Weekly COVID-19 Round-up - 3/10/22
River City Data No. 71
This week, we have more good news in Missouri’s data, which shows a robust set of improvements. In general, cases are approaching their lowest points late last spring. At the same time, while our vaccination progress has slowed to the point where I’ve stopped reporting these numbers (about 58% of Missourians have initiated vaccination per DHSS), we have far better vaccination rates than we did ten months ago. So, there is undoubtedly a reason to be optimistic.
On the flip side, many of those vaccinated people have failed to get boosters and therefore have less protection from severe disease. Rates of vaccination among children are similarly dismal. We’re also learning that even mild illness can cause profound changes. For example, researchers have identified significant differences in brain structure in a large sample of British adults who almost all had mild infections (those that did not require hospitalization). These findings should give everyone who believes that mild infections have no serious consequence pause.
At the same time, motivated by these positive changes, non-pharmaceutical interventions like mask requirements have rapidly disappeared from most places where they had remained. This change has come despite an ever-accumulating body of evidence that supports these measures. Just this week, we got yet another study showing that masking in schools can be very effective.
So, what to make of all of this? First, we still have counties in Missouri that should have mask mandates even under the new CDC guidelines that are far more permissive. So, right now, the push to have school districts and counties require masking should be ongoing. Looking beyond our immediate, we need to ensure that jurisdictions commit to re-implementing masking and other measures should they be warranted again. Therefore, counties and states must have clear, data-informed on-ramps (and stockpiles of masks and other PPE) ready for the next surge instead of sinking back on their laurels and assuming the worst is behind us.
Finally, we need to prepare ourselves for the epidemic after the epidemic. The changes in brain matter noted in the link above are part of a growing body of research that points to poor cardiac outcomes, neurological challenges, and fatigue, to name a few issues. There is a genuine possibility that we need to expect our health and social services systems to be managing the consequences of COVID-19 for decades to come. These eventualities - both the risk of new waves and the long-term burden of chronic that has already resulted from COVID-19 - are something we must all anticipate and actively create plans to manage.
COVID-19 by the Numbers
Total cases in MO: 1,418,704 (+3,975 from last Thursday)
7-day average of new cases per day in MO: 567.86 (-219 from last Thursday)
Counties with per capita rates (per 100,000) over 30 new cases per day this past week:
Bollinger (58.16 per 100,000), Mississippi (48.84), Dunklin (43.19), Lewis (39.89), Daviess (36.14), Grundy (35.58), Linn (34), and Gentry (30.01)
Total deaths in MO: 19,528 (+256 from last Thursday)
7-day average of new deaths per day in MO: 36.57 (-52.43 from last Thursday)
Case and mortality numbers are current as of Wednesday, March 9th. Additional statistics, maps, and plots are available on my COVID-19 tracking site.
Trends in the Past Week
You can get an immediate sense of the recession of COVID-19 new case rates. There are just fifteen counties with rates above 20 new cases per 100,000 residents per day on average. This situation is a stunning reversal from January, when we averaged eight to ten thousand more new cases per day than all of the new cases we added in the past week.
It’s worth noting that these rates are certainly too low right now. I have received frequent questions about at-home tests, which are rarely reported to counties and therefore not reflected in these data. It is hard to know just how much uncertainty this introduces, though we know that many thousands of Missourians continue to get PCR and Antigen tests - nearly 90,000 in the last week.
We also know that our case rates did not capture all infections before the widespread use of at-home tests. At various points during the pandemic, testing availability, reporting practices, and asymptomatic infections have meant that the data on cases appearing in maps and charts has always been an undercount of infections. As before, I believe that our data signal the trajectory of cases even if they do not fully capture the scope of infections.
Unlike last week, where what appeared to be “data dumps” dominated my charts, the counties with high rates right now seem to be genuine increases in new case rates. The highest rates are in Southeastern Missouri in places like Bollinger and Dunklin counties, which see growing rates of new cases, and Mississippi County, where rates are falling.
There are also a set of jurisdictions in Northern Missouri (Daviess and Linn counties, for example) where rates continue to hover at slightly higher rates than we see elsewhere in Missouri.
You can get a clear sense of the declines most of Missouri is experiencing in St. Louis’s trends. The variance between the high’ highest and lowest new case rates is much narrower, and rates are significantly lower than they were three weeks ago. Rates are now below 10.75 new cases per 100,000 residents per day in every one of the counties in the metro area.
For those worried that the numbers are artificially low, it’s essential to triangulate these new case rates with other metrics. In St. Louis, where we have the most up-to-date data, hospitalizations are now averaging just about 200 patients per day on average. There is only about a month period last May and June where we had lower hospitalization rates.
The same is true for critically ill patients. We have the lowest one-day number of patients in the ICU and on ventilators right now. Our seven-day averages for both metrics are among the lowest we have seen during the pandemic.
While we have not had a significant update in mortality data statewide, we do know that deaths in St. Louis hospitals have dropped precipitously as well.
All of this points to the same narrative - we are seeing fewer cases, fewer hospitalizations, fewer critically ill patients, and fewer deaths than we have had in months. Indeed, each of these metrics has hit some of the lowest levels we have seen in recent memory (except for mortality). So, if you are skeptical of new case data, step back and look at the broader data picture that supports the overall narrative of dramatic improvement.