As we creep up in Hospitalizations, I feel like I am in a rock climbing reality show - this, when I have neither the physical traits nor the inclination to compete in the sport. Questions flood my brain - while I rest between steps: How much higher can this face of rock be? How long can I survive without a misstep? What happens to me if my gear fails or the weather gets bad? I report back on the trail so far, hoping that others will benefit from my effort to date.
This week, we are seeing the new-found demand for vaccinations. Many counties, including ones with large populations, had incremental increases that were as high as 6%. The state overall numbers remain in the 50's due to people and places that are determined to "stick it" to rest of us as an act of pyrrhic resistance.
Figure 1 shows the latest numbers on Vaccination as reported in terms of my five-
region breakdown of the data (as of Saturday, August 21). The Border is way out in front. In fact, this collection of 24 counties at 71.2% of their 12+ eligible population fully immunized exceeds Vermont, ranked first among the states at 69%. Hovering around the mid-50's are Central, North, and Gulf Coast. Even though these have many "high flyers", their overall results are dragged down by laggards who are part of the geography and whose schools we support, with or without masks. Therefore, it is important that we get their teachers and children "with the program". These regions are in the same regime as Virginia, Pennsylvania, Colorado, Wisconsin, Minnesota, California, Delaware and Hawaii. Finally, the Panhandle is in a class by itself. I predict that once Texas Tech classes resume, they will stall out completely even though on a per 100,000 population basis, their hospitalization numbers are the worst. To see which states compare, I have to go to the bottom five on the list: West Virginia, Arkansas, Louisiana, Idaho, Wyoming, Mississippi, and Alabama.
This week, I am introducing a new metric: Doubling Status. This parameter measures the number of times a region's Covid-19 population has doubled since Week 68. This Week is chosen since it represents the last entry before Delta starting rearing its ugly spiked ratty head (Week ending on Sunday, July 4). This is a calculated result which equals the Covid-19 Hospitalizations for a given region divided by the value for Week 68, shown in Figure 2. This table represents Texas Initial Conditions for our state hospital system at the beginning of our Delta Variant "light-off" in our Covid-19 metrics.
Figure 3 is the plot of this ratio through this report, Week 75.
What is so interesting is that the clustering and order of colors corresponds to the Vaccination results shown above. In other words, the Panhandle (red) ratio is the highest with the lowest % Vaccination data; the Border (mustard) ratio is more or less constant just above a ratio of 1 with the highest % Vaccination data. We will follow this data in future reports to see what happens as the Hill Country and Gulf Coast build their Vaccination numbers over the next few weeks. What will it take for them to turn their surge around and will public policy changes on the local level, for example, show up in this plot of the data.
At Week 75, the Hospitalized Covid-19 Patients Graphic continues to work its way up curve, at levels that equal or surpass those seen last January - at just one month into vaccinations. Figure 4 shows four out of five regions between 40 and 50 Hospitalized Covid-19 Patients per 100k population. This value puts us in the same
category as Arkansas, Kentucky, and Georgia. The Border, at 28, is at the US average along with data from Arizona, West Virginia, and North Carolina. With numbers still climbing, we will need to change the scale in order to plot the Gulf Coast which is presently hovering close to the y-axis Maximum of 50.
We are around four weeks into the Delta Surge and depending on which part of the state you are in, deaths are about to start increasing. In my plots, I wait for the Death Certificate data to come out before I put it on my plots. This can take as long as 6 to 8 weeks even though it is required after 10 days. With larger numbers, the medical examiners for certain parts of the state will get swamped and these delays can lead to these longer lag times. This, in addition to staff shortages leading to poorer outcomes and much lower infection to fatality ratios (IFR's).
Figure 5 are paired case-Hospitalization, fatality-Hospitalization graphs for each region.
Typically, Cases are a leading indicator. However, with such a rapid rise in hospitalizations, this has not been the case. With schools open across the state starting this week, we will see if cases reflect the change in routine and associated behaviors.
Figure 6 reports the state totals. It gives an overall picture and mirrors the top three population centers: Gulf Coast, N. Texas, and Central Texas. It is easy to see how the
low fatalities at the end of June caught everyone off guard. On a state level, statewide cases did come before rising hospitalization numbers. In this view, the comparison to the Winter Surge, the next week or two will determine the extent to which January peaks are exceeded. While North Texas Hospitals set the levels and timing of the January data, Texas's current picture will be controlled by the Gulf Coast. Back in January, restrictions were in place. Currently, the whole economy, the arts, restaurants, and even cruises are back in business. Counties along the Gulf Coast, hoping to benefit from recent FDA approval of the Pfizer Vaccine are bringing back mass vaccination sites that operate during the week. I will be working the phones as a volunteer at the Galveston County Health Department site this Friday. .
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