Week Ending January 16: Some good news this week! Almost every metric has leveled off or started dropping – ER visits for COVID-Like Illness (CLI), test positivity, new cases, new hospitalizations, new ICU cases, current hospitalizations… Death reports were very high, in part due to continued catch up after weeks of underreporting over the holiday season (over half the deaths reported occurred in 2020).
Highlights from the Week
- Reported testing was up this week by over 50K tests, but if you recall, the previous week had over 10K cases added from non-ELR testing, indicating over 50K PCR tests were not reported.
- % Positivity fell for the first time in several weeks, over both the 7-day and 14-day periods, by collection date and report date.
- Vaccinations of American health care workers and long-term care residents have begun in Georgia, and first responders and seniors 65 years and older have been added in an expanded Phase 1A+. If you think you are eligible for a vaccine, you can contact your local health department for more information or search for a COVID vaccination site near you. Georgia DPH has a Georgia COVID-19 Vaccine Status Dashboard, which shows we have administered almost 400K vaccines as of January 16, more than doubling the amount from the previous week.
- The CDC tracker for ER visits for COVID-Like Illness (CLI) was recently fixed, and shows that CLI reached a high in Georgia on New Year’s Day and the 7-day average of CLI has been falling.
- The fall/winter virus spread began in North Georgia, but is now worse in other parts of the state, particularly the Augusta area. The metro area has also had huge increases in the past several weeks, with Gwinnett and Fulton both reporting over 3000 cases this past week again.
- I am still focusing my reporting and analysis on confirmed cases and deaths, not antigen cases and probable deaths (although I do show those in my daily metrics). The PCR test (used to identify confirmed cases) is considered the gold standard; however, these tests are extremely sensitive and someone can test positive well after they are no longer infectious (up to 3 months, per the CDC). This NY Times article brought the issue to light months ago, and Florida recently started requiring labs in the state to report Ct values, although they are not reporting that data publicly at this time. Rapid tests (antigen tests) have different accuracy issues – they are less sensitive so may not pick up infections as early as PCR tests, but they are also less specific, so 20% of positives may be false positives (particularly in asymptomatic people).
I’ve had several followers who use my web site ask how they could thank me for the work I’m doing, so I’ve set up a Virtual Food Drive benefiting the Atlanta Community Food Bank to help feed families in need during this difficult year. I already met my initial goal, so I doubled it. Thanks to everyone for your support. Click here to donate!
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). As you can see, all of these metrics have continued to follow similar paths. (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. We are currently in their red zone for confirmed cases (daily average >25 cases per 100K). As of Saturday, Jan. 16, we are at 62 daily average confirmed cases per 100K. If we add in antigen positive cases, we are at 82 daily average total cases per 100K. Both of these numbers are down from last week, when they were 63.5 and 86, respectively.
Using a different metric, we are 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, Jan. 16, we are at 431 weekly confirmed cases per 100K, or if you add antigen positive cases, we’re at 573 weekly total cases per 100K. Starting with the WHCTF report dated Dec. 13, antigen tests are now included in their case rates, and I plan to update my daily graph to reflect both numbers.
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. (Keep in mind testing was under reported by an estimated 50K tests the week ending Jan. 9.)
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.
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, over the summer, 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, but due to lab reporting delays, reported cases peaked later and remained high.
In mid-December, we exceeded our weekly case peak from the summer based on report date as well as onset date, and cases continued to climb for several weeks. Remember that 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.
The following table shows when the deaths reported over the past week occurred. There was a net change of 749 deaths since last Saturday. We had several weeks of underreporting between Thanksgiving to New Years, so that is part of the reason for the especially high reporting numbers now. Recent weeks have also seen a lot of deaths, so reported death numbers will likely remain high in the coming weeks unfortunately, although not as high as the record set this 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 focused effort to find and report previous deaths, similar to the week ending June 13. Since then, most of the deaths reported were more recent, and several older deaths were removed.
You can see in the second graph below that for weeks ending Dec. 5-19, deaths reported in the first two weeks were increasing. This was a sign that current deaths were on the rise in early December. The first two weeks of reporting generally match the shape of the final curve as you can see. The weeks ending Nov. 28, Dec. 26, and Jan. 2 are lower, likely due to holiday underreporting, but you can see that deaths reported in just the first full week of January are already very high. Deaths are always higher in January and February, due to the normal pattern of respiratory viruses, so it’s not surprising to see an increase at this time, especially given the high case rate we saw throughout December.
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 during normal weeks. For holiday weeks, expect the multiplier to be even more. (The week of Thanksgiving originally only reported 30 deaths that occurred that week, but it is now over 200.
I have links on my Hospitalizations page to external dashboards showing more detailed hospitalization data by region. Current hospitalizations were nearly flat this week. Reported hospital and ICU cases fell this week, which is good news.
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 generally 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 keep reporting it for now.