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There is a lot of information about COVID-19, and it is presented by government agencies in a lot of different ways.
Just take perhaps the simplest piece of information: COVID-19 cases. The Georgia Department of Public Health is reporting cumulative cases since the pandemic started, cases over the last two weeks, cases by day, cases per 100,000 residents, cases by the date they were reported, cases by the date that a person first showed symptoms. Not to mention the various ways the agency reports and displays data about testing, hospitalizations and deaths.
All this information is being used by local and state governments, schools, businesses and ordinary people to make decisions about how best to live during the pandemic.
Amber Schmidtke recognized that regular Georgians might struggle to make sense of all the information. She also knew that public health officials, suddenly put in the spotlight to explain the pandemic, default to speaking in specific and complicated terms that might confuse the public.
Schmidtke lives in Houston County, just south of Macon, and is a member of the state’s task force for COVID-19 data management, which gives her access to the most updated information about how the pandemic is playing out across the state. Schmidtke has been using much of that data, and her background in public health and teaching in higher education, to help Georgia residents make sense of the pandemic through her Facebook account (with about 12,000 followers now) and email newsletter. She recently started a podcast, too, called “Public Health for the People.”
“I’m happy to be that bridge,” Schmidtke said.
On a daily basis, Schmidtke has a pulse on the state of the pandemic in counties across Georgia, from Glynn on the coast to Whitfield near Tennessee and everywhere in between.
So what about Hall County? The Times spoke with Schmidtke, who provided a snapshot of what the numbers say locally.
What numbers matter?
While the amount of COVID-19 data can be bewildering, it’s necessary to better understand the current state of the pandemic, Schmidtke said.
“You can’t look at just one metric alone,” she said. “It needs to be a combination of multiple things.”
Overall, Schmidtke has narrowed her focus to a set of data points to understand how the pandemic is playing out on a local, state and national level:
● Case positivity rate;
● 14-day rates of disease for cases;
● Current hospitalization rate;
● New hospitalization rate;
● Deaths.
Schmidtke also has a few rules that she follows.
First, she prefers looking at recent trends in the data — like the past 14 days — rather than cumulative totals, which aren’t as useful to making decisions today four months into the pandemic.
Second, for some data points, like cases, it’s more insightful to adjust for population to compare the state of the pandemic from one county to another.
Schmidtke also notes important caveats to some of the most noteworthy data reported by state agencies:
● The reporting of almost everything — cases, hospitalizations, deaths — is delayed. The longest delay is for deaths;
● The number of deaths from COVID-19 is likely higher than the number reported by the DPH, Schmidtke said, which is true with many infectious diseases;
● Hospitalizations reported by the DPH and Georgia Emergency Management and Homeland Security Agency are strictly related to COVID-19, but data about bed capacity and ventilator usage in hospitals is not.
Case positivity rate
What it is: The percentage of people who test positive for the virus.
Why it’s important: The case positivity rate is an indicator of how well a state is testing for the virus and whether the virus is being contained.
What to look for: The World Health Organization set a threshold of 5% to consider the virus successfully contained in a community.
Hall County: 14% (July 24-30), according to data provided by the DPH to The Times. That’s well above the threshold set by WHO. The week before, from July 17-23, it was 14.6%.
When case positivity rates are higher than 5%, it means not enough tests are being conducted to catch asymptomatic carriers, who could potentially spread the virus in a community.
“We probably have undetected community transmission, and so the virus is going to have additional opportunity to spread and grow within our population,” she said.
Schmidtke said Georgia’s case positivity rate has been averaging about 12%, although Thursday saw a rate of about 10%, the lowest since June. The state’s case positivity rate is still about twice as high as it should be based on World Health Organization recommendations, she said.
Georgia has also been plagued by long delays at specimen collection sites and in laboratories conducting the tests. Schmidtke said there is a nationwide shortage of the chemicals used in the test kits, which is leading to people waiting two to three weeks for their test results.
“It’s rough,” Schmidtke said.
14-day rates of disease for cases
What it is: The percent increase in confirmed cases over a 14-day time period.
Why it’s important: The percent increase provides a clearer picture of the virus’ recent history of transmission.
What to look for: Schmidtke said she gets most concerned about counties that have a 50% or higher rate of increase over the past 14 days.
Hall County: 23.5%, as of Thursday, Aug. 6.
“When I look at your case curve, at date of onset, it looks like you have seen increases lately that kind of match the trajectory of what’s been going on with the state overall for the last month,” she said. “While it may not seem like that great of an increase, a lot of that has to do with the explosive growth that (Hall) had earlier in the year, and so that can make these rate increases seem smaller than they are.”
Schmidtke said people should still follow public health guidelines, like social distancing, avoiding unnecessary travel and large gatherings, and wearing a mask.
