COVID Status: Jan 16, 2021: Some positive indications, and are we seeing the impact of vaccinations in the elderly population?

 VA COVID Status, Jan 16, 2021

Today is full update

The introduction section, situation awareness, is updated with every post.  The figures and tables in the document are always updated, but the text in the remainder of the document is only changed as needed.


Situational Awareness

Big picture: Throughout the Commonwealth of VA, we remain at our peak values with yesterday’s caseload breaking the previous record by 1000 cases or nearly 20%). One possible positive indicator is the week-over-week growth appears to be slowing.  In addition, it appears that the number hospitalized is past a peak; a few days ago, there were 3200 inpatients whereas now the number is at 3117.  This could be a random fluctuation, or it could be a positive indicator.  Time will tell. Right now the percent of COVID tests coming back positive has decreased to 13.5%, suggesting that 1 in 2 to 1 in 3 cases are being missed. But, the % positive is lower than it has been for several weeks, which is a third positive indicator.  Still, the overall case load is high; positive indicators reflect what could happen in the coming weeks.  For now, hunkering down is the advice of the day.  This is a high-risk time period.  The good news is the vaccine is present, which (with a little luck), will mark the end of the pandemic (once complete).


Yesterday, VA shattered new cases of COVID-19 with 6,757 new cases, nearly 1000 cases above the prior record of  Today’s count close to two standard-deviations above the three-week bias-adjusted average of 4,955 cases.


The current weekly total of 35,676 new cases, or 5,097 cases per day, which works out to 61.0 cases/day/100K people. This is in line with observations from the past several weeks. The hospitalizations are down (3117) from the all-time high (3200). We continue to have capacity for 3000 more COVID cases in Virginia Hospitals, or about double the current numbers of COVID patients, and we will not exceed that for at least a month at current growth rates.


The trends over the last three weeks now are showing an increase at 2.96% per day or 22.6% per week.  


Projection for tomorrow: 5,792, with a 90% chance the cases will be between 4,607 – 7,287


The testing numbers now show the percent positive to be about 3x the 5% metric over the last week (% positivive at 13.5%).  The 5% metric 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 tested about 2.2% of the population in the last week, down from 2.9% in the week prior to thanksgiving.  Factoring in the test rates and the percent positive, it would not surprise me to find out we are missing between 50% & 80% of the case


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:

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, 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.


Region

Rt

NOVA

1.014

Central VA

1.022

Hampton Roads/Eastern VA

1.049

SW VA

1.027

NW VA

1.024


The entire state is increasing with Rt=1.030


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

42.2

47.6

Eastern

50.7

68.2

Central

48.6

59.7

NW

55.0

88.8

SW

64.6

72.4


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.


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 1200/cases per day.


 



Fairfax Co.

 1.053

Arlington Co.

 1.005

City of Alexandria

 1.021

Prince William Co.

 1.006

Loudoun Co.

 0.992


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.  With time constants above 1, we are experiencing exponential growth in the case numbers.


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 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 1


 

Most localities in NOVA have case counts near or above 40/100K/day which is a dramatic increase since the fall.   In Vienna, for example, we were under five in late September but are now at 41.3/100K/day.

 

Region

Last month

Last week

Growth rate (%/day)

Fairfax County:

Vienna

32.6

52.2

 3.0

McLean

29.8

45.7

 2.5

S. Alexandria

51.3

65.3

 1.6

Reston/Herndon

34.0

42.8

 0.3

Annandale/Fall Church

46.0

59.3

 0.2

Fairfax

32.5

42.8

 2.4

Arlington/Alexandria:

 No. Arlington

39.6

46.5

-1.1

 So. Arlington

54.7

69.8

-1.7

 Alexandria

48.4

60.3

 0.6







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.


UPDATE: 2021/01/16:

Interestingly, we are seeing a drop in elderly cases.  this could be a indication of success in vaccination.





 

Colleges

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

 

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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