Category: Data Update

It’s deja vu all over again.  (But worse).  A few days before Thanksgiving, test positivity rates, which had begun to level off after sharply rising through much of the fall, began to increase significantly again. A few weeks after Thanksgiving, positivity rates had once again started to level off and even decline somewhat from the Thanksgiving surge. Unfortunately, on the 24th of December, positivity rates across all testing categories started to increase once again, with no short-term end in sight.

For newly tested individuals, the 7 day trailing positivity rate is at its highest level since April 23rd. Higher education positivity rates are at their highest recorded level, but the state didn’t break out this category until mid-August. Not surprisingly, higher education testing has declined significantly, currently accounting for about 10% of all tests. Conversely, the highest percentage of tests since early September are for people being tested for the first time.  This could be because of the drop in higher education testing (almost all repeat testing) or because more people are feeling symptomatic and are getting tested.

 

Table 1: Massachusetts Testing Statistics
7 Day  Trailing Average
December 30, 2020
Testing Statistic		Current	7 Days Ago	4 Weeks Ago
Test Positivity Rate (Individuals)		23.0%	18.1%	17.0%
Test Positivity Rate (Include Suspected)		24.9%	18.8%	18.0%
Test Positivity Rate (All Tests)		8.4%	6.1%	5.7%
Test Positivity Rate (Newly Tested)		23.0%	18.1%	17.0%
Test Positivity Rate (Repeat Testers)		1.7%	1.3%	1.0%
Percentage Repeat Testers		68.5%	71.3%	70.6%
Test Positivity Rate (Higher Ed)		0.6%	0.4%	0.5%
Test Positivity Rate (Non Higher Ed)		9.4%	7.3%	7.4%
Percentage Higher Ed Testers		10.7%	17.3%	25.3%
Newly Tested (Lagged 1 Week)		24,637	24,457	26,103
Higher Ed Tests (Lagged 1 Week)		14,830	20,118	31,140
All Tests (Lagged 1 Week)		85,842	87,781	94,095

 

The number of patients in the hospital is also increasing, but at a slower rate than over the past week or month.  So far, hospitalizations are under control, but we haven’t seen the likely surge from the Christmas (and New Years?) positivity and case increases.  The percentage of hospitalized patients in the ICU has held steady at about 20% for quite some time, but the percentage of ICU patients who are intubated is increasing – clearly not a good sign but perhaps only temporary.

 

Table 2: Massachusetts Hospitalization Statistics
7 Day Trailing Average
December 30, 2020
Hospitalization Statistic		Current	7 Days Ago	4 Weeks Ago
Confirmed  Patients Hospitalized		2167	1950	1100
Confirmed  Patients in ICU		421	393	233
Confirmed  Patients Intubed		233	212	117
New Confirmed Admissions (15-Dec)		229	229	125
Net New Confirmed Patients		27	31	45
Net New ICU Patients		3	4	8
Net New Intubated Patients		1	3	3
Percent ICU / Hospitalized		19%	20%	21%
Percent Intubated / ICU		55%	54%	50%

 

The inevitable consequence of rising positivity, case counts, and hospitalizations is deaths.  There had not been more than 100 reported deaths in one day since May 20th, and Massachusetts surpassed that threshold both on December 27th and December 30th, increasing the 7 day average number of reported deaths to its highest level since early June.  The percentage of deaths in long-term care continues to remain (relatively) low, even as the absolute number of long-term care deaths has risen with the total number of deaths.  Case counts have leveled off, although testing is down somewhat as a result of the holidays.

