The Daily Digest, 20Nov2020

Georgia COVID-19 Updates

Good afternoon! There have been some positive developments this week with the coronavirus vaccine. I really liked the way Dr. Anthony Fauci described the situation at a press conference yesterday. He likened the coming vaccine as the “cavalry is coming.” But “if you’re fighting a battle and the cavalry is on the way, you don’t stop shooting.” We still have to do our parts to limit transmission, especially with things escalating as they are.

That being said, things continue to get worse and worse at a national level. In my area, the stores are running out of things that aren’t necessarily part of the typical pre-Thanksgiving rush. The percent positive rate is sky high. Many of my neighbors are preparing for another shelter in place order. I have found that my anxiety about all of this is escalating too. Having lived in the COVID-19 data since mid-March, I know what is coming. If we knew that a catastrophic hurricane was bearing down on our area, we wouldn’t carry on with life as usual. Everyday people would be making preparations. And yet, that is not the culture we live in. I had a hard time naming what was driving my inability to concentrate, etc, until I saw this tweet. I mention this today to offer my solidarity if you are feeling the same way. You are not alone.

The CDC had its first press conference in months yesterday, to offer an update on the coronavirus. They unveiled new guidance on Thanksgiving travel and celebrations.

Again, we aren’t in a great spot right now nationally. In fact, the New York Times coronavirus tracker had to add a new color to their map to show intensity beyond red.

The surge happening throughout the country is happening in Georgia too, but at a delay. In the graph below you can see that cases are rising sharply, in a way reminiscent of what we saw in July. You still have time to limit your losses and I encourage you to do so.


Testing

Today there was a net increase of 32,450 new PCR test results reported, a higher than usual day for us. Of those, 7.8% were positive. Ninety one percent of today’s PCR-identified cases were reported through Electronic Laboratory Reporting (ELR) so the 7.8% is a reliable estimate of today’s percent positive rate. Of today’s newly reported cases, PCR was used to identify 80.5% of them. The remainder were identified through the antigen test. It’s shaping up to be a big week for testing. We have already surpassed last week’s total and it’s only Friday (I track Monday - Sunday for week to week testing numbers). Given that the state’s testing strategy is ‘anyone who wants a test can have a test,’ it would seem that a lot of people want tests. Whether this is due to symptoms or suspicion of exposure versus people trying to get tested ahead of Thanksgiving is unclear.


Cases

There was a net increase of 3439 cases reported today, with 2769 identified by PCR and 670 identified by antigen test. The updated statewide total is 440,595. Of today’s newly reported cases, nonrural counties outside of the Atlanta metro contributed 36%, Atlanta suburb counties contributed 26%, rural counties contributed 21% and Atlanta counties contributed 16%. The graph below shows how the 7-day case rate per 100,000 has varied over time for different county types. Ignore the big spike in early October - that’s when the state began providing data on antigen cases. The current statewide case rate is 178. At the height of the summer surge it was 229. So we are only 22% below our previous peak.

The school-aged surveillance data report is now available at the bottom of the daily status report, along with the county indicators reports, LTCF percent positivity reports and flu updates.

The graph below shows us the case rate per 100,000 for different age groups, accounting for both PCR and antigen-identified cases. The left graph looks at pediatric and school aged populations (ages 0 - 22) and the graph on the right shows the entire population.

The left graph shows that case rates are increasing for all pediatric and school-aged individuals. However the increase is greatest for those 18-22. That may have important implications as thousands of college students are heading home for Thanksgiving next week. Refer to the CDC guidance in the introduction for how to welcome your student home…it’s not ideal but it’s also not forever. The graph on the right shows that case rates are greatest among the 18-22 year old population, greater than all other adults and all children. Even among this larger population, they show the greatest rate of increase. But case rates are increasing for all age groups. The next graph shows PCR and antigen-identified cases among K-12 aged children. The gray bar approximates the elementary school population, the mustard color is middle school and the blue line is for high school. To be clear, these are all cases across the state - not those currently linked to a school cluster.

These are raw case counts, not adjusted for population. But they show that cases have increased dramatically in the last week, across all age groups. We are nearly at the same level we had at the height of the summer surge for this K-12 population. The good news in this week’s school-aged surveillance data report is that there is a continued decrease in the number of school-associated clusters.

Each week, the DPH produces an update in a news release summarizing the pandemic. In that report is a table describing the settings associated with outbreaks (see below). Last week, schools were the #1 source of outbreaks followed by workplaces and long term care facilities. Cumulatively, the top three settings associated with outbreaks are long term care facilities, schools and workplaces.


Hospitalizations

There were 119 COVID-19 patients newly admitted as of today’s report. To date, 33,897 Georgians have been hospitalized for COVID-19 illness. There were 13 new ICU admissions for COVID-19. The number of patients currently hospitalized is 1800, an increase of 35 over yesterday. It is also the highest number we have seen since 02Sep.

Across the state, 82.6% of ICU beds are in use (yellow zone) and this is not specific to COVID-19, but for all medical reasons. Twenty nine percent of the adult ventilators are in use and this is also not COVID-19 specific. The state’s use of ventilators is similar to what the state experienced before the summer surge began. In other words, it’s an “okay” number.


Deaths

There was an increase of 22 confirmed COVID-19 deaths today, bringing the statewide total to 8591. Of today’s deaths, 36% came from nonrural counties outside of the Atlanta metro, 32% came from the Atlanta suburbs, 23% came from rural counties. You can check your county’s classification here. On the whole, the 7-day death rate is decreasing across the state. However, our state’s death rate remains 76% higher than where we were at the start of the summer surge’s increase in deaths, starting 09Jul.

That’s it for today. Make good choices regarding your exposure risks. We really do not want this case growth to go exponential if we can help it. We need to put our community’s needs ahead of our own, possibly until the end of 2020. As Dr. Fauci pointed out, help is on the way. We won’t live this way forever. Let’s prevent as much death and suffering as we can between now and then.


References

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

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

https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/holidays/thanksgiving.html

https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html?name=styln-coronavirus&region=TOP_BANNER&block=storyline_menu_recirc&action=click&pgtype=LegacyCollection&impression_id=4c28e731-2b4c-11eb-a87a-7d7768bcf50a&variant=1_Show


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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.