Daily Status, Nov 8: Every trend I was tracking 10 days ago remains. Which is not good.

  Daily Status, Nov 8

Reminder:  Any sections that are unchanged since yesterday are grayed out.  

 

Please be kind.  I have been putting out a daily update since March.  As you may have noticed, I had not put one in 10 days.  I am trying to get this one out, but my energy level is low.  I spent half of the last 10 days in the hospital, and had multiple procedures to fix the acute issues (bile duct blockage) so I can address the longer term issues of fighting off the cancer which is growing inside of my body.    I had started working with an editor to improve the quality of the writing, but I am going to forgo that, as the process takes time, and I can not be assured that I will have the energy to complete the writing at that time.  


I am not sure how much longer I can keep this up.  I remain concerned that the media does not understand the math well enough to accurately report the situation. However, I am confident that, on Jan 20 at 12:00 noon, the excellent and dedicated government scientist will be able to speak unencumbered by politics.

Situational Awareness

 Big picture: We are well into the fall surge in COVID-19 Cases.  I do not know how bad it will get, but it is getting worse.  

 

Local: The caseload in Vienna doubled in the last month, but leveled off.  Because the case numbers are low, random variations can make it more difficult to assess the trends.  But they are increasing.


Colleges:  I am not updating those today.  

 

Yesterday, VA reported 1,302 new cases of COVID. The data were reported by VDH on Nov 8, 2020 were just above the three-week bias-adjusted average of 1,704 cases. We had been seeing a caseload increase, which continues.  Also note that Virginia did set a daily record yesterday, at 2106, with no evidence of a data glitch.

 

Viewed over the last seven days, VA reported 9,783 cases, or 1,397 cases per day, which works out to 16.7 cases/100K people. This is the highest verified weekly number during the pandemic, though it is likely the May numbers were significantly under-reported by a factor of four. The best way to demonstrate that is through hospitalizations which peaked at 1,600 in early May but are currently at 1080 (but increasing).  Since hospitalizations should not be impacted by testing levels that provides a strong indication that the caseload was probably higher in May, but underreported.

 

The trends over the last three weeks now are showing a minimal increase at 2.8% per day or 21% per week.  

 

By combining our current regional trends with the typical reporting for the day of the week, I expect about 1,152 cases tomorrow (Friday) with a 90% chance of the numbers falling between 921 to 1,443 cases. If tomorrow's numbers differ from that, we will have a very rare event. This is useful to consider if I am unable to report tomorrow since you can compare the state reported numbers with this.


The testing numbers now show the percent positive to be above the the 5% metric over the last week (6.2%) which is often used to indicate sufficient testing. VA is testing about 2.8% of the population every two weeks .  


When we look at the local ZIP code data, we see that the observed increases are almost universal across VA. I am comparing the current estimated % positive to that of one month ago. Note that almost all is a warmer color (further from blue and closer to yellow). This is an indication of the uniformity of the increase. As a practical matter, it means to be safe and careful, no matter where in VA you live, there is risk, and it is increasing.



Now:
Oct 1:







 

Regions

In the spring, COVID-19 in VA was primarily a concern in the DC suburbs. Over three to four weeks, (from late May to early June), NOVA recovered and for about a month the disease was under control to the point that restrictions were eased. Unfortunately, in eastern VA/Hampton Roads, the easing of restrictions resulted in a surge in cases which peaked just before August 1st resulting in stricter restrictions in that area. Since then, with the exception of growth on college campuses, the disease has been stable, excluding the rural parts of the state where safeguards (social distancing and masks) are largely ignored. Starting in October our weekly case count has been increasing throughout the Commonwealth, particularly in NOVA and SWVA. 

 



 

Looking at the weekly case count, we see that the numbers are higher than at any other point in the pandemic.

 

Regional growth rates (in fraction per day) continue to show degradation over the past three weeks. Note: It is easier to show a decline when the prior numbers increased. The current growth rates for the different regions are shown below.