 

Table 3: Massachusetts Reported Case and Death Statistics
7 Day Trailing Average
December 30, 2020
Statistic		Current	7 Days Ago	4 Weeks Ago
Total Deaths Including Suspected		67	54	34
Total  Deaths Confirmed Only		66	53	34
Deaths in Long-Term Facilities (All Cases)		22	17	15
Percent from Long-Term Care		33%	32%	45%
Total Cases Including Suspected		4593	4554	2927
Total Confirmed Cases		4302	4334	2716

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Testing positivity rates remain at elevated levels, but are down from their highs – just in time for what will likely be a spike as a result of Christmas gatherings. All positivity rates are at levels last seen in early December, with the exception of the rate for repeat testers, which is at its highest level for the fall surge.  Unfortunately, the positivity rates are well above what they were prior to Thanksgiving.

As one would expect, the amount of higher education testing has dropped back to the levels seen at the beginning of September as colleges and universities have closed for the holiday break, and education testing is now only 20% of all testing statewide.

 

Table 1: Massachusetts Testing Statistics
7 Day  Trailing Average
December 23, 2020
Testing Statistic		Current	7 Days Ago	4 Weeks Ago
Test Positivity Rate (Individuals)		17.2%	19.2%	10.4%
Test Positivity Rate (Include Suspected)		18.2%	20.0%	10.9%
Test Positivity Rate (All Tests)		5.9%	6.3%	3.4%
Test Positivity Rate (Newly Tested)		17.2%	19.2%	10.4%
Test Positivity Rate (Repeat Testers)		1.4%	1.3%	0.7%
Percentage Repeat Testers		71.5%	72.0%	72.1%
Test Positivity Rate (Higher Ed)		0.4%	0.5%	0.3%
Test Positivity Rate (Non Higher Ed)		7.3%	8.0%	4.9%
Percentage Higher Ed Testers		20.5%	23.0%	33.1%
Newly Tested (Lagged 1 Week)		24,521	24,886	22,701
Higher Ed Tests (Lagged 1 Week)		20,118	21,578	31,744
All Tests (Lagged 1 Week)		87,594	86,325	83,801

 

Given the number of current number of daily cases, hospitalizations will inevitably continue to increase for the foreseeable future. We’ve more than doubled the number of covid patients in the hospital, the number of patients in the ICU, and the number of intubated patients in the past four weeks.  While the net increase in these patient counts has slowed somewhat since the beginning of the month, it is likely that hospitals will come under increasing strain, especially several weeks after Christmas.

 

Table 2: Massachusetts Hospitalization Statistics
7 Day Trailing Average
December 23, 2020
Hospitalization Statistic		Current	7 Days Ago	4 Weeks Ago
Confirmed  Patients Hospitalized		1950	1723	918
Confirmed  Patients in ICU		393	343	194
Confirmed  Patients Intubed		212	182	89
New Confirmed Admissions (15-Dec)		229	195	105
Net New Confirmed Patients		31	39	8
Net New ICU Patients		4	11	5
Net New Intubated Patients		3	6	5
Percent ICU / Hospitalized		20%	20%	21%
Percent Intubated / ICU		54%	53%	46%

 

With test positivity rates down a bit, and the number of tests holding relatively constant, the number of cases are also off their highs.  The number of deaths is still rising, unfortunately.  Today’s reported death count of 81 is the second highest since May – there were 89 deaths reported on December 9th.  (As a side note, relatively high numbers of deaths are typically reported on Wednesday, as there is a lag in reporting deaths that have occurred over the weekend).  The highest number of deaths occurring on a single day during the fall surge was 60 on December 7th.

 

Table 3: Massachusetts Reported Case and Death Statistics
7 Day Trailing Average
December 23, 2020
Statistic		Current	7 Days Ago	4 Weeks Ago
Total Deaths Including Suspected		54	50	28
Total  Deaths Confirmed Only		53	48	28
Deaths in Long-Term Facilities (All Cases)		17	18	14
Percent from Long-Term Care		32%	36%	50%
Total Cases Including Suspected		4554	4957	2681
Total Confirmed Cases		4334	4713	2538

 

It has been over a week since my previous post, with very little change in the statistics other than hospitalizations. Testing positivity rates generally are somewhat higher than those reported in the prior post, but the large increases in positivity rates seem to be abating. However, even if the current case and positivity rates level off, the increasing strains on medical and hospital resources aren’t sustainable in the long run.

