The Daily Digest, 26Mar2021

Georgia COVID-19 Updates

Today’s update will likely be more brief than most. I’m in a bit of discomfort after having a medical procedure yesterday that required stitches.


I wanted to take a moment to talk about some logistics of vaccinations.

No one can be denied a vaccination for lack of ID or health insurance. HOWEVER, you may be asked for these things. On the health insurance side of things, this is so that the provider can file for reimbursement for the “administration fee” associated with vaccination. But, if you do not have insurance, you are not liable for that fee either. On the ID side of things, they may ask in order to confirm that you are the person who registered for the appointment. It can be anything that has your name on it, including a driver’s license, passport, photo ID, birth certificate, utility bill or piece of mail, etc. But either way, you should not be turned away. I was able to confirm this with the Georgia Department of Public Health.

The vaccination is free. As I said above, the provider can try to recoup some of the cost of the vaccination by filing for reimbursement for “administration” but there should be no copay or other fee for you as the recipient.

For teens 16-17 who are now eligible, they will need a parent or guardian present in order to provide consent. Again, ID and health insurance is not required, but bring it if you have it. Remember, these individuals are only authorized to receive the Pfizer vaccine under Emergency Use Authorization (EUA) because that was the only manufacturer that included 16-17 year olds in their clinical trials. The best places to find the Pfizer vaccine consistently are CVS, Walgreens and the GEMA mass vaccination sites.

The Columbus and Savannah mass vaccination sites still take appointments to guarantee your vaccine will be available for you on that date. But they have also added no-appointment service. When the shots run out for the day, then they’re out. But this can help remove a barrier to access for some.


Testing

It was an average day for testing with 21,893 PCR tests newly reported and 10,281 antigen tests newly reported. Of the PCR tests, 4.8% were positive and 6.9% of the antigen tests were positive. The graph below shows how test positivity has varied for the two test methods since we started getting the antigen test data in mid-February.


Cases

Today there was a net increase of 1060 PCR cases and 599 antigen cases that were newly reported, for a combined total of 1659. The 7-day case rate for the state is relatively flat for the past week, but has increased ~26% in the past 11 days for the Atlanta and Atlanta suburb counties.


Hospitalizations

We’re seeing more hospitalizations so far this week than we did at this time last week, so I anticipate that the weekly total on Sunday will be an increase over the previous week.

Today there was a net increase of 103 new COVID-19 hospital admissions and 15 admissions to the ICU.

ICU bed usage is starting to tick up again (see the red trend line). It’s not time to panic or sound the alarms, but another reminder that we need to continue to be careful about limiting disease transmission.

For a few regions, we’re starting to see the patient census (number of patients currently hospitalized for COVID-19) increase too. I’ve provided the data for region D (Atlanta) below. Increases are also observed for regions J, K and M.


Deaths

Today there was a net increase of 81 newly reported confirmed COVID-19 deaths and 17 probable deaths. That’s a combined total of 98. The 7-day death rate is on the rise for rural and nonrural counties outside of the Atlanta metro.

Lastly, an article came out today that indicates that Governor Kemp has limited DPH Commissioner Dr. Kathleen Toomey’s autonomy and has ignored her guidance and expertise since early on in the pandemic. It is a truly powerful article that I think will be used to analyze Georgia’s response to the pandemic for decades to come. I’m quoted in the article but I wanted to offer my thoughts here now that I’ve seen the breadth of the investigation.

Public health is intrinsically political. The head of each public health agency is a political appointee. The funding is all determined by government budgets and the politics of legislatures. It’s not really possible to separate public health from politics. But public health professionals are typically as apolitical as possible because it is so important for earning and maintaining public trust. What this means is that they often don’t have the means or power to fight back against political interference. I’ve discussed the interplay of politics and public health before here in the newsletter and on my podcast.

In my experience, the more a politician understands and is comfortable with science, the more they tend to take a hands-off approach to public health. When a politician doesn’t understand science they tend to fear it and go on to micromanage a public health department. So reading that Dr. Toomey has been ignored, had her public statements written for her by the Governor’s office, had Kemp loyalists installed in her office once the pandemic began, etc, tells us that Governor Kemp doesn’t trust her or the science. And that means that public health data have not driven much, if any, of the decision making in this pandemic. It also likely means that DPH largely isn’t in control of the vaccine rollout - the Governor’s office is instead.

Dr. Toomey is a political appointee. The Governor could have fired her at will since he clearly doesn’t trust her. But he didn’t. He needed her credibility in that post, so that he could lend his pandemic response the air of scientific legitimacy. So when he says “we’ve followed the science” what he really means is that he co-opted Dr. Toomey’s hard-earned credibility as his own and then did whatever he wanted, irrespective of what the data showed. It’s profoundly disappointing and 16,417 (18,849 if you consider probable deaths) Georgians have paid the price for this with their lives. We now know that the Department of Public Health was set up to fail in this pandemic - in terms of funding, staffing, and basic autonomy to use their years of education and experience to serve the state of Georgia to the best of their abilities. This warrants further investigation. My heart goes out to everyone at DPH who must be so frustrated. I wish so much that you could have a do-over on this pandemic, responding in the way you wanted.


References

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

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

https://www.ajc.com/news/coronavirus/georgia-governor-ignored-experts-as-the-pandemic-raged/M24YAXPPTFBPXA5HMV7I4LGWOY/


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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.