A lower case rate, closer to 20%, would help local hospitals maintain adequate capacity for COVID-19 patients and make the virus easier to track and contain, she said.
And here’s a look at how Hall County’s cases per 100,000 people in the past two weeks compares to bordering counties, as of Thursday:
Hall: 539.4
Forsyth: 201.6
Gwinnett: 426.5
Dawson: 429.3
Lumpkin: 257.4
White: 233
Habersham: 419.2
Banks: 295.3
Jackson: 417.7
Barrow: 412.1
Current hospitalization rate
What it is: The rate of people currently in the hospital with COVID-19.
Why it’s important: Current hospitalization rate reveals the length of hospital stays for patients with COVID-19.
Hall County: Gainesville-based Northeast Georgia Health System reported that it had 173 confirmed patients with COVID-19 between its four hospitals, New Horizons Limestone and Laurelwood on Friday, Aug. 7. The Gainesville hospital had 99 COVID-19 patients Friday, while the Braselton hospital had 40.
NGHS updates its information daily and provides a couple of charts on its website
As of Friday, DPH has reported a cumulative 729 hospitalizations for Hall. That number was 601 about two weeks ago on July 23, according to spokesman Dave Palmer. While DPH reports its data based on the patient’s county of residence, NGHS serves patients from several counties in Northeast Georgia at its facilities.
Schmidtke said it’s helpful for hospitals to be transparent about their COVID-19 patient burden. Regular communication from Phoebe Putney Memorial Hospital, in Albany, the area of one of Georgia’s earliest COVID-19 hotspots, helped that community understand the seriousness of the pandemic and adjust its behavior. It is now considered a relatively cold spot, Schmitke said.
There are times when a hospital shouldn’t be transparent, Schmidtke said, particularly if doing so would violate HIPAA privacy laws.
“I think there are ways to (be transparent),” Schmidtke said, “to communicate to the public what the burden is for your community but also reassure them that we are here … we don’t want anybody to suffer at home through something that a hospital could help with.”
New hospitalization rate
What it is: The rate of new hospital admissions due to COVID-19.
Why it’s important: New hospitalization rate hints at the potential strain on hospitals from an influx of patients.
NGHS saw an increase of 11.6% between Friday, July 24, and Friday, Aug. 7.
GEMA has been reporting hospital bed capacity on a regional level. Hall County is in Region B, along with nine other counties, including Lumpkin, White and Habersham. On Aug. 5, GEMA reported that 81.6% of Region B’s 158 critical care beds were in use, which was lower than the overall state percentage of 87.2%.
Schmidtke said there is usually a delay between a surge in cases and the following surge in hospitalizations. As people hear about rising cases, many become more risk-averse and take more precautions, she said.
And people should still seek treatment at a hospital if they need it, Schmidtke said.
“I don’t want anybody to try to ride out really severe COVID symptoms at home because they’re afraid of whether or not they’ll get rapid treatment in a hospital,” she said. “I want them to just go to the hospital and let the hospital sort out their care.”
Deaths
What is it: The number of people who have died due to COVID-19.
Why it’s important: Schmidtke says deaths are the ultimate indicator of “the severity of the pandemic.”
Hall County: 88 cumulative, as of Thursday, Aug. 6, or 42.6 deaths per 100,000.
Hall’s death rate per 100,000 people is higher than most surrounding counties, as of Thursday:
Hall: 42.6
Forsyth: 8.7
Gwinnett: 25.1
Dawson: N/A
Lumpkin: 17.8
White: 15.7
Habersham: 104.8
Banks: N/A
Jackson: 17.4
Barrow: 37
“You’ve had more cases as well, so there’s been more opportunity for that to happen, unfortunately,” Schmidtke said. “It’s kind of more of a numbers artifact.”
Schmidtke said other factors such as patient age could affect deaths. DPH reports ages of COVID-19 patients who have died, and while the youngest person from Hall who has died was 24, the data includes several older patients.
Looking ahead
Two things about the future of the pandemic worries Schmidtke.
The first is school. Georgia did not take the necessary steps to lower COVID-19 transmission enough to safely open schools, she said. Instead, outbreaks are likely to occur in schools and parents should have plans in place for when their child’s school closes.
“Don’t go into this thinking your kid is going to be in school from now until the winter holidays,” she said. “It’s very unlikely.”
The second is the cold and flu season. People can be infected with more than one thing at a time, like the common cold or influenza and COVID-19, which have similar symptoms.
Schmidtke says “we need this to be the very best year we’ve ever had with influenza vaccines.”
People should stay home if they have cold- or flu-like symptoms “because you could just as easily be transmitting COVID,” Schmidtke said. Same goes for sending kids to school, she said. Regardless, Schmidtke expects the pandemic to surge again during the cold and flu season.
Brian Paglia of the Forsyth County News, a sister publication of The Times, contributed to this report.