Kentucky’s Covid-19 Epidemic Is On The Wane. How Low Will It Go Before Winter?

New cases reported each Monday have on average been declining but not nearly as rapidly as overall state incidence rates or test positivity rates. Indeed, these latter two metrics have been decreasing exponentially for the past 4 weeks. “Catch-up” counts of cases older than 30 days diminish the predictability of where we are headed. We are not improving as rapidly as other states. Whether we are approaching a to a still-too-high plateau or an “acceptable” endemic status of disease activity remains to be seen. The very real challenge of winter is ahead of us. Nonetheless, this week’s news is favorable and can be taken as evidence that we have been doing at least something right!

The decline in new case numbers in the state as a whole is reflected in a marked progressive decrease in the number of “Red” counties in the weekly Current Incidence Rate in Kentucky, from a total of 97 at the beginning of September to only 18 in this week’s report! Unfortunately all but three of the current red counties (with an incidence rate of ?25 per 100K) are clustered in the far east part of the state, especially in the counties recently devastated by floods. It is a historical truism that disease is often a fellow traveler following disaster.

Still over 1000 new cases identified statewide per day with many times more unrecognized or unreported.!

The nation needs a more timely and complete uniform data reporting system badly.

Test Positivity Rate falling exponentially.

Case loads in eastern KY have generally been higher than elsewhere but surged in recent weeks to highest incidence rates in the nation.

Other Metrics of Disease:
Deaths are not yet falling at 67 last week. Hospitalization census numbers looks like they are going in the right direction. The number of PCR (viral RNA) tests performed has increased a little and account for only 52% of all new cases identified– still a much lower rate than in past months that I do not understand. Noteworthy is another surge in new cases in school-age individuals ?18 years old. As long as the virus is free to churn away in our schools and colleges, we are unlikely to arrive at incidence rate we can more comfortably live with this winter. Too bad that the issue of masks and testing in schools became so politicized.

Individuals 198 and younger making up a record high of 37% since March.

Wherever we are headed, we will do so together.

Peter Hasselbacher, MD
Emeritus Professor of Medicine, UofL
Kentucky Health Policy Institute
27 September, 2022