Keeping in mind that positivity rates are updated retroactively as more test results get reported, the positivity rate for newly tested individuals (that group represents 25% to 30% of all tests) has been essentially stable for over a week. The test positivity rates for other groups are roughly at the same levels as two weeks ago – other than repeat testers, for which positivity is continuing to increase slowly, and is at its highest level in almost five months. This may be because higher education testing, for which the positivity rate remains very low, has declined to about one-quarter of all testing, down from about 40% before Thanksgiving (virtually all higher education testing is repeat testing). Overall testing counts are higher again after dipping somewhat through Thanksgiving.

 

Table 1: Massachusetts Testing Statistics
7 Day  Trailing Average
December 17, 2020
Testing Statistic		Current	7 Days Ago	4 Weeks Ago
Test Positivity Rate (Individuals)		18.8%	18.8%	10.8%
Test Positivity Rate (Include Suspected)		19.8%	19.6%	11.5%
Test Positivity Rate (All Tests)		6.0%	6.1%	3.4%
Test Positivity Rate (Newly Tested)		18.8%	18.8%	10.8%
Test Positivity Rate (Repeat Testers)		1.3%	1.0%	0.6%
Percentage Repeat Testers		72.9%	71.3%	72.7%
Test Positivity Rate (Higher Ed)		0.4%	0.5%	0.4%
Test Positivity Rate (Non Higher Ed)		7.9%	8.1%	5.3%
Percentage Higher Ed Testers		25.1%	25.3%	37.8%
Newly Tested (Lagged 1 Week)		24,406	20,683	20,824
Higher Ed Tests (Lagged 1 Week)		21,491	17,810	31,094
All Tests (Lagged 1 Week)		84,928	70,174	78,218

 

Not surprisingly, hospitalizations continue to increase.   Unfortunately, case levels from several weeks back were sufficiently high that the number of new admissions to hospitals is greater than the number of discharges (and deaths), which leads to more covid hospitalizations.  The only positive news is that the number of net hospital admissions hasn’t changed much over the prior four weeks.  Unfortunately, that isn’t the case with ICU or intubated patients, as the net patient increases are trending higher.

 

Table 2: Massachusetts Hospitalization Statistics
7 Day Trailing Average
December 17, 2020
Hospitalization Statistic		Current	7 Days Ago	4 Weeks Ago
Confirmed  Patients Hospitalized		1761	1498	792
Confirmed  Patients in ICU		354	298	162
Confirmed  Patients Intubed		187	151	72
New Confirmed Admissions (15-Dec)		229	195	105
Net New Confirmed Patients		38	40	37
Net New ICU Patients		11	7	4
Net New Intubated Patients		6	4	1
Percent ICU / Hospitalized		20%	20%	20%
Percent Intubated / ICU		53%	51%	45%

 

Cases and death counts are essentially stable from one week ago.  The percentage of deaths in long-term care facilities are also stable, and have decreased substantially since four weeks ago and from earlier in the pandemic. Since deaths overall are significantly higher than four weeks ago, this means that deaths outside of long-term care account for the bulk of the increase from four weeks ago.

Table 3: Massachusetts Reported Case and Death Statistics
7 Day Trailing Average
December 17, 2020
Statistic		Current	7 Days Ago	4 Weeks Ago
Total Deaths Including Suspected		50	48	28
Total  Deaths Confirmed Only		49	47	27
Deaths in Long-Term Facilities (All Cases)		17	17	15
Percent from Long-Term Care		34%	36%	55%
Total Cases Including Suspected		4924	4839	2623
Total Confirmed Cases		4692	4599	2442

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There is some evidence that testing positivity rates are leveling off after the Thanksgiving surge (the surge actually predates Thanksgiving by a few days). For example, the all test positivity rate of 5.7% is at its lowest level since December 1. The repeat tester positivity rate has held steady at 0.9% since late November.  In addition, both the higher education positivity rate, and the positivity rate outside of higher education have declined slightly in the past several days. Hopefully, this trend will continue into Christmas.

