The Week in Review, 22-28Feb2021

Georgia COVID-19 Updates

Combined Data

The graph below shows how four of our big metrics for tracking the COVID-19 pandemic are tracking over time. Cases are represented by the blue line and correspond with the left y-axis. All other metrics correspond with the right y-axis. The reason I graph all of these things together is so that we can see the way these things trend together (or differently) over time.

This week hospitalizations and deaths decreased, by 6% and 35% respectively. Meanwhile, cases leveled off with a small increase of 1.2% compared to last week and ICU admissions rose by 19%. So there are fewer people in the hospital this week, but more of them have severe cases that require an ICU bed.


Testing

This week we saw a decrease in PCR testing output, of 15.6%. In total, there were 159,745 PCR tests reported. Of those, 7.4% were positive, a decrease of 27.4% compared to the previous week. The test output trend over time can be seen in the graph below, represented by the blue line that corresponds with the left y-axis. The red line represents the test positivity rate over time, and corresponds with the right y-axis. The gray dashed line is the goal line for test positivity.

The percent positive rate is getting closer to the 5% goal line. But we aren’t there yet. And when we do drop below 5%, the real challenge is staying below that number. On a weekly basis, Georgia has never dropped below 5%. The state has come very close but then reverses quickly. Let’s hope things are different this time. In the meantime, we are likely missing some cases, but not as badly as during the height of the winter surge.

For antigen testing, there were 36,856 tests reported through Electronic Laboratory Reporting (ELR) and 8.5% were positive. This is also a big drop in testing output, since the previous week’s test total was nearly equal to this week’s but for only 3 days. Testing has slowed way down.

However the DPH still does not provide data regarding demographic details for cases identified by the antigen test. Keep that in mind as we go through the demographic data in the following sections. You’re only seeing part of the data. Meanwhile, antigen testing identified 35% of the cases this week.


Cases

The number of combined new cases (by date of report) is as follows:
- 24 hours: 1543 by PCR + 791 by antigen = 2334 (+0.2%)
- 7 days: 13,704 by PCR + 7,312 by antigen = 21,016 (+2.1%)
- 4 weeks: 68,649 by PCR + 28,427 by antigen = 97,076 (+10.7%)

The new statewide total is 1,006,521, combining PCR and antigen-test identified cases. Bear in mind that because our test positivity rate is above 5%, these numbers are likely an under count of the disease burden. In the graph below, I show the Georgia cases by date of report for both PCR and antigen cases for each county type. Ignore the big bump around 11Oct - that was a data dump of antigen cases. You can check how your county is classified here. The case rate has leveled off over the past week which is not great news. The state’s case rate is now 14% below the peak of the summer surge, but 188% higher than the pre-winter surge baseline. As the more transmissible variant is expected to become widespread and dominant in Georgia in March, this is a precarious position for the state to be in right now. We likely have at least one more surge to go before enough people are vaccinated to start our steady march down for good - even if the more transmissible variant wasn’t here. What we’ve seen happen in the past is that Georgia surges and then levels off at a higher baseline, each time. As a consequence, each new surge is bigger than the ones that preceded it.

The next two graphs show us some of the demographic details of those who are getting sick and testing positive. In each graph, you’re looking at 8-week timelines for each age group side by side.

This week we saw decreases in cases for every age group. However, the decrease this week was really shallow compared to previous weeks, confirming the observations elsewhere in the data that the descent from the winter surge is slowing down and we are leveling off. If cases are leveling off, it’s possible that hospitalizations will level off soon too since the two tend to track together.


Hospitalizations

The number of combined new hospital admissions (by date of report) is as follows:
- 24 hours: 76 new COVID-19 admissions, 11 admissions to the ICU (weekend reporting is typically light)
- 7 days: 1286 new COVID-19 admissions, 199 ICU admissions
- 4 weeks: 5802 new COVID-19 admissions, 727 ICU admissions

The number of ICU admissions in the past 24 hours is high for a weekend. In fact, the last time we saw a number this high on a weekend was 24Jan2021.

