One hundred Five weeks sounds like a very long time. Breaking it up in weekly pieces was my approach from the beginning. Back in 2020, all of my colleagues would spend their time writing about the data as it was issued, daily. However, as one surge followed another - the weekly evaluation became more suitable for averaging, incorporating the deviations associated with weekend holidays, and more straightforward for corrections.
One could easily overlook this novelty when learning to understand the data on a regional as opposed to a county-by-county basis. However, as hospitalizations proved to be a better leading measure of Covid-19 spread than cases, the 22 Trauma Service Areas [A-V] served as a more natural basis from which to gather and evaluate data. Having tracked the data in this fashion and lumped it accordingly, plots of Weekly Averaged Hospitalizations Overlaid with Weekly Fatalities between June 2020 and March 2022 cover all stages of the pandemic: from original restrictions and buildout of Hospital ICU capacity to Vaccination Rollout programs and Variant Surges. At the present, we find ourselves at the waning of Omicron which turned up in November right before Thanksgiving. This variant peaked during January, 2022 - after a rapid, exponential spread. The next variant, another Omicron sub-variant is expected six months later: in the May to June timeframe.
I believe that this is a good stopping place for this weekly blog. While I am looking to branch out my writing to another subject, Energy at the Crossroads, it is also time to organize these reports and write a few articles. Such material needs to be communicated to: Texas DSHS, Texas Demographic Conference (5/24-5/26), and the Rockefeller Foundation Pandemic Tracking Initiative (the organization which took over the Covid Tracking Project's mission which shut down after structuring the effort between 3/20 to 5/21).
Since that time, Dashboards across the country and Covid-19 literacy have improved dramatically. While much has been written about misinformation, conspiracy theories, and the CDC, the public has had to manage its spending, its shopping, its schools, and its workforce according to a messy reading of the news, the data, and policy. Except for occasional lapses such as missing a date for snapshots or unclear y-axis units for historical trends, those who have followed the data since the beginning are familiar with how to get answers. Few, if anyone outside of the media, create their own plots from scratch.
With these points, this week's report will be a summary of the what each plot shows. While the blog will not be publishing on a weekly basis, I will post updates for any items of interest. Also, the plots will be polished in terms of the various presentations planned. No e-mails will go out; however, the website will still be up and running. Most of these will go under the Articles Category https://www.texascovid19trail.com/my-blog/categories/article . And, I will keep the numbering of weeks going until I have reached the end of my tracking.
Vaccinations:
Figure 1 tabulates the status of each region with respect to "full vaccination". This is defined as taking the first two shots (Pfizer or Moderna). It does not include whether these have been followed up by a booster (or second shot per Johnson & Johnson). Such a detail is essential to knowing whether those in specific groups will be vulnerable to new variants. Nevertheless, studies show repeatedly that vaccinations matter. While breakthrough infections occur, these studies are the basis for the effect of future variants on Covid-19 Hospitalizations. Here are links to a few articles:
Note how low the incremental change is (and has been for the last few months). Where last summer, we were looking to the new year to reach for each of the regions to reach the 70% target, only the Border achieved this milestone. Central Texas and the Gulf Coast may get there by 2023; however, by then, we may be several boosters into the Vaccination Schedule making these kind of Tables not instructive as they were when the shots were first introduced.
Another important point is that the Texas DSHS uses 2019 Census data as the basis for all population estimates. To be consistent with their accounting, I have continued this practice for my work. However, one "article" I want to write is how different my conclusions would be if I cut over to 2020 Census numbers. Will this bring Presidio County vaccination counts less than or equal to 100% of its population? Will this boost the low numbers associated with the Panhandle? To be clear, the % vaccinated is based on the total eligible (by age).
Here are some interesting Takeaways:
The Regional % Fully Vaccinated breakdown is weighted by population. The Border (85%) has the highest fraction of the eligible population fully vaccinated. The Gulf Coast (64%) and Central Texas (62%) have the highest populations of vaccinated residents and set the State population-weighted Average (63%)
On a county-by-county survey, there are 20 counties at or above 70%. More than half of these are located along the Border. Several of the Border Counties show Vaccination Rates over 100%. This suggests that the 2019 Population total and age distribution is incorrect.
On a county-by-county survey, there are 45 with populations that are less than 40% fully vaccinated. Three-Fourths of these are located in one of two regions: the Panhandle (17/45) or North Texas (18/45).
The Panhandle has the tightest spread at 29% (Max, 53 - Min, 29 ).
The Gulf Coast has the largest spread at 52% (Max, 78 - Min, 26).