 

NOVA:                                            1.031 --GMU

Central VA:                                     1.028 --VCU

Hampton Roads/Eastern VA:         1.038 --W&M, CNU & ODU

SW VA:                                           1.027--VA TECH & Radford

NW VA:                                           1.027-- JMU & UVA

 

The entire state is increasing with Rt=1.028

 

The following table shows the number per 100K for each region. Again, NOVA and Eastern VA are doing the best, and the mountainous regions in NW & SW continue having more cases. The concerning aspect is that in all regions the numbers for last week are significantly higher than the preceding three weeks. What is most concerning is that SW & NW VA are hitting significantly higher caseloads.

 

Daily Cases/100,000 

Region

Last month

Last week

NOVA

 10.5

14.1

Eastern

 9.1

11.7

Central

13.1

16.0

NW

11.4

26.3

SW

26.0

30.8



The following charts show all five regions zof the Commonwealth over time.

The individual line charts show the unfiltered data per day, coupled with the trend lines. 

 

The trend lines show the different periods of growth.  

 

Early in the pandemic, the different parts of VA were functioning largely independently, with NOVA mimicking the northern states, and Hampton Roads mimicking the southern states. Since September 1, the regions have trended together. 

 

Currently SWVA has the greatest number of cases even though they have half the population of NOVA.  

Note that the effects at both ends of the chart are probably artifacts of the (seven-day polynomial filtering I use for averaging); the filter is poorly constrained in the first and last few days of the time history.  For those technically inclined, the filter is called a Savitzky-Golay filter, basically a moving window polynomial filter. At the edge (first and last days of the time series), the filter will over-compensate for the trend as it is unconstrained. I recommend the Wikipedia article if anyone is interested in more information, or contact me.











Local/Northern VA:

 

After the early peak in May (~1,000 cases per day), NOVA saw a sharp drop in all COVID metrics, reaching a broad valley in mid-June (~200 cases/day), which lasted until around August 1st.  By Sept 1, NOVA increased to 300 but the caseload dropped to about 150 by late in the month. Since then we have had a steady increase averaging about 380+ per day, which is significantly higher than our recent low of 150/day in late Sept.




 

Fairfax Co.

 1.032

Arlington Co.

 1.038

City of Alexandria

 1.037

Prince William Co.

 1.026

Loudoun Co.

 0.988


The number above is Rt:  Rt is an exponential time constant, where the number of cases in a time segment is approximately, n=Ao Rt ^ t, where Ao is the number of cases at the start of the segment, Rt is the exponential growth rate, and t is the number of days since the start of the segment.  So, if Rt is greater than 1, it is growing exponentially, if it is less than one, it is decreasing each day.  

 

 

Another way to look at it, todays number are approximately the growth rate times yesterday's numbers.  This is the exponential time constant.  Fortunately, the time constants are below 1 and our rate of cases is about 6/100,000 per day.  Ideally, we would be 0, but 6 is much better than our peak in which was around 30/100000K. 

 

Looking at the trends, the strong downward trend in daily case count we observed since around September 1st has ended.  We now see significant jump in cases in every jurisdiction, starting about 4 weeks ago. The cause of that is unknown but may relate to the cooler weather.  I expect the trend to continue for the foreseeable future.





The difference in the colors (contrast) in the NOVA map is increasing. In addition, the NOVA map is warming (as is happening throughout the Commonwealth). At this point, it seems likely that this is related to the fall surge others had predicted.

   

CURRENT

Oct 29



 

Most localities in NOVA have case counts near or above 10/100K/day.  In Vienna, for example, we were under five in late September but are now at 10.3/100K/day.

 

Region

Last month

Last week

Growth rate (%/day)

Fairfax County:

Vienna

 9.3

10.3

 1.6

McLean

 6.5

 8.5

 6.4

S. Alexandria

10.7

15.0

 2.7

Reston/Herndon

10.8

13.1

 3.8

Annandale/Fall Church

 11.8   

15.0

 4.5

Fairfax

9.1

10.6

 6.0

Arlington/Alexandria:

 N. Arlington

10.7

13.8

7.8

 S. Arlington

16.0

19.4

 2.7

 Alexandria

11.0

14.8

 4.2


Recently, the trends show two groups of rates for Fairfax County: McLean is doing the best.  All the other locations are grouped at a higher number -- every region is seeing small upticks in the last few weeks. 

