Month: November 2020

Well, I was wrong. I thought we’d have to wait for about another week to potentially see higher test positivity rates – at the last update four days ago, it appeared rates were headed down coming into the Thanksgiving holiday. But they bottomed last Monday, and have spiked significantly since then. This does not bode well for the coming weeks. (One note: since testing rates are based on the day the tests are performed rather than reported, they change as new test results come in and the dashboard updated. My November 25 update reported the 7 day newly tested positivity rate as 9.3% using data through November 24.   The 7 day rate for November 24th is now 9.9%).

In fact, every positivity rate is higher or the same as it was a week ago, with the exception of the higher education rate, which dropped slightly. However, the percentage of tests associated with higher education fell to about 31% from close to 45% four weeks ago – I’d expect the higher education testing percentages to remain at these levels or drop lower through at least the end of the year as college students begin to return home from fall classes. Since higher education has had the lowest positivity rate among the reported categories in Table 1, this will put upward pressure on the all test positivity rate and the repeat tester positivity rate as the testing mix changes.  The repeat tester positivity rate is at its highest level in over three months.

There had been a temporarily lull in the rate of increase in hospitalized patients; that is now over.  There have been over 1000 covid patients in Massachusetts hospitals for the past tow days, and the 7 day average is inching closer to 1000.  The average number of new admissions for the week ending November 24 is almost 20% higher than the previous week.  ICU and intubated patient averages have continued to rise as well – the 7 day average of number of intubated patients increased more than 35% week over week.

The average number of cases may be leveling off, but it is a bit too soon to tell if this is just a reporting artifact from Thanksgiving.  Given the higher positivity rates from Table 1, I’d guess this is just a lull. Deaths, as a lagging indicator, are continuing to tick up.

Happy Thanksgiving.  Apparently, there were technical glitches that delayed yesterday’s dashboard report, and it covers a 30 hour period, rather than 24 hour period.  Take that with a grain of salt as the number of reported confirmed cases yesterday hit a pandemic record, besting the prior record on April 23rd.  Of course, there is significantly more testing now  (more than seven times as much).

Despite that apparently bad news, most testing positivity rates have been level or moving down the past few days – a definitely positive sign that may come to an end after Thanksgiving.  The 7 day average positivity rate for newly tested individuals (9.3%), the overall positivity rate (3.0%), the higher education positivity rate (0.3%), and the rate outside higher education (4.6%) all hit their lowest levels in over two weeks.  Only the rate for repeat testers (0.7%) edged up. 

The overall number of tests and the number of new individuals tested are at their highest levels ever, which at least partly explains the increased number of cases even with lower positivity rates.

The number of hospitalized covid patients is also increasing, of course, but the rate of increase appears to be slowing, as the 7 day average of net new hospitalized patients dropped from 32 one week ago to 8, more in line with the increases from four weeks ago.  Unfortunately, patients are being admitted to the ICU and intubated at a faster clip than one week ago.   Both these counts hit their highest levels in the fall surge on November 24th.

The 7 day average of cases continues to increase, but at a slower rate than previously (up a bit more than 4% compared to a week ago), reflecting the decreasing positivity rates among newly tested individuals.  The impact of the 30 hour reporting window should be seen in Friday’s report (no report today). Deaths are continuing to edge up slowly, even as the percentage of deaths in long-term care facilities is lower than it had been through much of the pandemic.

There are signs that the upward trajectory on test positivity is leveling off or even decreasing – unfortunately, with Thanksgiving less than a week away, I’m afraid this won’t last. We’ll get a much better handle on the situation in roughly two weeks or so, after the impacts from Thanksgiving start to show in the test and case data.

Almost all measures of test positivity are better or no worse than one week ago, with the exception of higher education testing, for which positivity rates are marginally higher than one week ago. But higher education results are still better than any other category.  One other item to note: assuming statewide records are accurate, about 45% of the Massachusetts population has now been tested at least once for coronavirus.  Because of widespread higher education testing, the total number tested in Massachusetts (over 3 million) may include out-of-state college students, which would inflate the numbers somewhat.

I’ve added back a line to the Table outlining hospitalization statistics – New Confirmed Admissions.  After dropping this from the daily dashboard report, the state recently added it back to the weekly public health report.  It is only updated weekly, so I’ve included the as-of-date of November 17 in the report.  This also means that the figures for 7 days ago are as of November 10, and the figures for four weeks ago are as of October 20. 

Since hospitalizations lag cases (and case numbers are still increasing), it isn’t surprising that hospitalizations are continuing to increase, but the rate of increase might be slowing down. Still, the 7 day average of Covid patients in the hospital are up one-third from one week ago, but ICU patient are up less than 15%, and intubated patients are up about 10%.  Newly admitted patients increased by slightly more than 30%.

Cases are continuing to rise despite the leveling off of positivity rates, but at a slower rate than before – the 7 day average of confirmed cases is up only about 9% over the past week.  However, the state reported 2,991 confirmed cases on November 21, the second highest number of confirmed cases ever reported (the highest was on April 23), and 3,206 confirmed and suspected cases, the highest total yet. However, on April 23rd the 7 day average positivity rate for newly tested individuals was 24% compared to 10%.  There were also over 3800 patients in the hospital on April 23rd.