According to the US Department of Health and Human Services, they’re tracking that Georgia currently has 2552 patients hospitalized for COVID-19. According to HHS, there are 54 children currently hospitalized for COVID-19 in Georgia.

The graphic below shows us the Georgia Emergency Management Agency hospital regions. The table on the right tells you how each region is doing with respect to usage of their available ICU beds and how their COVID-19 patient population compares to their overall patient population. These numbers are all based on data from the Georgia GIO COVID-19 data hub.

There’s a LOT of good news to celebrate here. First, the state’s ICU bed usage number is below 80% for the first time since 09Nov2020. And there is only one hospital region that is using >90% of its ICU beds - region L. Most of the state is in the yellow or orange category for COVID-19 patient census, or how much of the total hospitalized population is there for COVID-19 treatment. There are just two hospital regions (A and N) in the red zone.

As a reminder, hospitalizations are down - yes. But they aren’t dropping as fast as cases and remain at a high level. For example, cases have dropped 68% and are now leveling off. Hospitalizations have dropped only 40%. We see a lot of improvement for regions of the state but the state still has the second highest confirmed COVID-19 admission rate in the country, led only by Kentucky. Furthermore, the state’s 12% patient census is a great number - we’re in the yellow zone, but it’s the highest patient census number in the country. In other words, things are getting better for Georgia. But things are getting better faster for other states. And with cases leveling off, it’s possible that hospital numbers will level off soon too. We need to continue to do the long, difficult work of limiting disease transmission while we wait for vaccination to pick up.

Next, let’s look at the demographic details that we have for hospitalizations.

This week hospital admissions increased for 40-49, and 60-79 year olds. However COVID-19 hospital admissions and ICU admissions are increasing for multiple racial groups.

In Georgia, the COVID-19 hospitalization rate is 5.6% of all cases. For those who are hospitalized, 16.3% require an ICU bed. While the case fatality rate for confirmed cases and confirmed deaths right now is 1.77%, the fatality rate for people admitted to the ICU for COVID-19 is 41.3%. The ICU mortality rate has increased 10.2% since I started tracking this information, the week of 10Oct. That’s an indication of just how bad the winter surge was.

Let’s compare those numbers to the US rates overall that were presented today at the ACIP meeting. Among those who have been hospitalized since the start of the pandemic, 25% required an ICU bed, and 11% died. So more COVID-19 inpatients needed an ICU bed nationally compared to Georgia, but the mortality rate for those in the ICU is 2.8 times higher in Georgia.


Deaths

The number of new confirmed deaths (by date of report) is as follows. The percentage in parentheses indicates how the increase compares to Georgia’s cumulative total at the start of each window of time.
- 24 hours: 1 (+0.01%), 0 probable deaths
- 7 days: 435 (+3%), 116 probable deaths
- 4 weeks: 2498 (+20%), 599 probable deaths

This week the number of confirmed deaths decreased by 35% compared to the previous week (FANTASTIC news) however we should note that Friday’s death reporting was atypically low. The graph below shows how the 7-day death rate per 100,000 residents has trended over time for each county type. The state death rate is 20% below the peak during the summer surge but 133% above the pre-winter surge baseline. The death rate is worst for rural counties and best for the Atlanta suburb counties. It’s good to see rural death rate decreasing as it is here. In the summer surge we saw the rural death rate remain high for months.

Next, let’s look at the demographic data for this week’s deaths. Deaths increased for those 40-49. Deaths decreased for all other age categories.

If we look at race, deaths are declining for all groups.

That’s it for today. I will be back tomorrow to discuss how the state fits into the national and global context.


References

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

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

https://beta.healthdata.gov/dataset/COVID-19-Community-Profile-Report/gqxm-d9w9

https://healthdata.gov/dataset/covid-19-reported-patient-impact-and-hospital-capacity-state

https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2021-02/28-03-01/04-COVID-Oliver.pdf

https://www.cdc.gov/vaccines/acip/meetings/slides-2021-02-28-03-01.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.