 






 

In Vienna, the average daily case count has doubled; I do not why (I have not been out and about). While, the growth rate may have stabilized, the absolute numbers remain higher than they have been since May.  

 



Local Safety/Risk

I am attempting a different means of discussing risk. Risk is very personal-- people will react to COVID differently; however, we know how many people have died (and how many cases) for each age group in VA so we can get a case fatality rate for age groups. Also, based on serology studies, we know the case numbers are low by a factor of 2.4, so we can get an infection fatality rate (IFR).  We also know how co-morbidities play in. 

 

In the following tables, I have combined the current probability of a person being infected around Vienna to compute the probability that a person in a specific crowd is infected.  

 

Assuming one interacts with everyone in the crowd (big assumption), I assume if you interact with an infected person, you have a 50% chance of getting infected. I do not know what that rate is



; it will be a function of how long you interact, how close, and if masks are used, etc. This is the big unknown.

 

That gives me a probability of being infected based on the number of interactions. I then combine that with the IFR to estimate the risk of dying by age and number of interactions for people with and without co-morbidities.  

 

For comparison, the risk of dying in a car accident in per day is about one in three million. That is a baseline but none of us likely knows anyone who will not get into a car because of the risk of dying.

 

 

 

No Co-morbidities

#exposure        0-9      10-19      20-29      30-39      40-49      50-59      60-69      70-79        80+ 
         1   0.00e+00   4.12e-08   3.71e-07   1.57e-06   3.83e-06   1.07e-05   2.42e-05   3.90e-05   7.29e-05 
         5   0.00e+00   2.05e-07   1.85e-06   7.81e-06   1.91e-05   5.32e-05   1.21e-04   1.94e-04   3.63e-04 
        15   0.00e+00   6.12e-07   5.50e-06   2.32e-05   5.69e-05   1.58e-04   3.60e-04   5.78e-04   1.08e-03 
        50   0.00e+00   1.98e-06   1.78e-05   7.53e-05   1.84e-04   5.14e-04   1.17e-03   1.87e-03   3.51e-03 
       100   0.00e+00   3.81e-06   3.43e-05   1.45e-04   3.55e-04   9.88e-04   2.24e-03   3.60e-03   6.75e-03 
       500   0.00e+00   1.42e-05   1.28e-04   5.40e-04   1.32e-03   3.68e-03   8.35e-03   1.34e-02   2.51e-02 
      1000   0.00e+00   2.06e-05   1.85e-04   7.83e-04   1.92e-03   5.33e-03   1.21e-02   1.95e-02   3.64e-02 
      2000   0.00e+00   2.48e-05   2.23e-04   9.41e-04   2.30e-03   6.41e-03   1.46e-02   2.34e-02   4.38e-02 


Comorbities

#exposure        0-9      10-19      20-29      30-39      40-49      50-59      60-69      70-79        80+ 

         1   0.00e+00   4.12e-07   3.71e-06   1.57e-05   3.07e-05   5.34e-05   7.27e-05   7.79e-05   1.46e-04 
         5   0.00e+00   2.05e-06   1.85e-05   7.81e-05   1.53e-04   2.66e-04   3.62e-04   3.88e-04   7.27e-04 
        15   0.00e+00   6.12e-06   5.50e-05   2.32e-04   4.55e-04   7.92e-04   1.08e-03   1.16e-03   2.16e-03 
        50   0.00e+00   1.98e-05   1.78e-04   7.53e-04   1.48e-03   2.57e-03   3.50e-03   3.75e-03   7.02e-03 
       100   0.00e+00   3.81e-05   3.43e-04   1.45e-03   2.84e-03   4.94e-03   6.73e-03   7.21e-03   1.35e-02 
       500   0.00e+00   1.42e-04   1.28e-03   5.40e-03   1.06e-02   1.84e-02   2.51e-02   2.69e-02   5.03e-02 
      1000   0.00e+00   2.06e-04   1.85e-03   7.83e-03   1.53e-02   2.67e-02   3.63e-02   3.89e-02   7.29e-02 
      2000   0.00e+00   2.48e-04   2.23e-03   9.41e-03   1.84e-02   3.21e-02   4.37e-02   4.68e-02   8.76e-02 

Age Distribution: 

I am not updating this section for the time being except for the charts.  I will leave it here as is for a while longer--at times it can be very interesting.  This is particularly so when specific age groups do not follow other groups. For example, teens and 20-somethings surged in early September while the other age groups did not due to the outbreaks at colleges.







