgia campus. Lastly, Stewart county is ranked #19 in the nation.

As cities go, there are two cities in the top 20 for case rate per population in the past 2 weeks. Last week, Statesboro and Athens were ranked numbers 4 and 9, respectively. This week, Statesboro has dropped to #18 and Athens has climbed to #4.

According to the CDC, Georgia has a cumulative test rate of 23,066 per 100,000 residents and we are ranked 12th in the nation for this. If we look at percent positive rate using the map below, you can see that all of the South is experiencing a high rate. It appears this is based on cumulative data, though the website is not clear on that.

To look at more recent testing data, we have to go back to the New York Times resource. It indicates that Georgia is ranked 23rd in the nation with 205 tests performed per 100,000 people in the past 2 weeks. Together with the Harvard Global Health Institute, they estimate that Georgia is performing at 44% of the ideal testing target. Last week we were performing 207 tests per 100,000 residents which was 46% of the testing target. So we are doing slightly worse this week than the previous week. Ideally, we need to be ramping up screening and testing at locations where we expect outbreaks to occur - healthcare settings, nursing homes, K-12 schools, college and universities, meat processing plants, jails and prisons, etc.

The Department of Health and Human Services hospitalizations dashboard hasn’t updated since September 9th, so I’m going to instead highlight some data on hospitalizations that CDC has compiled, updated 05Sep on hospitalizations by age and race. First, here’s how hospitalizations have varied over time based on age. Note that adults are tracked using the right y-axis. Children, because their numbers are smaller overall are measured on the left y-axis.

Hospitalizations are declining for all adults and school-aged kids while holding steady for children 0-4 years old. You can also see that hospitalization increases with age.

Next, they’ve provided a look at how hospitalizations vary (cumulatively) by race and ethnicity. You can see that hospitalization rates are greatest among Hispanic or Latino, Non-Hispanic Black and Non-Hispanic American Indian or Alaska Native populations. These rates are about 4.6 times higher than for Non-Hispanic White populations.


Georgia

Here is how the state of Georgia is looking based on the risk tool from the Harvard Global Health Institute. The color coding is explained below the map.

This is a big improvement from previous weeks. Four counties are green, considered on track for containment (keep the testing and tracing going!). Forty five counties are yellow, indicating that there is community spread that might be manageable with adequate testing and contact tracing. These counties include some of our most populated ones such as Fulton and DeKalb. However, the remaining 110 counties have such widespread disease that containment of the virus is not currently possible without a shelter in place order. There just isn’t enough testing or contact tracing to monitor or control disease spread. Instead, we need human behavior to play a role here such as mask wear, adhering to social distancing guidance, etc. Eventually, we could all get to that green or yellow category but it won’t happen by magic. We have to do the work.

For today, Georgia’s net increase in numbers probably shows a lot of weekend effect.

  • Testing: 13,045 new tests (low end for us), 8.2% were positive. 104.4% of today’s cases were identified through ELR, so the 8.2% is most likely a reliable estimate.

  • Cases: 1023 cases (low end for us lately). The new statewide total is 295,337. We will likely pass 300,000 by the end of the week. Of today’s cases, 44.1% came from nonrural counties. Another 22.4% came from rural counties. In other words, 66.5% of today’s cases came from outside of the Atlanta metro.

  • Hospitalizations: 25 new COVID hospital admissions and 3 new ICU admissions (these are low numbers for Georgia). There are currently 1536 COVID patients hospitalized, a decline from yesterday (1553). Adult ventilators are being used at 31% of our state’s capacity.

    There is something interesting going on in Hospital Region E (Athens-Clarke and surrounding area). They appear to have finally dipped below the 90% ICU occupancy rate but this is an artifact of the addition of 22 new ICU beds. The number of patients occupying an ICU bed in the region jumped by 10 overnight, to 77 while the total available ICU beds also jumped by 22 to 92. The result is that the ICUs in region E are 83.7% occupied. The number of ICU beds available in Region E has been consistently 70 beds since late May (exception, July 30 when it was 75), where other regions have had a lot of change. So it’s possible that they’re standing up a new ICU or hired on new staff to manage already existing beds. Region E is the only hospital region to see a large increase in bed capacity today or in the past week. Given their intense increases in case rate, it’s good to see the local hospitals preparing for what could be an increase in ICU demand.

  • Deaths: 20 newly reported deaths (mercifully, a low day for us). Of these, 15 came from nonrural (n = 8) and rural (n = 7) counties. In other words, 75% of the deaths reported today came from outside of the Atlanta metro. The new statewide total is 6353.

That’s it for today. Be safe and be well!


References

https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html

https://globalepidemics.org/key-metrics-for-covid-suppression/

https://www.nytimes.com/interactive/2020/04/23/upshot/five-ways-to-monitor-coronavirus-outbreak-us.html

https://covid.cdc.gov/covid-data-tracker/#testing_testsper100k

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

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


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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.