Week Ending November 21: New cases were up more this week, with greatly increased testing (likely in part due to pre-travel testing for Thanksgiving). % positivity appears to be leveling off. Hospital metrics are rising, but at a slower rate than cases. Death reporting was way down this week, and most deaths reported were recent. Deaths by date of death seem to have hit a plateau over the past several weeks of ~20-25 deaths per day.
Highlights from the Week
- We had a couple of data dumps this week, with both PCR and antigen tests on separate days, as more providers are transitioning to the ELR (electronic lab reporting) system. Cases were mostly fairly recent, but it makes the daily numbers erratic and misleading and even the weekly numbers are a bit skewed. Testing numbers are bit inflated this week as a result, but testing by date of collection is near record high levels we saw in July.
- There’s still a lot of talk about antigen positive cases (positives from rapid tests). They are being reported daily on the GA DPH web site, but no antigen test data is available. Per the CTSE and CDC definitions, antigen positives are “probable cases”, not “confirmed cases” (confirmed cases come from PCR tests), and currently the case rates and graphs on the DPH site include confirmed cases only. Antigen cases should be interpreted cautiously, as there are false positive issues with antigen testing (potentially 20% or more), especially in asymptomatic people. For this reason, I am pleased with GA DPH’s decision to report these numbers separately. Anyone who is reporting on COVID data is able to add the two numbers together to get the number of “total cases”. I show the daily new confirmed and antigen cases per county on my Daily Changes page, and on my Maps page, I include a maps showing daily average case rates per county, for confirmed cases only, as well as combined cases, so you can see the difference. You can also see case and testing data with confirmed and antigen cases on my Weekly Testing Data page.
- Probable deaths were also added to the GA DPH web site recently, and they have been increasing, but we don’t know when they occurred, so we don’t know if they are recent deaths or not. These may be mostly deaths of people who only have positive antigen tests, but not PCR confirmation. I’m trying to get more information about these deaths.
The visualization below shows multiple COVID metrics on the same graph, based on their weekly values as a percentage from the summer peak. Early in the summer, you can first see a peak in cases (by symptom onset) and ER visits with COVID-Like Illness, followed by a peak in hospital admits and current hospitalizations, and then a peak in deaths (by date of death). Then all of these metrics began falling along similar paths. While these numbers are starting to trend up as we head into the traditional cold/flu season, you can see they are increasing at a much slower rate than they were during our summer spike. (NOTE: I do not show cases or deaths for the previous two weeks as the data is still incomplete.)
Cases & Testing
My preference to focus on overall trends and indicators other than raw case counts, but many thresholds for risk levels are based on reported case numbers, so I’m adding some additional tracking and context around these numbers.
Harvard has risk levels based on daily average case rates. Based on the current rate for the state of Georgia, we are just below their red zone for confirmed cases (daily average <25 cases per 100K). As of Saturday, Nov. 21, we are at 23.5 daily average confirmed cases per 100K. To reach Harvard’s yellow zone for new cases, we need to get down to 10 daily average cases per 100K. If we add in antigen positive cases, we are at 32 daily average total cases per 100K.
Using a different metric, we are back in the White House Coronavirus Task Force red zone for new cases. The WHCTF red zone is over 100 cases per 100K in a week or more. I track our weekly cases per 100K metric daily on my Today in Georgia page, which is updated daily. The rates are labeled every Friday, to reflect when the WHCTF pulls their data. As of Saturday, Nov. 21, we are at 164 weekly confirmed cases per 100K, or if you add antigen positive cases, we’re at 225 weekly total cases per 100K.
In the graph below, I show cases and testing (note that in some weeks, I used an estimated number of viral tests after removing antibody tests). The percent of positive tests is shown in a second graph below.
If you want to see a table of the raw numbers with additional explanation of the numbers, I created a separate page for the chart of Weekly Testing and Cases.
Weekly Increase in Total Cases
Cases were increasing very rapidly in late March and early April, doubling or more every week. Then the case growth slowed to substantially less, and doubling time was 7 weeks or more. With the spike in case growth in late June, our doubling time shorted to around three weeks for a while, but is now around four months. (This is based on the cumulative case totals, so it will never go negative.)
Reported Cases vs. Actual
In the graph below, the blue bars represent the number of reported cases in a given week, and the orange squares represent the number of COVID cases where symptom onset or lab test occurred that week. All of the actual case total (in orange) are subject to change some over time. However, the majority of changes will occur in the final week of the graph, which is likely less than half of the final amount it will be, and the previous weeks should see smaller changes. According to the graph on the Georgia DPH site, new cases per day were at their highest on July 6, after weeks of steady increases, and the 7-day average peaked on July 11. You can see on the graph below, the week ending July 11 is a clear peak. (Please remember the final week of this graph is still quite incomplete.)
We are processing labs and reporting cases much more quickly now than were were during the summer peak in the sun belt states, when testing facilities and labs were very backed up. Free COVID tests are readily available all over the state for anyone who wants one, and turn around times have improved considerably from the extreme delays we were seeing in July.
Reported Deaths vs. Actual
Georgia records deaths by actual date of death on their graph on the DPH web site, and I track this, so that I can report on how many of the reported deaths each week are recent deaths vs. older deaths. Deaths reported in a given week often did not occur in the past week, or even the previous week.
During the week ending Nov. 14, GA DPH reported a very large number of old deaths from July-September. It seems like that was a concerted effort to find and report previous deaths, similar to the week ending June 13. On the other hand, this past week, most of the deaths reported were fairly recent, and some of the older deaths from March-September were removed.
There is often lower death reporting on Sundays and Mondays, and fluctuations from day to day, with higher days often on Tuesdays, so it remains important not to focus on the number of reported deaths in a single day. It does not reflect the number of actual deaths that actually occurred that day. Read more about how deaths are reported in Georgia.
In the graph below, the blue lines represent the number of reported deaths in a given week, and the orange squares represent the number of known COVID deaths that actually occurred that week. All of the actual death numbers (orange squares) are subject to change some over time. However, the largest changes typically occur within the two final weeks.
Remember that deaths for recent weeks, especially this past week (which is still preliminary) will increase further over the next few weeks. Final death totals for the week are typically around 3-4 times the total at the end of the first week.
I have links on my Hospitalizations page to three external dashboards showing more detailed hospitalization data by region, as well as a CDC graph showing rates for ER visits with COVID-like symptoms. While these numbers increased this week, you can see the increase has been much more gradual so far than it was in during the summer spike.
Georgia reports the number of patients currently hospitalized who are COVID positive. The state also reports on total numbers of COVID cases who were hospitalized or in the ICU. The weekly changes to these numbers are shown in the graphs below. I also show the percent of cases that require hospitalization or ICU admission, which has been dropping as new cases have greatly outpaced new hospital and ICU admits. These numbers are affected by reporting delays, so I’m not sure how good this data is, but I will continue to share it for now. Read more about the different hospitalization numbers.