Colleges


I am not updating the colleges today.  

Overview: Things are static at most colleges. My data mining by ZIP code requires that I group them together when they share a ZIP code. 

 

My process combines the VDH h data and what is reported by the colleges. The assumption is that students feeling ill are going to seek health services; however, we have all heard anecdotal reports of people not doing that because they did not want to quarantine. The colleges usually update the dashboards after this post, or on Monday/Tuesdays. Except for Radford, all weekly updates are complete at this time and the numbers are encouraging (except for UVA).

 

As the process has evolved, it has become clear that I need to show active cases (over a ten-day period) in addition to cumulative cases.

 

I am assuming the colleges are promptly reporting their numbers to VDH. As it turns out, W&M is reporting the cases approximately two days after updating the dashboard. 

 

Note: I have been finetuning the following table to improve the estimated number of cases. Also, I am adjusting the pre-student caseload: to estimate the number of cases from students, I subtract out the average number of cases prior to the student arrivals from the reported cases. If the numbers are large (UVA, VA Tech, JMU & Radford), the impact is minimal. This makes it harder though to identify cases in more urban settings like ODU, VCU and CNU.

 


RED       Clear evidence for community spread

YELLOW There may be community spread; still ambiguous

GREEN   No evidence of community spread

 

College

% Positive

Cumulative

Last 10 days

 

Dashboard Cases

 

% that had COVID

***

VDH Cases*

Est

Cases**

VDH Cases*

Est

Cases**

VA TECH

5.2

1827

5024

140

187

1383

 14.7 

GMU

1.9

104

107

8

11

94

  0.3 

UVA

1.2

865

1900

59

56

964

  8.0 

ODU

10.7

114

227

22

51

153

  0.9 

JMU

9.4

1823

7711

114

214

 1606

 36.3 

CNU

13.0

47

157

19

49

78*****

  3.1 

UMW

5.7

0

0

0

0

25

  0.0 

RADFORD

32.7

692

3317

80

364

524

 41.9 

VCU

5.2

212

371

18

29

304

  1.2 

WL/VMI

4.5

165

234

27

29

104/61

  6.1 

W&M

2.5

24

24

5

3

49

  0.3 

 Va Tech,   4.6,    2039,  5248,     225,   217,  15.4 
        GMU,   2.8,     129,   134,      24,    26,   0.4 
        UVA,   0.6,     885,  1924,      22,    23,   8.1 
        ODU,  10.6,     134,   275,      21,    42,   1.1 
        JMU,   8.6,    1944,  7988,     129,   248,  37.6 
        CNU,  10.9,      58,   183,      13,    25,   3.7 
        UMW,   5.8,       0,     0,       4,     3,   0.0 
    Radford,  27.3,     766,  3715,      76,   315,  46.9 
        VCU,   6.1,     255,   432,      46,    62,   1.4 
     WL/VMI,   4.1,     205,   276,      40,    40,   7.2 
        W&M,   3.3,      37,    37,      14,    13,   0.4 

Large Scale Community Spread:

VA TECH: VA Tech is finally getting a handle on COVID with only a few new cases a day. VA Tech is more than a college...it is a football team.  And the football team has been decimated by COVID-19. The real test is when VA Tech can field a full team.  That has not happened yet.  

 

Watch List:

JMUJMU returned to in-person classes 10/5;  So far so good with the return. The case count at JMU continues to rise, but slowly. JMU has been fairly transparent with the situation but could not get ahead of it initially. As it stands now, caseloads continue to smolder. They are neither increasing nor decreasing. My one significant concern is reporting: there are a lot more cases in Harrisonburg than there are new cases at JMU even though they are in the same city. This may be due to students failing to report, or it could be due to cases in the non-student population.

 

CNU -- I am not sure what is happening at CNU because they are in a populated area and their dashboard does not supply the data required to understand variation over time. They are showing a significant increase in caseloads and I will be monitoring them more closely now.