And, not surprisingly, deaths are also rising (it is now more than two months since the case increases started after Labor Day), with a 65% increase in the 7 day average rate compared to four weeks ago.  However, now about half of deaths are in long-term care facilities, compared to about 70% for most of the pandemic.   

Are the testing and case metrics beginning to level off in Massachusetts? Test positivity for newly tested individuals was 10.9% today, and has been between 10.8% and 11.1% for the past five days. Unfortunately, this type of holding pattern happened once before recently, when the newly tested positivity rate held at 6.6% and 6.7% for seven consecutive days near the end of October and the beginning of November. It is way to soon to draw any conclusions, especially with Thanksgiving coming up. This test positivity holding pattern seems to be in place not only for newly tested individuals, but for repeat testers (0.5% and 0.6% rate for twelve days), and higher education testers (0.3% rate for eight days) as well.

Of course, hospitalizations lag cases, and the Covid patient count continues to accelerate, with over 30 net new patients added to the Massachusetts hospital rosters each day on average over the past week (versus about 20 net new patients daily over the prior week).  In the short run, ICU and intubated patient counts are leveling off, as are the ratios of ICU to total Covid patients, and intubated patients to ICU patients.

Confirmed reported cases have topped 2000 for seven of eight days now – the only day under 2000 was yesterday (and the data released on Monday tends to have light totals reflecting cases reported on Sunday).  The number of reported cases have leveled off somewhat, reflecting the short-term leveling off of test positivity rates.  Deaths are slowly increasing, reflecting the increases in cases from several weeks back.

No surprises, although Massachusetts did hit several negative milestones in the past several days – test positivity rates of 10% for those newly tested, test positivity rates of 5% outside of higher education, and an overall test positivity rate of 3%. The total number of tests continues to increase, but slowly, and the percentage of first-time testers remains about 25%.

Hospitalization statistics are back to where they were in early to mid-July, but of course the numbers were headed down then, and they are now headed up.  Unfortunately, total hospitalizations are increasing at a faster clip – Massachusetts’ hospitals added almost 170 patients in the last 7 days compared to just under 100 in the 7 days prior to that.  It also appears that patients are a bit more ill than they were four weeks ago, as the percentage of hospitalized patients in the ICU, and percentage of ICU patients who are intubated are higher than they were.

A higher test positivity rate naturally leads to more cases – we’ve had over 2000 reported confirmed cases each day this week.  That number may drop Sunday and Monday, as reporting tends to slow down over the weekend.  The 7 day average of reported deaths, which had been somewhat held in check, hit 24 today for the first time since July 2.   On July 2nd, 70% of those deaths were in long-term care facilities compared to 53% today, which implies that healthier people are dying now.

Nothing good to report today. Test and case positivity rates are still increasing, and at a faster rate than before. No matter which measure of positivity at which one looks, the rate is double or triple what it was four weeks ago. The one exception is for repeat testers, for which the rate is approximately 50% higher, based on 7 day trailing averages. Test positivity is even increasing in higher education (albeit from a very low level), which had been the standout for quite some time. Keep in mind that there is a very large overlap between repeat testers and higher education testers.  Most people tested in higher education have been tested multiple times.

And of course, hospitalizations are rising too, and almost as fast as positivity rates. The 7 day trailing average number of ICU patients has more than doubled from four weeks ago, and the number of intubated patients has almost tripled.  Hospitals in the state added almost 20 patients per day over the past week  (this is not new admissions, but net new admissions including discharges and deaths).

The only slightly positive news is that deaths haven’t dramatically begun to increase (and given better treatment options this might be the case going forward). The 7 day average of reported deaths had stayed under 20 per day from mid-July until October 22 (over three months), but it hasn’t moved much higher since then (let’s keep our fingers crossed). Cases are skyrocketing of course, with the 7 day average tripling since four weeks ago.

This is the last post for this blog.  As many of you know, after election day, Covid disappeared. So there were no new cases, no new hospitalizations, and no new Covid deaths in Massachusetts today, nor will there be any going forward. There is no point in continuing this blog.

Just kidding of course. Unfortunately, the coronavirus news in Massachusetts is not good, and is continuing to get worse. The test positivity rate for newly tested individuals reached 7% today after being between 6% and 7% for twelve consecutive days. I’d been hoping we were at a plateau. No such luck. Positivity rates for higher education, which had been 0.1% throughout September and October, ticked up to 0.2%.  The number of tests each day continues to increase slightly, but the large increase in confirmed cases is not from increased testing, but from higher positivity.

As test positivity and cases rise, hospitalizations follow.   The 7 day average count of hospitalized patients, patients in the ICU, and intubated patients all increased by almost 25% or more in one week.  Particularly disturbing is that over 50% of patients in the ICU are intubated, the highest rate since early September.

Over 2000 new cases were reported today, and the 7 day average of new confirmed cases topped 1300, the highest amount since mid-May.  Deaths are holding steady.  It is unclear whether this is because of the lag from diagnosis to death, or because the current batch of covid patients is healthier compared to the spring.