Week Ending October 17: Reported cases and testing were both up this week, and % positive also rose slightly. Death reports were down a little from last week. Deaths by date of death continue to decline. Hospital metrics were mixed. ER visits for COVID-Like Illness went up last week, but started trending back down. We have hit somewhat of a plateau at this point, or we could be on the verge of another increase.
Highlights from the Week
- Antigen tests have remained a big topic of discussion. Currently, GA DPH is not reporting testing or cases from antigen testing; however, they are working to add this data soon – hopefully this coming week. Per the CDC definitions, antigen positives are “probable cases”, not “confirmed cases” (confirmed cases come from PCR tests). Based on new data from the past few County Indicators Report, probable cases added 13% to our case totals this past week (1167 probables), and 25% to our case totals the previous week (2131 probables). I’m not sure why there was such variation from week to week. Hopefully, we’ll get some antigen testing data soon so we can make more sense out of this data.
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, although CLI had a bit of a bump, followed by an increase in hospitalizations. I am watching these numbers to see where things may be headed, but it’s unclear at this point. (NOTE: Cases and deaths for the week ending Oct. 10 will increase some. I do not show cases or deaths for the week ending Oct. 17 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. Testing increased, and along with it, cases increased. However, % positive on electronically-reported labs also increased slightly.
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, Oct. 17, we are at 12.3 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 out of the White House red zone for new cases, which is set at <100 cases per 100K in a week. As of Saturday, Oct. 17, we are at 86 cases per 100K in a week. Only 6% of cases added this week were older, which is an improvement from 9% last week. I track our weekly cases per 100K metric daily on my Today in Georgia page.
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. This week, I adjusted the numbers to remove the counties where the data dump occurred. Our adjusted percent positive was 5.6%, up from 5.4% last week. We’re staying well under the 10% threshold and are near the 5% goal used by many as an important metric, but our decline has stopped for now.
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 six months. The weekly % increase trended up slightly this week. (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.)
We are processing labs and reporting cases much more quickly now than were were a few months ago. 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 continued to add a lot of older deaths – 72 deaths from September 26 or earlier, more than we reported for the most recent week (44). Only 66% of the deaths reported this week occurred after September 26.
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 up a little this week with a lot of older deaths reported, and deaths by day of death have peaked the week ending August 8 (currently 502 deaths vs. 476 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 with new cases and hospitalizations still declining, deaths will continue to fall as well.
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.
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. 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 increased by 65 patients, but PUI dropped by 89 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. Hospital cases are up slightly, but ICU cases are down from last week.
I also show the percent of cases that require hospitalization or ICU admission. 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.
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.