Daily Status, August 28

Daily Status, August 28:

Note:  Today, I focused on the colleges.  Much of the text in other sections could be reused.  The figures are 100% from today, though.

Summary/Situational Awareness

Like yesterday, today's concern are with the universities.  Only two (W & M and CNU) are showing no increase since the students arrived.  Va Tech and UVA are showing increases, but probably consistent with the increased populations -- they have moved to monitor closely.  Meanwhile, there is large scale community spread at JMU, Radford and possibly VCU. More on this in the section title "Colleges".  The discussion of colleges will take up most of the new discussion

Across the commonwealth, there were about 1013 reported new cases (including Radford).  This with is consistent average number of cases in the last three week.  Regionally, Northern VA is now flat to slightly negative.  In fact all of the regions within the state arestrending down -- with the leader in the decrease being Hampton Roads/Eastern VA.  It is worth noting that the areas seen growth have a much lower prevalence of the virus, and and much better testing statistics.    The testing numbers across the state remain ok, but not great.

While the areas of I64 are typically doing better, there are now multiple concerning hotspots north of I64.  For example, Warrenton VA reported a 25% growth in cases over the weekend, mostly attributed to a single outbreak in a long-term care facility.  In general, the smaller cities are not doing as well as the more urban parts of the state.   It is worth noting, though, most of the state is doing okay.  There are a few communities experiencing outbreaks, but most are improving..  The previously hard-hit areas around VA Beach and Norfolk are doing much better; at its peak about 1 month ago, Virginia Beach had about 200 cases per day whereas it is now about 50.  




 

Regions:

The statewide numbers are decreasing slowly, and the five identified regions of the state are doing about equally well:  all are decreasing (for the first time since June), but the absolute numbers remain just above the threshold of many states for entry without quarantine (we are at 11.5/100K, the threshold is 10/100K). We need to be cautious throughout the state. Yesterday, the sky was not falling and today, we are not doing great.  But, as locations go, much of Virginia is improving, no overall region is particularly concerning.  We are around the median for all states.







The three week growth rates are (in fraction per day)


NOVA: 0.997

Central VA: 0.991

Hampton Roads/Eastern VA:  0.965

SW VA: 0.997

NW VA:  0.986

 

The state as a whole down 1.0% per day, being driven by Hampton Roads (down 3.5% per day). 


The following charts are for the 5 regions/trends.  To me, what is most fascinating is each part, even though we are mostly part of the same guidelines.  Note that the total number of new cases in East/Hampton Roads is now about the same as Northern VA (though NoVA has a significantly more people).


One interesting aspect of the virus currently is the trend lines have been constant for 6 weeks:  nothing has changed in any region requiring a new trend line (the last change was when Hampton Roads/Eastern VA started behaving better).



Local/Northern VA:

The overall trend in Northern Virginia indicates, that after correcting for testing, the case load has dropped by more than a factor of 10x since our early may peak, though significantly higher than the early July minimum.  However, over the last several weeks, Northern VA has been essentially flat, at about 240 new confirmed cases a day.  That is twice the rate from early July (120 / day), but down from about 3000 cases per day at the peak (because of the availability of testing, 40% of the tests were positive in northern VA, indicating that only 1 in 8 cases were confirmed).  Hospitalizations and deaths are also down from the peak, but up in the last month.





None of the counties is showing significant growth; all are essentially flat (or statistically, they are indistinguishable from flat).  This is an improvement over the last several weeks.


Fairfax Co.: 1.002
Arlington Co.: 1.011
City of Alexandria: 0.993
Prince William Co.: 0.992
Loudoun Co.: 0.992

The growth rate is defined as Rt, or the growth time constant.  Simply, todays number are approximately the growth rate times yesterday's numbers.  This is the exponential time constant.  Fortunately, the time constants are about 1, and our rate of cases is about 7/100,000 per day.  Ideally, we would be 0, but 7 is much better than our peak in which was around 30/100000K





If we look at the current status by zip code, we see that most areas are doing ok -- The previous hot spots are doing better, and the "blue regions" are not green  The one exception is the area around Warrenton, but that is caused by a single outbreak at a long-term care facility.  Also, in general, for Fairfax and Arlington County, North of US50/I66 are doing marginally better than south of I66/US50.  No area with significant population is doing really well (<0.1%), but all are less than 1%.



In Fairfax County, the different communities had been following similar overall trends, with higher numbers in May, much lower numbers in late June-Early July, then slow growth to the present, except the absolute rate per capita differs as much as 3x (this is a log plot).   In the last week, most of Fairfax County has continued the slow growth, with the exception of Vienna and  McLean decreasing g about 20% week over week.   My suspicious in the variation is the result of household income: the wealthier parts of the county can afford to be more careful.


Arlington and Alexandria seem to have leveled off, which is positive.



Age Distribution:

The age distribution of cases shows growth (RT>1) among all age groups, but the working age people (young adults & middle age) are higher than younger and older groups.  And once again, the Teens and Tweens are showing the slowest growth rate (practically flat).  Once again, the teen bubble's social isolation from anyone not a teen is working for them.  It proves if one only associate with non-infected individuals, then the risk is low.  However, based on observed behaviors among that age group, if the disease expands at all, then there will be a problem.  