Overall testing has declined somewhat, led by the decline in higher education testing – over 40% less testing compared to four weeks ago as students headed home for Thanksgiving.

 

Table 1: Massachusetts Testing Statistics
7 Day  Trailing Average
December 10, 2020
Testing Statistic		Current	7 Days Ago	4 Weeks Ago
Test Positivity Rate (Individuals)		18.2%	17.7%	10.7%
Test Positivity Rate (Include Suspected)		19.4%	18.7%	11.1%
Test Positivity Rate (All Tests)		5.7%	5.9%	3.3%
Test Positivity Rate (Newly Tested)		18.2%	17.7%	10.7%
Test Positivity Rate (Repeat Testers)		0.9%	0.9%	0.5%
Percentage Repeat Testers		72.7%	70.3%	73.2%
Test Positivity Rate (Higher Ed)		0.4%	0.5%	0.3%
Test Positivity Rate (Non Higher Ed)		7.7%	7.8%	5.2%
Percentage Higher Ed Testers		28.4%	25.4%	40.0%
Newly Tested (Lagged 1 Week)		20,785	24,727	19,216
Higher Ed Tests (Lagged 1 Week)		17,808	28,346	31,686
All Tests (Lagged 1 Week)		70,029	87,555	74,114

 

Good news on the testing front, but not such good news on the hospitalization front, as hospitalizations have been increasing at roughly the same rate for several weeks.  Over the past week, we’ve admitted almost 200 new patients a day with covid (the net is lower because patients are discharged and unfortunately die), but the net increase has declined relative to a week ago.  If we’re lucky, new admissions will stabilize before hospitals become severely overcrowded.

 

Table 2: Massachusetts Hospitalization Statistics
7 Day Trailing Average
December 10, 2020
Hospitalization Statistic		Current	7 Days Ago	4 Weeks Ago
Confirmed  Patients Hospitalized		1498	1151	592
Confirmed  Patients in ICU		298	240	141
Confirmed  Patients Intubed		151	121	65
New Confirmed Admissions (08-Dec)		195	138	80
Net New Confirmed Patients		40	51	23
Net New ICU Patients		7	7	5
Net New Intubated Patients		4	4	2
Percent ICU / Hospitalized		20%	21%	24%
Percent Intubated / ICU		51%	51%	46%

 

The 7 day average of reported and suspected cases actually dropped slightly from its pandemic high of over 5,000 reached yesterday.  It is amazing that at these high levels this 7 day average increased almost 50% from one week ago (although the averages one week ago might  have been suppressed slightly because of the Thanksgiving weekend). Unfortunately, the 7 day average of reported deaths continued up, reaching a fall surge high water mark (and the highest total since June 7).

 

Table 3: Massachusetts Reported Case and Death Statistics
7 Day Trailing Average
December 10, 2020
Statistic		Current	7 Days Ago	4 Weeks Ago
Total Deaths Including Suspected		48	34	23
Total  Deaths Confirmed Only		47	33	22
Deaths in Long-Term Facilities (All Cases)		17	15	11
Percent from Long-Term Care		36%	43%	47%
Total Cases Including Suspected		4839	3337	2147
Total Confirmed Cases		4599	3123	2036

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I’m not totally sure there is any point to doing these periodic updates on the covid statistics in Massachusetts, as cases, hospitalizations, and deaths continue to increase rapidly. There are perhaps some signs that test positivity rates are beginning to level off, albeit at staggeringly high levels compared to the lulls of the late spring and summer.  But I’ve been lured into thinking that before, only to be blindsided by higher rates shortly thereafter.

