Thread by @ProfPhoebe

Ok, can we get back to watching the #COVID19 maps instead? I have a new one for you, #Colorado. It's ugly, so get ready. I'm about to throw a lot of data at you. @denverpost @ColoradoSun @jaredpolis

The above is a screen capture from the Colorado COVID-19 Dial Dashboard view showing the two-week incidence. Red indicates that the incidence qualifies a county for a Stay-at-Home rating. 90% of Colorado's population lives in those red counties.

About 4.8 million people comprising 87% of Colorado’s population live in Larimer, Weld, Boulder, Broomfield, Adams, Denver, Arapahoe, Jefferson, Douglas, El Paso, and Pueblo counties. They're red, baby, and it ain't for Valentine's Day.

Can I interest you in the two-week incidence in those I-25 corridor, Front Range counties with most of Colorado's human inhabitants?

Governor @JaredPolis has called for Coloradoans to behave as though there is a Stay-at-home order in effect yet has not declared a Stay-at-home order, preferring instead to implement certain measures such as curfews and remote K-12 in a few of the affected counties.

The thing is, though - people migrate up and down I-25 daily, doing our thing. Breathing on each other. Sometimes washing our hands. Sometimes not. Sometimes wearing a mask. Sometimes not. Democrats, Republicans . . . turns out nobody's perfect.

It would be prudent to declare a Stay-at-Home order for all of the affected counties instead of focusing efforts just on counties with a lot of Democratic voters. Republicans also have hearts and lungs and parents and siblings and grandmas and reasons to live.

Following the first SARS outbreak in 2003, healthcare workers who survived taking care of SARS patients suffered many long-term consequences including post-traumatic stress disorder.

Essential workers are also at grave risk of exposure under the prevailing conditions and would be safer if everyone else stayed home.

When there is a blizzard, the state closes the interstate not just to protect people who are overconfident in their tires, four-wheel drive, and anti-lock breaks but also to protect the first responders who would have to risk their own lives to rescue members of the public.

And now, some more data! Because #SciComm. Figure 2. Cumulative reported cases of COVID-19 for El Paso County, CO. Values reported by the county department of public health are in black while estimates based on fitting exponential curves to the most recent data.

So while you are all out there drinking champagne or drowning your sorrows, depending, consider that a substantial rise in #COVID19 cases will occur in #Colorado unless we enact major public health measures immediately. I mean, immediately. Not in a couple of weeks.

Figure 3. COVID-19 hospitalization census in El Paso County, CO. The census is reported by the Colorado Hospital Association, an advocacy group for the for-profit hospitals in Colorado.

On Oct 9, a reporter disputed the validity of the hospital census data, finding that they are an under-report but these are the only publicly-available data pertaining to the local situation. But, ya gotta work with whatchya got. So this is what we know..

Although the private Colorado Hospital Association discloses the census in aggregate for county hospitals, we do not have independent verification of this source, the list of hospitals it includes, or the percentage of occupants who are in regular or ICU beds.

The Colorado Hospital Association has not provided the public with information on staffing, medication, or PPE. The state has not explained how healthcare-related resources including skilled workers might be deployed in the event that one or more hospitals becomes overwhelmed.

Figure 4. Rolling 14-day COVID-19 incidence per 100,000 people in El Paso County, CO. The reported cases normalized per 100,000 people in El Paso County are reported in the standard 14-day rolling metric and are represented by black X’s.

The dotted lines correspond to the September 15 Colorado guidelines for the COVID-19 Dial. It's pretty hard to see those nice safer levels on the Y axis necessary to show the reasonable projections.

Next week I predict a 14-day rolling incidence per 100,000 people of 733-857. The highest incidence during our summer peak was 155; incidence this week will be about 5 times higher than that.

The predicted 14-day incidence for next week is also more than twice as high as that required to qualify for Stay-at-Home (350) according to the Colorado Department of Public Health and Environment Dial Policy. We surpassed 350 on November 1.

We will remain under Stay-at-Home incidence conditions for the next few weeks unless substantial public health measures are enacted immediately. "Immediately." Inmediatamente. Right now. Yesterday would also be fine.

Figure 5. PreK-12 school guidance. The thresholds are those recommended by Harvard experts because there are no similarly-clear county, state, or nation-wide recommendations for us to follow.

See: The Harvard T. H. Chan School of Public Health Schools For Health and The Harvard Global Health Institute The path to zero and schools: Achieving pandemic resilient teaching and learning spaces.

We are in the red zone; teachers, staff and students are at risk of contracting and spreading COVID-19 in schools even if those schools are properly ventilated and everyone is trying their best to observe physical-distancing and enhanced hygiene.

To my knowledge, there has not been a comprehensive effort to inspect school ventilation in El Paso County, CO.

Figure 6. Nasopharyngeal swab testing for viral nucleic acids (“PCR test”). The dotted line thresholds reflect the Colorado State Dial Policy. Daily percent positivity is in light blue diamonds while the dark blue symbols show the 14-day rolling calculation.

The spike on November 3 could be due to testing at the El Paso County Jail where hundreds of prisoners and staff tested positive. But that's not clear at this point.

It's horrific that the state failed in their responsibility to keep imprisoned people safe.

Moreover we are going to hear about how we shouldn't worry too much about the jail cases because imprisoned people are separate from the rest of us. The thing is that jail imprison people for the short-term. Lots of people have been to jail. Even people you like.

There are some pretty infamous cases of infectious diseases spreading because of exposure in jails. Cook County Jail and MRSA are a case in point from the 1990's. Pneumonia, TB . . . so many smart bugs and so many humans with blinders on.

As long as I'm on the DoomScrolling Train, I should point out that test results are recorded on the day that the county documents the test result, not on the day the test was administered.

According to the county COVID-19 web site, as of Saturday, November 7 at 8:28 a.m., the average turnaround time from swab to test for the last week has been 2.74 days. The necessary turnaround for contact tracing to be maximally-effective is 1 day or less.

Tl; dr: #Colorado is super-#COVID19-screwed. @JaredPolis. @DenverPost. @ColoradoSun. #IsAnybodyOutThere

I used the public El Paso County dashboard for all the reported cases and testing data. Updating the dashboard with the number of reported cases, hospitalizations, deaths, and results of testing has slowed compared with the usual.

I performed this analysis as a private citizen; the analysis and forecasting are not necessarily the opinion of my employer.

@threadreaderapp unroll please