‘Worst month’ yet? Local COVID-19 reporting fails to provide any context

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You’re being told that October was the “worst month” for COVID-19 cases in the Augusta County, Staunton, Waynesboro region yet.

You put “worst month yet” in your headline, you’re trying to get across a certain message.

As usual, context could help, but is lacking.

What does the number ‘468’ even mean?

The reporting: 468 positive COVID-19 tests were confirmed in the region in the month, on top of what had been a record 306 positive tests confirmed in September.

Everything else being equal, this is roughly a 50 percent increase in COVID-19 prevalence in the area.

Which, yeah, whoa.

Fifty percent. That’s a lot.

Now, context.

The latest Census estimates for the Augusta County, Staunton, Waynesboro region put our combined population at 123,178.

All the sudden, 468 confirmed positive COVID-19 tests in a month might not sound like all that many.

That’s one positive test for every 263 people.

Over the course of a 31-day month.

Context.

More context: the 468 positive tests for the month works out to 15.1 new reported positive tests per day.

Doing more math: that 15.1 per day works out to 12.3 new reported positive tests per 100,000 population.

Virginia reported 34,121 new positive COVID-19 tests in October, which works out to 1,101 new positive tests per day.

That, in turn, works out to 12.9 new positive tests per 100,000 population.

Our local area, then, at 12.3 reported positives per day is tracking 4.7 percent below what the state saw for the month of October.

Context.

One other bit of context that may be helpful: to numbers for the U.S. as a whole.

According to the COVID Tracking Project, there were 1,961,054 new COVID-19 positive test results reported in the month of October.

This comes out to 63,260 per day, and 19.1 new positives per 100,000 population.

Going back to our region, which was at 12.3 new positives per 100,000 population in October, and we were still 35.6 percent below the national positive rate.

“Worst month yet.”

Massive increase in testing

Could it be that the recent increases in positive COVID-19 tests confirmed in the region might be as much reflections of a massive increase in COVID-19 testing?

It’s worth a look.

To wit there: Virginia reported having conducted 318,081 COVID-19 tests in the month of June, according to the COVID Tracking Project.

That number ratcheted up to 468,523 in July, 486,008 in August, 492,945 in September and then 597,654 in October.

Testing, thus, has almost doubled over the course of the past five months, and it would seem to stand to reason that conducting a substantially higher number of tests that pick up both live virus and dead virus would lead to more positive confirmed test results coming back.

Data from the Virginia Department of Health seems to bear that point out. The seven-day average positive test rate on June 1, when we were doing barely half the testing we are now, was 10.1 percent, but as testing increased, we saw the positive rate drop somewhat noticeably – to a low of 4.6 percent on Oct. 8, before ticking back up slightly to where we are currently, at 5.7 percent.

VDH puts the current positivity rate for the Northwest region, which includes Augusta County, Staunton, Waynesboro, at 3.5 percent.

Context.

Hospitalizations

There was nothing in this rendering of the “worst month yet” on hospitalizations, probably for good reason.

According to the VDH data, there were 16 total COVID-19-related hospitalizations in Augusta County, Staunton, Waynesboro in the month of October.

Sixteen hospitalizations in a 31-day month among a population subset of 123,178 people.

The case hospitalization rate compares favorably to what VDH is reporting at the state level.

Our local CHR – 16 hospitalizations from among the 468 reported positive COVID-19 tests reported in October – works out to 3.4 percent.

That compares to a CHR statewide of 7.3 percent – based on 2,493 cumulative COVID-19-related hospitalizations from among the 34,121 reported positive COVID-19 tests statewide.

Of note here: the COVID Tracking Project put new COVID-19-related hospitalizations nationwide in October at 66,376, which would lead to a CHR nationwide of 3.4 percent, half the state rate, but in line with the local CHR.

Fair question: Why would we ignore the hospitalization numbers in reporting on COVID?

The hospitalization numbers – particularly, how COVID-19 is impacting capacity and resources – would seem to be the key metric to watch.

The all-too-real fear that a spike in COVID-19 cases could inundate hospitals and force triaged care was at the heart of the stay-at-home orders and elective-surgery bans back in the spring.

We were trying to preserve beds and staff to be able to throw at COVID-19, basically.

There’s no indication that the 16 cumulative hospitalizations in Augusta County, Staunton, Waynesboro over the 31-day month of October – or the 59 cumulative hospitalizations in the region dating back to mid-March – has put any strain on the primary local healthcare provider, Augusta Health, which has 242 staffed beds, according to the most recent data from the American Hospital Directory.

Statewide, the VDH dashboard has us at 1,031 COVID-19 patients among the 12,761 people currently being treated in-patient in Virginia hospitals.

Our total bed capacity in Virginia is 16,476, so hospitals are currently operating at 76.9 percent of capacity, and COVID-19 patients are currently taking up 6.3 percent of our total available bed capacity.

The Virginia Hospital & Healthcare Association reports today that ICUs are at 77 percent capacity, which is up 10 percent from the 67 percent occupancy rate that VHHA says is typical.

The VHHA dashboard reports today that there are 214 COVID-19 patients in ICU, representing 12.9 percent of the state’s overall ICU capacity, and 8.3 percent of what is called surge capacity – which incorporates beds that hospitals can upgrade to ICU care in the event of a short-term need.

Bottom line: We got this

Is it true to report that October was the “worst month” for COVID in Augusta County, Staunton, Waynesboro?

Sure, if you have one metric as your basis – and that metric is reported COVID-19 positive tests.

As you can see with the reams of context detailed here, it could also be argued that if October was the worst month seen so far, the situation has been well under control all along.

Our hospitals locally and statewide have done a great job, and have ample excess capacity to be able to handle more if more is thrown their way.

Not trying to bust anybody’s chops here.

But, “worst month yet”?

It’s a bit myopic, is what I’m trying to get at.

Story by Chris Graham


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