Local COVID-19 updates

[edschweppe]

As of 4PM today, the Commonwealth of Massachusetts is reporting 32 newly reported confirmed deaths (for a total of 8,470), 162 newly reported confirmed cases (for a total of 111,533), and 11,555 new patients tested by molecular tests (for a total of 1,262,877), with a total of 1,653,792 molecular tests administered to date. The ratio of newly confirmed cases to individuals tested by molecular test is 1.4%. The state also reported zero newly reported probable deaths (for a total of 221), 69 newly reported probable cases (for a total of 8,341), and 598 patients tested by antibody tests (for a total of 99,768). Combining the confirmed and probable numbers gives 32 new deaths (for a total of 8,691) and 231 new cases (for a total of 119,874).

The seven day average number of newly confirmed cases per day is 304.7 compared to 245.3 last week and 201.7 two weeks ago. The seven day average number of newly confirmed deaths per day is 13.6 compared to 15.7 last week and 14.6 two weeks ago. The seven day average number of molecular tests per day is 14,489.0 compared to 11,738.0 last week and 11,987.7 two weeks ago. The seven day average percentage of tests coming back positive per day is 2.1% compared to 2.1% last week and 1.7% two weeks ago. (The above averages are calculated from today's raw data download.)

Cases down day-over-day, which is great; deaths up day-over-day, which isn't. Testing was down by a lot, but the percent-positive ratio was also down by a lot, which (to my mind) is more important. Over the longer term, the case count continues to be trending upward, while the deaths are trending downward; given that deaths trail cases by a couple of weeks, I'm more worried about the former than the latter.

Those rising case counts are also worrying hospital administrators, as this front-page story in today's Boston Globe reports:

As COVID-19 cases tick up in Massachusetts, no one is eyeing the numbers more keenly than the hospital leaders who will have to respond to a second surge.

Hospitals officials are watching the case counts daily, with memories still fresh of legions of sick people filling wards in the spring. The number of people hospitalized with COVID-19 around the state remains low, but has been inching up in certain places in the past couple of weeks. So, too, has the rate of positive COVID-19 tests reported statewide. And any increase in cases in the community will eventually reach the hospital doors.

"We are very concerned about the rising [infection] rates that we have seen," said Dr. Paul Biddinger, director for emergency preparedness at Mass General Brigham, the hospital group formerly known at Partners HealthCare.

[ ... ]

Usually hospitalizations start to spike about two weeks after positive tests results go up, and intensive care unit admissions increase two weeks after that.

"The key is to recognize changes so that we can act quickly," Biddinger said.

In the spring, hospitals cobbled together the space and staff to care for hundreds of severely ill patients — in many cases more than ever before seen — and the lessons on how to do that will guide the response to whatever the fall brings. Advances in understanding how to treat the illness might lead to shorter lengths of stay or fewer admissions. And improved testing capacity means hospitals are no longer in the dark about how many patients might show up at their doorstep.

But hospital officials also foresee new challenges that weren't encountered in the spring.

The annual onslaught of flu and other respiratory viruses will complicate efforts to respond to COVID-19.
Related: Testing delays are hurting the effort to contain COVID-19

With the coronavirus flaring throughout the country, it will be harder to find traveling nurses to back up the staff, still exhausted from the spring ordeal.

And hospitals hope to avoid completely shutting down elective services as they did in the spring, which resulted in people missing or delaying necessary care. That will make it harder to find space for COVID-19 patients.

Hospital officials emphasize that the severity of the fall illnesses can be mitigated — but only if a pandemic-weary public can stick with disease-prevention measures for quite a while longer.

"If you look historically at pandemics, there is almost always a second surge," Biddinger said. He has no idea when that second surge might occur, but sees two factors that could bring it on: a "loss of vigilance" against the virus as people tire of staying apart and wearing masks, and the tendency to gather inside as temperatures cool.

As the percentage of positive COVID-19 cases creeps upward, some public health experts have called on Governor Charlie Baker to roll back the reopening of the state's economy, and Baker said he would consider doing so if cases continue to rise.

[ ... ]

Baystate Health, a four-hospital system in the Springfield area, has seen "a slow but steady increase" in COVID-19 patients, said Dr. Andrew W. Artenstein, chief physician executive and chief academic officer, who runs the incident command for the Baystate's pandemic response.

Some 30 COVID-19 patients are currently hospitalized at Baystate, about double the number a week ago, Artenstein said. That's still well below the patient counts hovering around 200 in April.

"There seems to be more infection in the community," he said. "It suggests the Northeast is not going to be protected for that much longer."

[ ... ]

And two critical problems linger from the spring: inadequate testing and the continuing struggle to obtain enough personal protective equipment or PPE — the gowns, face shields, masks, and gloves that staffers need to avoid infection.

Testing is essential to determine when hospital employees can return to work, and whether patients need to be isolated and cared for only by people in full PPE.

Baystate Health does not "have the capability to do point-of-care, rapid-turnaround testing," said Artenstein, who called for a coordinated federal response. "We have not yet received the equipment or reagents to do that kind of testing. Without that, we don't have the ability to make decisions quickly."

We are nowhere near out of the woods yet. And the federal "response" isn't helping matters.

The town of Acton has yet to post an update today. As of the most recent report at 3PM on July 28,the town reported 183 cumulative cases of COVID-19 in Acton with 4 individuals in isolation, 158 recovered and 21 fatalities.