The Daily Digest, 17Aug2020

Georgia COVID-19 Updates

Good afternoon! Things continue to worsen for Georgia and while we cannot control our state’s response, there are things we can do as ordinary citizens that can help. We are not entirely powerless in this situation and we have seen ways that human behavior can limit disease transmission and bring cases back down (and thereby hospitalizations and deaths).

  1. Wear a mask any time you’re outside of your home with people you do not live with, in situations where proper ventilation or social distancing are not possible. If you are outside, but at least 6 feet apart from others, you are probably okay to remove the mask. If you are inside, I would wear the mask continuously. We have some evidence that the virus might be spread through airborne transmission as well as through respiratory droplets. If that research is corroborated by other laboratories, then the safe distance between individuals expands to as much as 18 feet, rather than 6. If you cannot conduct an activity without a mask in an indoor environment (for example, eating), then don’t do that activity in that setting. This also goes for riding in a car with someone you don’t live with.

  2. If you have symptoms and seek a COVID-19 test, then please self-isolate until your test result comes back. Assume that you have COVID-19 until told otherwise. If you have a high risk exposure, it’s best to wait 3-7 days after the event before seeking a test.

  3. Keep a journal of the people you are physically within 6 feet of on a daily basis. Our state is not able to meet the demand for testing and contact tracing. Be prepared to do your own contact tracing and notify those you were in contact with in the event that you become ill. This is how we care for one another.

  4. Avoid unnecessary errands if an alternative approach is possible. If an errand cannot be avoided, consider going during hours when the crowds will be smaller and/or contact can be minimized.

  5. Make it habit to wash your hands when you enter your home, just as many households remove shoes when they enter their home.


As of yesterday, the Harvard Global Health Institute COVID-19 risk tool ranks Georgia as the top state in the nation for disease transmission rates, with an average daily case rate of 29.9 per 100,000 people compared to the national average of 16. As a reminder, when this tool color codes an area red, it means that a shelter in place order is not just recommended but required to bring disease transmission back within limits of what testing and contact tracing can successfully manage. To continue to ignore this is the equivalent of running up a credit card when your checking account is out of funds. We don’t have the capacity to cope with the amount of disease transmission we have in our communities.

Looking specifically at Georgia, there is only one county left right now that is not color coded red or orange (orange = shelter in place is recommended). So 158 of Georgia’s 159 counties should be under a shelter in place order.

Further, the Harvard Global Health Institute and the New York Times teamed up to create this risk tool for school reopening across the country. A teacher from Kansas has compiled this state by state database of schools with COVID-19 data, reopening plans, quarantine status, etc.

And this sense of foreboding isn’t just at the Harvard Global Health Institute but also at Georgia Tech, who updated their risk assessment of the states to also reflect that Georgia has the most disease transmission of any other state in the country.

Looking specifically at Georgia, let’s first orient ourselves to how this graph works. On the x-axis we are looking at event size (i.e. people) and it’s on a logarithmic scale. So each large tick is a factor of 10 higher than the tick before it. On the y-axis is the estimated risk that a person at an event of given size on the x-axis will be COVID-positive.

The dashed, curved line is the estimate based on currently reported disease incidence levels. However we know that there are testing backlogs, asymptomatic carriers, etc. So the folks at GA Tech help us to see what the risk is if there is 5 times more disease incidence than we currently realize (dark blue solid line), 10 times more disease (yellow line) and 20 times more disease (red line). The bigger the event size becomes, the more these estimates converge to 100% risk that someone will be positive. For our purposes today, I’ve provided a vertical blue line at 25 people that might approximate the average K-12 classroom size. I think we’re all willing to concede that we probably aren’t capturing the actual number of cases with our existing testing capacity in Georgia. But if we take the low-end estimate that there is 5 times more disease than we currently realize, then there’s about a 38% chance that someone in that classroom is positive, on average, across the state. If we drill down into individual counties the risk gets higher or lower. If we take the mid-range estimate that we there is 10 times more disease circulating than we currently recognize, then the risk jumps to about 60%. In a group of 50, then the risk is higher.

And cases aren’t the only area where Georgia is #1 right now. We also lead the nation in the number of beds that are occupied by COVID-19 patients, according to the Health Capacity dashboard from the Department of Health and Human Services.

Overall, here is how Georgia ranks within the United States for several COVID-19 metrics.

Georgia’s daily update

But specifically on Georgia today. There was initially something really, really wrong with the testing data in today’s report. Their math didn’t add up. Below are screenshots from today (2:50 pm update) and yesterday. Pay attention to the Number of Tests performed row and Number of Positive Tests for yesterday and today. For future reference, you can always access these screenshots by visiting this site. You can review the math problems with the earlier DPH report below.

UPDATE: At 5:44 pm they updated the report with corrected data for the testing section. Many thanks for their speedy clarification. The changes affected the column titled Total PCR/Molecular with a decrease of 2285 tests in the number of new tests. The number of positive tests declined from 221905 to 217481 (difference of 4424). There is no statement to go with the update, but it could have been a data entry error. With the update, there were 24,429 new PCR test results reported today, 1953 of which were positive for a percent positive rate of 8%.

The net increase in cases today (238861-237030 from yesterday) is 1831. 35% of the new cases came from nonrural counties and 25% came from rural counties. Of today’s newly reported cases, 15.8% were backdated prior to the 14-day window of uncertainty.

The net increase in deaths today (4727-4702 from yesterday) is 25. Nineteen of the deaths came from outside of the Atlanta metro with 10 from nonrural counties and 9 from rural counties.


References

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

https://www.medrxiv.org/content/10.1101/2020.08.03.20167395v1.full.pdf

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

https://covid19risk.biosci.gatech.edu/

https://protect-public.hhs.gov/pages/hospital-capacity

https://docs.google.com/spreadsheets/d/e/2PACX-1vQSD9mm5HTXhxAiHabZA6BPUByWBlP5HZ2jfOPEeGZkMB0ZFsmFBL5orqjIq22mjFNZ7n-11ObCylGn/pubhtml?fbclid=IwAR2tJ8yDVehGpxoP97Cco5HYAxoN014opwwm6uYt4s3E2xDr_8u9KF_LlgI&urp=gmail_link#

https://www.nytimes.com/interactive/2020/08/14/opinion/politics/covid-school-reopening-guidelines.html

https://covidtracking.com/data/state/georgia#historical


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