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jpoheim

Week 87: 11/8-11/14/2021

The holiday season is just over the horizon and it wouldn't take a fortune-teller to predict travel in your future. Whether visitors from your family or students home from college, all manner of people will be on the road. At transportation hubs, they will mix and mingle; at restaurants and stores, they will cross paths - and, it will be important for high performance mask use to keep everyone protected from indoor Covid-19 spread. As I have been reporting, the direction of concern is people coming here from the West, primarily New Mexico and Colorado. Figure 1, this week's NYTimes Hot Spots diagram https://www.nytimes.com/interactive/2021/us/covid-cases.html ,based on County

per Capita Cases, indicates that values in the range of 250k and over have crossed the Panhandle/New Mexico border further encompassing counties to the south along the Border. Fortunately, for now, North Texas has cleared up causing a "line of demarcation" to the left of the "Texas" label and parallel (southwest to northeast) to this weeks blue oval. Such a boundary separates the Panhandle counties from North and Central Texas. I will be watching to see whether Vaccination Rates are high enough to shield these regions from the Panhandle and Border spread, or not.


In New Mexico, Breakthrough Cases are tracked and currently account for 2% of recent cases (and rising) https://www.lcsun-news.com/story/news/2021/11/10/new-mexico-hit-full-beds-waning-immunity-and-rising-covid-19-cases/6378139001/ .


Figure 2 plots an overlay between Hospitalizations and Cases for North, Central, Panhandle and the Border. In all cases, previous surges are preceded by a period of lined out Hospitalizations and Cases followed by increases in both metrics. And, each period of line-out is preceded by periods of decreasing Hospitalizations and Cases from the Surge before it. It is the lined-out sections of the data that separate one surge from the next.

Figure 2 places a red line on each graph to show where the latest Hospitalization data falls relative to previous entries. In all four regions, we have lined out at levels above those of last Spring before the Delta came to Texas. From this red line, there are two arrows: one corresponding to Week 87 and the other to data from one year ago. While the Panhandle was peaking around that time last year, other parts of the state were still in store for their part of the wave to come through (similar to how a wave of fans stand and sit during a football game). The Border is an interesting case in this respect: last winter there were two peaks. The first occurred in the Upper Rio Grande (El Paso County, Trauma Area I) while the second was related to the Lower Rio Grande (Hidalgo and Cameron Counties, Trauma Area V).


Figure 3 breaks down the Border Hospitalization Data from the Trauma Service Area history for the same time period. The dates of the TSA-I Surge are from late October to the end of December while TSA-V Covid-19 Patient numbers start rising just as those from TSA-I peak.

Does the crossover at 250 Covid-19 patients which occurs during the week ending 10/10/2020 look similar to recent crossover data at 10/31/2021. While the level of crossover, 100 Covid-19 patients is lower than last years, will we see a similar wave across the rest of the state once Border Hospitalizations peak?


So much depends on Vaccinations and the extent to which compliance with indoor mask practices. It also could include the use of Quick Testing to catch those who are asymptomatic and/or recently infected. Remember, Breakthrough Infections do happen, and not everyone who is eligible for Boosters has found the time to fit one in. If these individuals were to self-isolate, spread could be controlled: these actions would extend line-out period and keep hospitalizations lower.


Figure 4 are the weekly numbers of Texans (including 5-11 year olds) who are fully vaccinated. Children were admitted to this population beginning last week, so it will not be until after Thanksgiving that their contribution will bump up these numbers which are increasing at a slow .5% per week.




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