 

Table 1: Massachusetts Testing Statistics
7 Day  Trailing Average
December 6, 2020
Testing Statistic		Current	7 Days Ago	4 Weeks Ago
Test Positivity Rate (Individuals)		17.5%	13.7%	8.7%
Test Positivity Rate (Include Suspected)		18.6%	14.4%	9.1%
Test Positivity Rate (All Tests)		5.3%	4.6%	2.7%
Test Positivity Rate (Newly Tested)		17.5%	13.7%	8.7%
Test Positivity Rate (Repeat Testers)		0.8%	0.9%	0.5%
Percentage Repeat Testers		72.9%	70.8%	73.7%
Test Positivity Rate (Higher Ed)		0.5%	0.3%	0.2%
Test Positivity Rate (Non Higher Ed)		7.4%	6.2%	4.4%
Percentage Higher Ed Testers		29.4%	27.6%	41.7%
Newly Tested (Lagged 1 Week)		19,070	26,037	17,469
Higher Ed Tests (Lagged 1 Week)		18,053	33,704	30,751
All Tests (Lagged 1 Week)		65,411	92,343	70,388

 

As high as these test positivity rates are, some have held steady or even dropped over the past few days.  Nonetheless, it seems clear that positivity rates this high aren’t sustainable for long without putting tremendous strain on our hospital resources.  As expected, higher education testing began to drop significantly as students headed home for Thanksgiving.   This, coupled with reduced testing outside of higher ed because of the holiday, accounts for the drop in the week-over-week testing totals in Table 1.

 

Table 2: Massachusetts Hospitalization Statistics
7 Day Trailing Average
December 6, 2020
Hospitalization Statistic		Current	7 Days Ago	4 Weeks Ago
Confirmed  Patients Hospitalized		1312	985	510
Confirmed  Patients in ICU		267	214	115
Confirmed  Patients Intubed		133	105	56
New Confirmed Admissions (01-Dec)		138	125	57
Net New Confirmed Patients		48	27	19
Net New ICU Patients		9	7	8
Net New Intubated Patients		4	3	2
Percent ICU / Hospitalized		20%	22%	23%
Percent Intubated / ICU		50%	49%	49%

 

And of course, high positivity rates and high numbers of new cases translate eventually to more hospitalized patients, with the 7 day average increasing one-third week over week.  ICU patients and intubated patients each increased 25% week over week,.

 

Table 3: Massachusetts Reported Case and Death Statistics
7 Day Trailing Average
December 6, 2020
Statistic		Current	7 Days Ago	4 Weeks Ago
Total Deaths Including Suspected		40	29	19
Total  Deaths Confirmed Only		39	29	19
Deaths in Long-Term Facilities (All Cases)		16	14	9
Percent from Long-Term Care		40%	47%	49%
Total Cases Including Suspected		4593	2620	1670
Total Confirmed Cases		4342	2479	1584

 

Cases continue to increase at a staggering clip.  Over the past week, we’ve averaged almost 50% more reported and suspected cases per day than the highest one day total in the spring.  Deaths, of course, are also rapidly increasing.  Although deaths in long-term care facilities are a smaller percentage of deaths than at any time previously during the pandemic, the absolute number of long-term care deaths are still as high as early July.

 

It looks to me that things are spinning out of control. By all measures, testing, hospitalization, case, and death statistics are getting worse.  Despite this, I expect no action from Governor Baker other than entreaties to avoid holiday gatherings.

The 7 day trailing positivity rate for newly tested patients is the highest it has been since May 4th, when testing was much less available. It is more than 50% higher than one week ago. The all test positivity rate is 44% higher than one week ago, and the positivity rate outside of higher education is 39% higher.  The all test positivity rate and the newly tested positivity rates have each more than doubled in the past four weeks.

