Thread by @firstresponses

Memphis/Shelby County
Covid Wk-In-Review

tl;dr: Hold On Tight!
* Cases, +671% over 4wks, from 27 to 206/day (22.0 per 100k)
* Positivity, from 2.4% to 12.8%+
* Infection rate, 1.34
* Hospitalizations & Deaths on the rise

1/

Just look at how daily cases have spiked over the past month. And notice that we've had 3 days straight over 200 cases.

For context, we've only had 1 day total over 200 since March. And the last time with 3 days straight over 200 was Feb6-8.

2/

We were avg'ing just 22 new cases/day on June 30. Today, July 24, we're up to 206/day.

That's an astounding +836% increase.

3/

The trends can sometimes become clearer when we look at the data by week instead of by day.

And what I see here is how cases slowly but steadily dropped over 10wks...and then how all that progress was reversed - and more - in just 3wks.

4/

Zoom out & we can see that the only time in the entire pandemic (70wks) that cases have been higher was for 7wks last Summer and then 16wks last Fall/Winter.

But we're clearly heading for a surge as bad as, if not worse than, last Summer.

There are no signs of slowing down.

5/

Our case rate is up to 20.0 per 100k ppl.

With vaccines widely available, I would not advocate for locking down, but we should recall that, in a pre-vax world, Harvard's Global Health Institute said that, at 25 per 100k, lockdowns were necessary to control the spread.

6/

This is just an estimate, but the case rate for the "susceptible" population (no vax, no prior infection) is over 80 per 100k.

For context, that's higher than our Winter peak.

In other words, if you have no immunity, it's never been more dangerous than it is right now.

7/

Let me explain how I calc'd the estimation above.

I took total pop, minus vax'd & infected. (But I assume, based on estimations by @youyanggu, that prior infections are 3x higher than reported.)

And then I assume that 90% of current reported cases are from this group.

8/

And our positivity rate is up to 12.8% and rising.

For context, this is higher than at any point last Summer. And it's higher than any point during the 70wks of the pandemic other than just 5wks during the Winter.

9/

A positivity rate this high tells us that we are missing a significant number of cases.

Not only does that mean that true case numbers are much higher (500+ cases/day instead of the 200/day being reported), but it also means those ppl are just unknowingly spreading covid.

10/

There are essentially two main ways to stop the spread.

One is to reduce the number of susceptible people (e.g., thru vaccination).

The other is to identify infected people, isolate them, and trace/isolate their contacts. Masks help, but test + trace + isolate is key.

11/

The good news is that new people vaccinated are up, +46% over 1wk, +132% over 2wks. Hopefully, this trend will continue.

We avg'd over 1k per day for the first time in over a month.

12/

But it's almost impossible to identify and isolate cases, much less trace and isolate contacts, with testing levels so low.

We did break 10k tests this week for the first time since May, but you can see we were avg'ing 20k+ before vaccines were widely available.

13/

Much (most?) of the testing that is being done, is being done in healthcare, where employees are still required to regularly be tested.

And then there are sick people either seeking testing or being tested by their doctors when they show up sick.

14/

What we're missing is general surveillance testing. And that means we're missing almost all non- or pre-symptomatic cases.

By the time people develop symptoms, and then feel sick enough to seek testing or care, they've already spread the virus to any number of people.

15/

That's why our infection rate is so high - higher, in fact, than any point since the first weeks of the pandemic in March 2020.

16/

About a month ago, they stopped regularly updating hospital data. But covid hospitalizations were at 52 on June 22, then 88 on July 6, 119 on July 13, and 165 on July 21. That's +162% over a month.

Source: docs.google.com/spreadsheets/d…

17/

Covid patients still represent a small fraction of total hospitalizations. In other words, we're not in danger of having our hospitals overrun.

But the covid patients we're seeing now are much younger than those from even 6 months ago. And they're increasingly rapidly.

18/

Deaths are rising too.

Over the past 6wks, we've gone from 1 to 3 to 4 to 7 to 13 deaths.

When we zoom out, that's still low compared to the rest of the pandemic. But we're definitely seeing an increase here. And that's cause for concern.

19/

I think @jameshamblin has a really important point here: We need to stop talking about "breakthrough" cases. That's a misnomer. Nothing is breaking.

"What's happening right now is a failure of vaccination," he says, "not a failure of the vaccines."

body.bulletin.com/177763447742744

20/

This from @ProfMattFox is also key.

With 90% effective vax, let's apply the math to Memphis.

33k vax'd ppl will get covid
300k vax'd ppl won't get covid

300k un-vax'd ppl w/no prior infection will get covid
0 un-vax'd ppl will never get covid

medium.com/@mattpfox/we-a…

21/

And @mattyglesias has some simple solutions around the low-hanging fruit of vaccination.

We're having a hard time convincing people to get vax'd. We should keep trying to do the hard work, but can we please just do the easy stuff?

slowboring.com/p/vaccine-fda-…

22/

And I'll close with a word of caution from @RbnLake on schools.

I'm glad @SCSK12Unified announced that masks will be required. (Not so in local suburban districts, though.)

But what's the plan for when we see outbreaks in schools? Bc we will.

https://twitter.com/RbnLake/status/1417169396661821456

23/

Until we get significant numbers of teens vax'd, and until vaccines are available for kids under 12, we're going to be in trouble.

https://twitter.com/drfixus/status/1418725332048400391

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