Nov 26: Turkey Day....Please be socially distanced. It is getting bad, and will continue to get worse.

 Daily Status, Nov 26

Today is a full update

I would have updated yesterday, but there were issues with the state database.  Tomorrow may or may not have an update, as it is a chemo day (update will be written from the infusion center if it happens).  . Sat and Sun and Mon, I expect to be too tired from the chemo to update.  


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

I try to update every day between 11:00 and 12:00; however, because my updates are based on when the Virginia Department of Health (VDH) updates, it takes some time to analyze and collate the data. In addition, because I have my own health issues, there will be days when the update is late or is not published at all.  

 

The one thing to remember is that the day-to-day changes are minor. Any trend takes several days to identify and I will be looking at the data daily (that is easy) but may not update the blog.

 

Situational Awareness

 

Big picture: The fall surge continues to accelerate.  In Virginia, every day in the last week was above 2000 cases, even though there have only been 12 days with over 2000 cases.  No part of VA is performing well.  If you have any risk factors for complications, NOW IS THE TIME TO BE HUNKER DOWN!  Those include age (60+), diabetes, heart disease, cancer, kidney disease, compromised immune system.  Please, even if don’t, wear a mask to protect those that do.  And if you do, minimize your outside in-public Activities.  The good news is progress is being made towards a vaccine, but that will probably be available to most no earlier that spring time.  It is going to be an ugly winter.  I expect to be on full lockdown sometime soon.

 

Local: The caseload in Vienna doubled in the last month. Be careful and wear your mask. Approximately 1% of the local population is probably COVID positive at this time.  For someone like me, in a high-risk group, that means that, for anyone in my bubble, a single non-distanced interaction, there is about a 2/1000 chance of me dying.  It might be time to buy the inflateable dino costume for COVID protection.

 

Yesterday, VA reported 2,600 new cases of COVID-19.  This continues a multiweek surge in case counts.  Today’s count is about 1 standard deviations above the three-week bias-adjusted average of 2,180 cases – this consistent growth is a reflection that the case count is not anywhere near constant, but rather is increasing rapidly over the last 9 weeks (since late Sept), averaging 13% per week; during this period, the weekly number of new COVID-19 cases increased from 5,255 to 18,113

 

The current weekly total of 18,113 new cases, or 2588 cases per day, which works out to 31.0 cases/day/100K people. This is the highest verified weekly number during the pandemic, though it is likely the May numbers were significantly under-reported.  However, the number of people hospitalized is now approaching the numbers from early May (currently 1569; peak was 1625).  Since hospitalizations should not be impacted by testing levels that provides a strong indication that the caseload is now probably similar to that in May.  Though, in May, the cases were concentrated in in NOVA, whereas now, the distribution is more uniform throughout the Commonwealth.  If we look at hospitalizations, we had 2x the number of hospitalizations in May in NOVA than we do today.  

 

The trends over the last three weeks now are showing an increase at 3.6% per day or 28% per week.  If the trends continue, we will achieve herd immunity in 6-7 months’ time, but at the cost of 28,000 lives in Virginia.  However, we should have sufficient hospital capacity.

 

By combining our current regional trends with the typical reporting for the day of the week, I expect about 2,962 cases tomorrow (Friday) with a 90% chance of the numbers falling between 2,257 to 3,892 cases.  This estimate, though, does not factor in the Thanksgiving holiday

 

The testing numbers now show the percent positive to be above the 5% metric over the last week (7.4%) which is often used to indicate sufficient testing. This is concerning because, as the percent positive increases, it is possible that some cases are being missed as the number of positives is constrained by the testing availability.  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.


Now:
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Sept 26:






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, and NWVA

 

 

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:                                            1.047--GMU

Central VA:                                     1.025 -VCU

Hampton Roads/Eastern VA:         1.056--W&M, CNU & ODU

SW VA:                                            1.040 -VA TECH & Radford

NW VA:                                            1.056 --JMU & UVA

 

The entire state is increasing with Rt=1.036

 

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

16.0

31.3

Eastern

13.2

22.4

Central

16.2

25.9

NW

17.0

58.3

SW

32.8

45.1

 

The following charts show all five regions of 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. Starting in late September, NoVA and SWVA diverged from the rest of the state, a trend that continues today.

 

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 up to a current value of 800/day.




 

Fairfax Co.

 1.049

Arlington Co.

 1.043

City of Alexandria

 1.054

Prince William Co.

 1.046

Loudoun Co.

 1.044

 

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. The cause of that is unknown but may relate to the cooler weather.  

 



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.

 


 

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 9.1/100K/day.

 

Region

Last month

Last week

Growth rate (%/day)

Fairfax County:

Vienna

12.0

22.5

 8.6

McLean

11.4

21.5

 8.7

S. Alexandria

17.9

31.5

 9.8

Reston/Herndon

16.2

20.4

 5.5

Annandale/Fall Church

17.9

34.4

11.0

Fairfax

13.3

24.3

 8.0

Arlington/Alexandria:

 No. Arlington

16.7

27.0

 6.9

 So. Arlington

24.7

39.0

 9.5

 Alexandria

17.0

32.3

11.9



In Vienna, the average daily case count has doubled; I do not why (I have not been out and about). However, I suspect the cause is primarily people locally and state wide tiring of the pandemic.

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

Given that most colleges are shutting down for the semester in the next week, the report on colleges will be on hiatus.


At this point, the focus should be on the risk of the offspring bringing COVID home.  That is easy enough to figure out:  take the # of active cases divided by the student population.  For example, at W&M, they tested 747 students last week; one was positive.  That means about 1/700 is positive, or about 0.14%.


Realistically, that means that there is a 0.14% chance your child from W&M will infect you -- providing you have no immunity.


Randomly, around town, in Vienna, the positive rate is probably about 0.2%; if you go out and about in Vienna, with a mask on, interacting with 100 people (but masked), the odd of contracting the disease is about 0.36%, or twice that getting it from your child. 


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.

 

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