 

ODU -- ODU is now showing a significant increase in the percent positive which suggests there may not be a complete count; however, the numbers remain relatively low for the size of the university. It is difficult to track ODU because it is in a populated area and they only update the dashboard weekly.

   

UVA: With the students return, there has been a marked increase in cases, week after week.   It appears with the much stricter rules UVA imposed two weeks ago that the caseload is abating. As a Hokie, nothing saddens me more than having to move UVA down on the watch list before I do VA Tech. Oh well. They still messed up COVID. There is that. 😊



RADFORD: Radford was moved back up primarily because of the % positive. Radford updates the dashboard weekly which is insufficient in my opinion. Fortunately, they report to VDH regularly (as mandated by law).  While it is not clear how many students at Radford contracted COVID-19, it would not surprise me to see enough that the community, when isolated effectively, has herd immunity (meaning over 60-80% contracted COVID-19). The only way to know would be antibody studies. Hopefully, VDH will look into that.  Currently, it seems that Radford has a manageable number of cases. While only 57% of the cases in the last two months are attributed to students, there were so few cases prior to the students’ return, this means either the dashboard is undercounting, or there were a lot of non-students infected by students. 

 

Other schools:

William & Mary -- There is at least a small-scale outbreak in the athletic department. W&M tested all athletes and stood down on athletics after having had a total of 20 positives; however, W&M (and Williamsburg) have gone a full week without a positive case (and completed nearly 1,000 tests). Most of the active cases are among athletes. W&M is quick to update the dashboard; they update prior to reporting to the VDH.  W&M tested all students prior to arrival in town--with the current outbreak (albeit small), the college probably is a bigger threat to the town than the other way around  which is a reversal of the last several weeks.

 

VCU seems to have the virus under control -- They have beaten back an outbreak, the % positive is good, and there are few new cases. It was promoted from RED to YELLOW. and now Green.  The numbers have shown no significant increase in the last several days; quarantine and isolation space is becoming more prevalent.   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.   

 

 

UMW -- Nothing noteworthy.  A few cases but they just returned.  I am concerned because they did not test all students.

 

GMU -- Nothing noteworthy.  GMU tested all students.

 

 

College Communities:



When I started talking about communities the focus was on the safety for incoming students. Unfortunately, that concept has changed. Now we are seeing the colleges impacting the surrounding communities. If we look at the age distribution of cases in the communities of JMU, Radford and VA Tech (New River, and Central Shenandoah health districts), we see that, starting about four weeks ago, the number of cases for non-college age citizens has been increasing -- about two weeks behind the college-age curve. This suggests the disease is infecting the general population. 

So far it looks like about an extra 372 middle-aged and senior citizens have been infected; there have been 12 cases to 24 cases per day in those groups. Furthermore, in the five months from the beginning of the epidemic to early September, there was an average of 10 deaths per month; in the last seven weeks there have been 35 deaths. This is concerning as the return of students has appeared to result in 21 extra deaths in the Commonwealth today in just the New River and Central Shenandoah health districtsNone of the additional deaths were of student age. This trend has been observed elsewhere in the country where the college students infect the more vulnerable populations.






  

Attribution:

1) You can repost/ share this information in its entirety by forwarding the entire link, or,  2) If you want to share partial content, you must receive my permission. This is proprietary information and I need to make sure you understand what I am saying. If anyone sees that 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.

 

 

 

 



Comments

  1. Stay well. Take care of yourself. Thank you for doing this. It is really the only source of solid reporting for the region. Your are in my thoughts and I appreciate your work, especially in these circumstances.

    ReplyDelete
  2. David, you are a treasure! Take care of yourself and know that we are grateful for your insights whenever you are able to give them.

    ReplyDelete
  3. Stay well and thank you for doing this..it has been the only "sane" information out there

    ReplyDelete
  4. Thank you SO much, David, for these incredible, detailed insights into covid in VA and especially the micro-analysis of the situation in Vienna/McLean (which is where I live). Like others have said, please take care of yourself and know that your community of followers are grateful for what you've done for us and hopeful that your health will stabilize so that you feel better. I'm so sorry you and your family are going through this.

    ReplyDelete

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