One interesting aspect of the case numbers is a comparison of the rate of cases for teens (about 0.02% of all teens in the commonwealth) are reporting to be positive, but the numbers for returning students at colleges are more like 0.25%, suggesting that most of the teens are not being diagnosed, and probably means that only 10% of that age group are sick enough to justify testing.



Colleges:

Before I get into details, I can not find evidence of any hospitalized college student at this time in Virginia.

VA Tech
UVA
JMU
CNU
UMW
Radford
VCU
William and Mary


Large Scale Community Spread:

RADFORD (linked to the university Dashboard)

First of all, Radford is now at 217 reported cases  in the last week or so.  And, they have only tested 397 people in that period (based on the ZIPCode 24141).  So, they are running a 55% positive rate.  That means that they are unable to test all of the people that are sick.  My estimate is they are probably undercounting by a factor of 10x1.  If so, that means at least 20% of the student body have been infected. I It seems that Radford has testing capacity of about 60 per day; This is the scenario that I have been worried about. Fortunately, at this time, none of the (likely) students have been hospitalized.  It has been very difficult  to get information beyond the state numbers, but anecdotal reports are that kids who are sick are being told not to test, just assume they have the disease (this is from comments on facebook).  If this is true, the state health department needs to get involved.  Note the dashboard has not been updated in several days, and is using data nearly a week old. There is very little information, and Radford has not been open with the situation.

JMU

JMU is open about what is going on, and had a plan to contain the virus.  Unfortunately, in the last two days, there has been 50 newly identified cases in Harrisonburg.  Looking at JMU's dashboard, there are 14 new cases on campus (health service), and 29 since the school reopened.  In addition, another 157 students self-reported (was 107 yesterday).  Note that the self-reported may not be laboratory confirmed cases.  Also of concern is the percent positive:  it is 15% in the community as a whole, and 27% on campus.  JMU is still in good for on-campus quarantine beds, with a total of 124 beds available.  Unfortunately, with the community spread, it is possible that JMU can no longer recover.

VCU

VCU is showing signs of community spread.  In the last three days 45 students tested positive, which is about 4% of the schools on-campus population.  (The case rate is not growing, and they have sufficient testing capacity such that, they can handle it).  VCU's problem, though is the space for isolation is and quarantine is near capacity.  Being in an urban setting the zip-code and regional surveillance that works well at some of the other schools is not particularly helpful here.  So, I have to rely on the dashboard.  

Watch List:

Virginia Tech:

With the return of the students, the population of Blacksburg increases by 2-3x.  As such we would expect a 2-3x increase in case load.  The initial surge was from testing all on-campus students prior to arrival.  That was expected and is now complete.  After that, it dropped back 20 about 2x the pre-student value, which is not surprising with the increase in people.  The concern -- why it is yellow, is the sudden increase, which may be the first step in community spread.  It is being watched closely.  It is not clear if the campus new cases were the result of surveillance or symptoms.    The school has a plan, and seems to be following up with it.  

Other schools:

William and Mary -- so far so good (1 case in the last week with 4000 students on campus now)
CNU -- I could not find a dashboard; looks ok.
UVA -- I could not find a dashboard;  it was close to going on a watch list, might happen tomorrow.
UMW -- Not open yet.


Communities:

In terms of the local communities around the colleges, I think we can feel confident sending our kids to college -- except for Radford.  So far, the numbers for incoming students at Tech have been low – which is good. Looking at the community number, the apparent growth around Tech is 100% the result of the student return, and the fact that Tech is testing on campus.  This means that the reported cases are showing up on campus rather than elsewhere.  With 11,000 tests, they have identified about 30 infected.  The concern here, though, is the infected students could cause the virus to spread to the regional community, which is not taking proper precautions.   In terms of the surrounding communities, ODU is no longer a problem W & M/ CNU are doing the best.  W & M is welcomed freshmen last week, as are some of the other schools.  The regional trends, which is good for W & M, CNU and ODU. VT is influenced by Radford, and VCU seems to be much of the problem around VCY


Commentary:

Here in Northern Virginia, we have the advantage of watching other parts of the country reopen schools.  Before criticizing the schools, please pay attention to those other areas.

Attribution:

1) You can repost / share in the entirety by forwarding the link, 2) If you want share partial content, you must receive my permission – I need to make sure you understand what I am saying. If anyone sees this work being used without attribution, please let me know as soon as possible. I am willing to have an informed discussion / debate on my approach, but I want to make sure the proper context is captured.

Links: 

Source data is from the Virginia Dept of Health COVID Site

Why I did this:  About the blog

State Actions: Impact on Growth:  TBD

Figure Descriptions:  TBD

Other Sites:  John's Hopkins

Masks Work:  https://link.springer.com/article/10.1007/s11606-020-06067-8.

Kids can pass covid to parents: Pediatric SARS-CoV-2: Clinical Presentation, Infectivity, and Immune Responses


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