 

Table 1: Massachusetts Testing Statistics
7 Day  Trailing Average
December 2, 2020
Testing Statistic		Current	7 Days Ago	4 Weeks Ago
Test Positivity Rate (Individuals)		15.6%	10.2%	6.9%
Test Positivity Rate (Include Suspected)		17.4%	10.7%	7.3%
Test Positivity Rate (All Tests)		4.9%	3.4%	2.1%
Test Positivity Rate (Newly Tested)		15.6%	10.2%	6.9%
Test Positivity Rate (Repeat Testers)		0.9%	0.7%	0.4%
Percentage Repeat Testers		72.6%	71.7%	74.0%
Test Positivity Rate (Higher Ed)		0.4%	0.3%	0.2%
Test Positivity Rate (Non Higher Ed)		6.8%	4.9%	3.6%
Percentage Higher Ed Testers		29.8%	33.5%	43.3%
Newly Tested (Lagged 1 Week)		26,240	22,898	17,222
Higher Ed Tests (Lagged 1 Week)		31,139	31,744	31,167
All Tests (Lagged 1 Week)		92,839	83,258	69,939

 

Hospitalizations are back to mid-June levels. In June, of course, hospitalizations were decreasing, rather than increasing.  Over the past week, we’ve added a net 45 confirmed covid patients per day (this accounts for discharges and deaths), and the7 day average patient and ICU count has increased 20% from a week ago and almost two and one-half times from four weeks ago. The number of intubated patients increased by more than 30% in the past week.

 

Table 2: Massachusetts Hospitalization Statistics
7 Day Trailing Average
December 2, 2020
Hospitalization Statistic		Current	7 Days Ago	4 Weeks Ago
Confirmed  Patients Hospitalized		1100	918	447
Confirmed  Patients in ICU		233	194	90
Confirmed  Patients Intubed		117	89	48
New Confirmed Admissions (24-Nov)		125	105	50
Net New Confirmed Patients		45	8	14
Net New ICU Patients		8	5	5
Net New Intubated Patients		3	5	2
Percent ICU / Hospitalized		21%	21%	20%
Percent Intubated / ICU		50%	46%	53%

 

The 7 day new confirmed case average is now the highest for the entire pandemic.  Yes, testing has increased significantly, but today’s reported case increase of over 4,600 is staggering (and the total is 5,000 if suspected cases are included). Like hospitalizations, deaths are now at mid-June levels, and the 7 day average has increased over 20% in a week and 70% in four weeks. 

 

Table 3: Massachusetts Reported Case and Death Statistics
7 Day Trailing Average
December 2, 2020
Statistic		Current	7 Days Ago	4 Weeks Ago
Total Deaths Including Suspected		34	28	20
Total  Deaths Confirmed Only		34	28	19
Deaths in Long-Term Facilities (All Cases)		15	14	11
Percent from Long-Term Care		45%	50%	57%
Total Cases Including Suspected		2927	2681	1298
Total Confirmed Cases		2716	2538	1206

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%).

Table 1: Massachusetts Testing Statistics
7 Day  Trailing Average
November 29, 2020
Testing Statistic		Current	7 Days Ago	4 Weeks Ago
Test Positivity Rate (Individuals)		12.5%	10.0%	6.7%
Test Positivity Rate (Include Suspected)		13.5%	10.5%	7.1%
Test Positivity Rate (All Tests)		3.8%	3.3%	2.0%
Test Positivity Rate (Newly Tested)		12.5%	10.0%	6.7%
Test Positivity Rate (Repeat Testers)		0.7%	0.7%	0.4%
Percentage Repeat Testers		73.7%	71.7%	75.1%
Test Positivity Rate (Higher Ed)		0.3%	0.4%	0.1%
Test Positivity Rate (Non Higher Ed)		5.4%	5.0%	3.4%
Percentage Higher Ed Testers		31.4%	36.6%	43.7%
Newly Tested (Lagged 1 Week)		26,041	21,756	16,908
Higher Ed Tests (Lagged 1 Week)		33,704	31,260	30,514
All Tests (Lagged 1 Week)		92,007	79,534	68,335

 

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.

