Weekly Overview

Week Ending September 12: All metrics continued heading down this week – cases, hospital metrics, and deaths. Even cases among 18-29 year olds, which were up last week, were down this week. Death reports were down 23% from last week, and many of the deaths reported this week occurred weeks ago.

The visualization below shows multiple COVID metrics on the same graph, based on their weekly values as a percentage from peak. This shows when each of these metrics peaked, and how they have dropped since then. This shows consilience, a convergence of evidence from different sources, to confirm that the COVID situation in Georgia is improving, and that the drop in cases, hospitalizations, and deaths all makes sense. 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). Now all of these metrics are falling along similar paths. (NOTE: Deaths for the week ending September 5th will increase some. I do not show Cases, CLI, and Deaths for the week ending Sept. 12th as the data is still incomplete.)

Cases & Testing

Despite my preference to focus on trends and indicators other than raw case counts, 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 out of their red zone (daily average <25 cases per 100K), so that’s good news. As of Saturday, Sept. 12, we are at 15.3 daily average cases per 100K. To reach Harvard’s yellow zone for new cases, we need to get down to 10 daily average cases per 100K.

We are nearly out of the White House red zone for new cases, which is set at <100 cases per 100K in a week. As of Saturday, Sept. 12, we are at 107 cases per 100K in a week (vs 130 a week ago). As new cases continue to drop, and we report fewer old cases, this number is dropping quickly. We are still are reporting over 10% old test results each week though (hoping that number drops soon). I track our weekly cases per 100K metric on my Today in Georgia page.

In the graph below, I show cases and testing (note that in some weeks, I am using estimated number of viral tests after removing antibody tests). The percent of positive tests is shown in a second graph below. This week, our percent positive was 7.7%, down a full point from last week, even with lower testing. We’re staying well under the 10% threshold and approaching the 5% goal used by many as an important metric.

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 as long as 7 weeks or more. With the spike in case growth in late June, our doubling time shorted to around three weeks, and now it is up to almost three months. The weekly % increase is down for nine week in a row, and I am optimistic that the downward trend in case growth will continue. (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. We are seeing a clear decrease in cases by their actual date (either symptom onset or lab date) for almost two full months. 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.)

You can see that reported case totals have been dropping each week, but cases over time have been dropping even more dramatically. This is due to reporting lag from when labs were backed up. Once we get through processing and entering these older labs, reported cases should drop more significantly. At least 12% of the cases we reported this week were for people who aren’t even infectious anymore. Now that the pandemic is improving in the sun belt states, demand for testing has lessened, and testing facilities and labs are not backed up like they were. 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. This week, we added a lot of older deaths – 110 deaths from August 22 or earlier, significantly more than we reported for the most recent week (62). Only 65% of the deaths reported this week occurred after August 22nd.

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. Reported deaths were down this week, and deaths by day of death have peaked the week ending August 8 (currently 483 deaths vs. 437 deaths the week ending August 15).

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.

Deaths lag cases by about 3-4 weeks, but as new cases and hospitalizations have been falling, deaths will continue to fall as well.

Hospitalization Data

Current hospitalizations declined significantly from their highs in April, then started increasing rapidly in July after they hit a plateau in late May to mid-June. More discussion about this number and other hospitalization data is available on my Hospitalizations page.

New! I have added links on my Hospitalizations page to three new external dashboards showing more detailed hospitalization data by region, as well as a CDC graph showing rates for ER visits with COVID-like symptoms. I also added a graph of the CDC data ER visits for CLI, which peaked a month ago and has been falling since. This is consistent with drops all across the sun belt states, including Arizona, Florida, Alabama, South Carolina, and others.

With the data from a new hospital census dashboard, I was able to add PUI (“patients under investigation” for COVID) to my daily graph of current hospitalizations. In the past week, the COVID + patient census dropped by 144 patients.

Georgia also reports on how many patients test positive for COVID while hospitalized, as well as how many cases have been identified in the ICU. New ICU admits are down slightly, and new hospitalization cases are down this week from the previous week (826 this week vs. 968 last week), and ICU cases dropped even more significantly (137 this week vs. 202 last week).

I also show the percent of cases that require hospitalization or ICU admission. Hospitalization rates were up a bit this week and ICU rates went down, but both are way down from where they were in the Spring. We’ve generally seen more mild cases requiring fewer hospitalizations and interventions than earlier on in the pandemic. Read more about the different hospitalization numbers.

Hospital utilization numbers, which I have added to my Hospitalizations page, fluctuate, but are now showing clear declines, especially ER utilization, which is consistent with fewer incoming cases of CLI. CLI is back down to levels they were at in late June.

Keep in mind, the bed and ventilator utilization numbers are primarily not for COVID patients. Hospitals have re-opened to important elective surgeries and people are less afraid to go to the hospital now, which increases bed utilization, especially in the ER and general beds. Like hotels, hospitals need to fill beds in order to stay financially viable, and hospitals frequently run at 85% utilization or higher in their ICU’s especially, and they have surge capacity they can implement if needed.

Links to Graphs