Another comparison based on three types of counties still needs to be performed: urban, suburban, and rural.
Hospitalizations:
The number of Covid-19 Hospitalizations continues to fall. Although the number is lower than at this time last year, they are still higher than they were just prior to the arrival of the Delta variant. Figure 2 illustrates this comparison. It also shows 8 weeks of falling data with a total Omicron surge of 12 weeks (Winter, 2022. This compares with lengths for: Delta (Summer, 2021) 18-23 weeks and Alpha (Winter, 2021) 28-43 weeks.
Hospitalization Takeaways:
Central Texas established its Covid-19 Hospital Capacity during Phase 4, when the Alpha Surge occurred. This part of the state had a similar peaks for Delta (40 Covid-19 patients per 100,000 population) and Omicron (35).
Gulf Coast Hospitals saw the highest levels of patients for Delta (53 Covid-19 patients per 100,000 population). Its Omicron and Alpha peaks were approximately the same (40).
North Texas Hospitals saw the same total patient peak for all three surges covered by the above time-period (50 Covid-19 patients per 100,000 population). Omicron arrived before this region had chance to get its Delta numbers down. As a result, there was overlap between the two surges.
The Border Alpha profile shows a two-pronged peak. By drilling down into the individual TSAs, one observes that the first peak is related to the upper part of the Border (El Paso County) while the second is from the contribution of the Rio Grande Valley (Hidalgo, Cameron). In addition, there was considerable overlap between Delta and Omicron since this region did not get its Hospitalization numbers down before the second variant arrived.
Even though the Panhandle has the smallest total population of the three regions, its scaled hospitalization data represent the highest in Texas. During Alpha when these exceed 60 Covid-19 patients per 100,000, this part of the state had a large share of congregate facilities which included Long Term Care and Prisons. Similar to North Texas and the Border, there was a large overlap between the fall of Delta Cases and the surge of Omicron. Omicron's peak at 57 patients per 100,000 represented the largest maximum of the five state regions.
Even though the peaks for each surge vary by a factor of 2 (30's to 60's), the data for Week 105 - late in the history of Omicron, all five regions are very close to one another between 5 and 6.
Hospitalization/Fatalities Overlay
While Hospitalizations are a measure of spread just behind Cases, Fatalities are a trailing metric. An overlay of the two provide a measure of Sever Infection to Fatality Ratio. This calculation will be used to compare one surge to another, one region to another. Because Texas Death Certificates lag reporting by 4-6 weeks, it will be another 4 weeks before fatalities line out just as Hospitalized Patients across the state have.
Whereas Figure 2 covered the period between September, 2020 to the present, Figure 3 starts at the beginning of June, 2020 in order to include the Summer, 2020 surge. As shown, it was during this surge and the following Winter, that the Hispanic community on the Border suffered the largest number of casualties. With a population that is one-third the size of the Gulf Coast, their peak fatalities should scale to [3x500]1,500/week; [3x300] 900/week; [3x150] 300/week and, [3x200] 400/week for Alpha Summer, Alpha Winter, Delta, and Omicron. The Gulf Coast results were 600, 600, 750, and 300 - in every case smaller than the scaled Border cases. Such results are especially unfortunate given that this Region has Vaccination Rates that rank with the highest Vaccinated states in the country. Early in 2021, it was hoped that the strong community demand for getting shots would protect the border. The protection did hold up during Delta when the Border population was freshly vaccinated. I speculate that Booster Shots were not delivered as quickly or with as much accessibility to these counties.
Message Going Forward
With masks off and offices back in business, there is a sense of denial that China isn't in lockdown or Europe isn't in surge. The second round of Omicron will happen. How bad will it be? The U.S. Government must rise to the occasion with good communication from the top.
While test kits are in stock now, I would have as many as 6 per person in your household. Entertaining is fine - but, why not have everyone test themselves in the back yard and well distanced during Appetizers and Wine? Those who test positive, get a rain check; those who don't get to stay.
Finally, modify your shopping routine to avoid times of the week when the no-mask-bullies are present. And, learn how to do grocery "take-out". This practice is temporary. Once the surge passes (2-1/2 months), you can relax and return to your Spring/Fall behavior.
Thanks for indulging me and my amateur epidemiologist person. Hopefully, a few of you learned a little over the last 105-70 = 35 weeks. It's been fun but now, I am going to check out another beat.
And, as I mentioned above - check in any time to see whether anything has been published and posted here since you heard from me last.
Signing out,
Judith P. Oppenheim
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