 

Table 2: Massachusetts Hospitalization Statistics
7 Day Trailing Average
November 29, 2020
Hospitalization Statistic		Current	7 Days Ago	4 Weeks Ago
Confirmed  Patients Hospitalized		985	872	407
Confirmed  Patients in ICU		214	176	81
Confirmed  Patients Intubed		105	77	43
New Confirmed Admissions (24-Nov)		125	105	50
Net New Confirmed Patients		27	22	11
Net New ICU Patients		7	5	1
Net New Intubated Patients		3	3	1
Percent ICU / Hospitalized		22%	20%	20%
Percent Intubated / ICU		49%	44%	53%

 

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.

 

Table 3: Massachusetts Reported Case and Death Statistics
7 Day Trailing Average
November 29, 2020
Statistic		Current	7 Days Ago	4 Weeks Ago
Total Deaths Including Suspected		29	26	21
Total  Deaths Confirmed Only		29	26	21
Deaths in Long-Term Facilities (All Cases)		14	12	12
Percent from Long-Term Care		47%	44%	57%
Total Cases Including Suspected		2620	2657	1308
Total Confirmed Cases		2479	2501	1220

 

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).

 

Table 1: Massachusetts Testing Statistics
7 Day  Trailing Average
November 25, 2020
Testing Statistic		Current	7 Days Ago	4 Weeks Ago
Test Positivity Rate (Individuals)		9.3%	11.1%	6.6%
Test Positivity Rate (Include Suspected)		10.0%	11.8%	7.0%
Test Positivity Rate (All Tests)		3.0%	3.5%	1.9%
Test Positivity Rate (Newly Tested)		9.3%	11.1%	6.6%
Test Positivity Rate (Repeat Testers)		0.7%	0.6%	0.4%
Percentage Repeat Testers		73.1%	72.4%	75.3%
Test Positivity Rate (Higher Ed)		0.3%	0.4%	0.1%
Test Positivity Rate (Non Higher Ed)		4.6%	5.5%	3.4%
Percentage Higher Ed Testers		37.3%	38.2%	44.6%
Newly Tested (Lagged 1 Week)		22,970	20,781	16,450
Higher Ed Tests (Lagged 1 Week)		31,744	32,376	31,847
All Tests (Lagged 1 Week)		83,205	79,623	68,389

 

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.

 

Table 2: Massachusetts Hospitalization Statistics
7 Day Trailing Average
November 25, 2020
Hospitalization Statistic		Current	7 Days Ago	4 Weeks Ago
Confirmed  Patients Hospitalized		918	756	375
Confirmed  Patients in ICU		194	158	79
Confirmed  Patients Intubed		89	71	37
New Confirmed Admissions (17-Nov)		105	80	41
Net New Confirmed Patients		8	32	6
Net New ICU Patients		5	3	2
Net New Intubated Patients		5	0	2
Percent ICU / Hospitalized		21%	21%	21%
Percent Intubated / ICU		46%	45%	47%

 

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.

 

Table 3: Massachusetts Reported Case and Death Statistics
7 Day Trailing Average
November 25, 2020
Statistic		Current	7 Days Ago	4 Weeks Ago
Total Deaths Including Suspected		28	27	21
Total  Deaths Confirmed Only		28	26	20
Deaths in Long-Term Facilities (All Cases)		14	15	10
Percent from Long-Term Care		50%	57%	47%
Total Cases Including Suspected		2681	2618	1154
Total Confirmed Cases		2538	2435	1080

 

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.

 

Table 1: Massachusetts Testing Statistics
7 Day  Trailing Average
November 21, 2020
Testing Statistic		Current	7 Days Ago	4 Weeks Ago
Test Positivity Rate (Individuals)		9.9%	10.9%	5.9%
Test Positivity Rate (Include Suspected)		10.7%	11.5%	6.2%
Test Positivity Rate (All Tests)		3.2%	3.4%	1.7%
Test Positivity Rate (Newly Tested)		9.9%	10.9%	5.9%
Test Positivity Rate (Repeat Testers)		0.6%	0.6%	0.4%
Percentage Repeat Testers		72.1%	72.7%	75.4%
Test Positivity Rate (Higher Ed)		0.4%	0.3%	0.1%
Test Positivity Rate (Non Higher Ed)		5.1%	5.4%	3.0%
Percentage Higher Ed Testers		40.7%	39.6%	44.9%
Newly Tested (Lagged 1 Week)		21,557	20,323	15,238
Higher Ed Tests (Lagged 1 Week)		31,232	32,324	29,483
All Tests (Lagged 1 Week)		78,851	77,038	62,869

 

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.

