The Daily Digest, 28Aug2020

Georgia COVID-19 Updates

Good afternoon! This might be more of a brief update than I usually do. Some will love that, some will hate it. But there’s a lot of chaos involved in a cross-country move so this will have to suffice. Similarly, the updates on Sunday and Monday will also likely be more slim than usual. Thank you for your patience and grace. I’ve been very moved by everyone’s well wishes. I mentioned it on the podcast this week that I grew up with a nomadic living situation and Georgia is the state I’ve lived in the longest. In many ways it feels like home and it’s hard to leave it, especially considering the stress that it is under with the pandemic.

There is a new research article out recently that suggests that reinfection with the virus that causes COVID-19, called SARS-CoV-2, is possible. There have been a few reports of this in the past where it was hard to tell whether it was just the same infection that never truly went away or a brand new infection. The article I link to here is more suggestive of a brand new infection for two reasons - the genetic fingerprint for the virus collected from the patient during their two bouts of infection are different enough that it is unlikely the virus mutated to that degree in a single human. The second reason is because the second infection was worse than the first, requiring hospitalization. The patient is a 25 year old, previously healthy man from Nevada who experienced infections less than two months apart. He did not have any sort of immunocompromising condition, nor was he taking any immunosuppressing medications. We will need to see if this kind of report is corroborated by others to know how big of a problem this is. But if it bears out, it would suggest that the brute force strategy of feeding people to the disease until herd immunity is achieved (whatever the deaths may be) might be unrealistic and unsuccessful. In the absence of that, we may be better served by a starve the disease out sort of strategy that limits transmission to the point that it can’t survive. That would involve a more intense shelter in place order than Georgia implemented in April, but I don’t think we are likely to see such an order implemented any time soon.


Testing

There were 18,147 new tests reported today and 9% of those were positive. Seventy one percent of the tests were reported through Electronic Laboratory Reporting, so the 9% percent positive rate may not be reliable. Further, 21.2% of today’s newly reported cases were backdated prior to the 14-day window of uncertainty on the case graph by date of symptom onset. When you look at total tests performed and positive tests per day graphed together, it’s interesting how much their trend lines match over the past few weeks. We haven’t seen that kind of near perfect agreement for that duration of time before. It’s the sort of agreement that would make me go back and check my numbers, if these were data for a study that I was doing for research.

Earlier this week there was a big data dump from a laboratory in Bibb County (see the most recent spike on the graph above). From news reports and communication from people who work at the North Central Health District, they are working through the historic cases that were identified that day (~50% of the state’s total was backdated well before the 14-day window, most of it in Bibb) and de-duplicating cases they had already been tracking. I don’t think we are likely to see a big correction to Bibb’s totals, though I could be wrong on this. More likely, I think, is we are going to see those corrections in the net increase each day from Bibb as they learn more. So rather than seeing the true increase in recent disease trends, those increases might be blunted by the adjustments to remove historic, duplicated cases.


Cases

There was a net increase of 2298 newly reported cases today and that brings the statewide total to 265,372. The largest contributor to today’s count is nonrural counties with 41.2% of the cases followed by rural counties with 30.2% of the cases. So despite the population density of the Atlanta metro, that is not where the majority of the disease is located. Good job to the people of Atlanta! Meanwhile, everyone needs to be sure to take this virus seriously and do what you can to limit exposures and transmissions.


Hospitalizations

The number of patients currently hospitalized for COVID-19 symptoms continues to decline. Meanwhile, the number of patients newly hospitalized or newly admitted to the ICU have flattened.

Of all the Georgians hospitalized as of midnight last night, 13.7 - 17.4% are confirmed or suspected of having COVID-19.


Deaths

In today’s installment of things about Georgia’s pandemic response that make me want to throw things, we recorded another pediatric death. This time it was a one year old boy from Cobb county. He is noted as having a comorbidity that may have contributed to a more severe outcome. All of these deaths are preventable and horribly sad. But as a mom, the pediatric ones are especially hard to cope with.

This baby boy was just one of 78 people whose deaths were reported today. The new statewide total is 5471. Rural and nonrural counties contributed 28 and 27 deaths, respectively. Below you can see how each day’s deaths have been distributed by county type for the past month.

A consequence of the slower increases in cases met with greater increases in deaths is that our case fatality rate is again increasing. Relative to where we were two weeks ago, the death rate has climbed from 1.99 to 2.06%. Considering how many cases we have now, even small increases in the death rate mean there is significant momentum for deaths in our state.

Have a safe, socially-distanced weekend. Be safe and be well!


References

https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3681489

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

http://208.97.140.204:8080/epicurveInteractive-cases.html


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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.