 

Table 2: Massachusetts Hospitalization Statistics
7 Day Trailing Average
November 21, 2020
Hospitalization Statistic		Current	7 Days Ago	4 Weeks Ago
Confirmed  Patients Hospitalized		850	641	347
Confirmed  Patients in ICU		171	149	70
Confirmed  Patients Intubed		75	68	31
New Confirmed Admissions (17-Nov)		105	80	41
Net New Confirmed Patients		27	24	8
Net New ICU Patients		5	3	3
Net New Intubated Patients		2	2	1
Percent ICU / Hospitalized		20%	23%	20%
Percent Intubated / ICU		44%	46%	45%

 

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%.

 

Table 3: Massachusetts Reported Case and Death Statistics
7 Day Trailing Average
November 21, 2020
Statistic		Current	7 Days Ago	4 Weeks Ago
Total Deaths Including Suspected		28	24	17
Total  Deaths Confirmed Only		27	23	16
Deaths in Long-Term Facilities (All Cases)		14	13	8
Percent from Long-Term Care		48%	53%	51%
Total Cases Including Suspected		2573	2367	939
Total Confirmed Cases		2409	2219	874

 

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.

 

Table 1: Massachusetts Testing Statistics
7 Day  Trailing Average
November 17, 2020
Testing Statistic		Current	7 Days Ago	4 Weeks Ago
Test Positivity Rate (Individuals)		10.9%	9.6%	4.8%
Test Positivity Rate (Include Suspected)		11.7%	10.0%	5.1%
Test Positivity Rate (All Tests)		3.2%	2.9%	1.4%
Test Positivity Rate (Newly Tested)		10.9%	9.6%	4.8%
Test Positivity Rate (Repeat Testers)		0.6%	0.5%	0.3%
Percentage Repeat Testers		73.9%	73.1%	76.2%
Test Positivity Rate (Higher Ed)		0.3%	0.3%	0.1%
Test Positivity Rate (Non Higher Ed)		5.3%	4.8%	2.6%
Percentage Higher Ed Testers		41.2%	41.1%	47.3%
Newly Tested (Lagged 1 Week)		21,047	18,132	15,762
Higher Ed Tests (Lagged 1 Week)		32,178	31,656	26,558
All Tests (Lagged 1 Week)		78,315	72,384	59,644

 

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.

 

Table 2: Massachusetts Hospitalization Statistics
7 Day Trailing Average
November 17, 2020
Hospitalization Statistic		Current	7 Days Ago	4 Weeks Ago
Confirmed  Patients Hospitalized		724	546	322
Confirmed  Patients in ICU		155	129	60
Confirmed  Patients Intubed		71	61	26
Net New Confirmed Patients		31	19	3
Net New ICU Patients		1	8	1
Net New Intubated Patients		1	2	1
Percent ICU / Hospitalized		21%	24%	19%
Percent Intubated / ICU		46%	47%	43%

 

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.

 

Table 3: Massachusetts Reported Case and Death Statistics
7 Day Trailing Average
November 17, 2020
Statistic		Current	7 Days Ago	4 Weeks Ago
Total Deaths Including Suspected		25	21	18
Total  Deaths Confirmed Only		25	21	18
Deaths in Long-Term Facilities (All Cases)		16	9	12
Percent from Long-Term Care		61%	44%	66%
Total Cases Including Suspected		2583	1899	724
Total Confirmed Cases		2400	1810	676