Unbridled Individualism Overwhelms Kentucky Hospitals With Covid-19 Admissions.

It’s January all over again in August– except for the temperature!

Tuesday’s New Case, Test Positivity Rate, and Hospital data continue their sharp rises equaling or exceeding the worst days of the epidemic in January. There are no reliable signs of things slowing down.

New Cases.
The number of new cases reported yesterday was 4,638. Of these,29% were in children and teenagers 18 and under. This was by far the highest number of Tuesday cases since the beginning of the epidemic, higher even than the 4,127 cases reported last December 1. Similarly, Monday’s new case count of 2,596 was the highest ever for that day. The counts of the previous Thursday, Saturday, and Friday were in the range of the worst of last winter’s surge.

KY Covid-19 Cases and Deaths as of 25 Aug 2021.

The 7-Day New Case Average is 425 cases higher than the 14-Day Average indicating a rapid rate of epidemic expansion exceeded only by one anomalous day in early January. There were 23,196 new cases last week (Sun to Sat), exceeded only marginally by 3 weeks last December and January. To visual inspection, the plotted curve of new daily cases shows its sharp upward climb to be unchanging. The Test Positivity Rate reached above 13% last week, the highest ever. All of these indicators are compatible with our entry into the worst of Kentucky’s surges– and this with a much-reduced percent of population still susceptible to recognizable infection!

Predictably, the number of deaths daily is noticeably rising. It takes weeks to months for the classification and recording of deaths to work its way through the system. We cannot predict at this time how bad it will get. The unmitigated disasters we are seeing with Covid-19 admissions to hospitals foretells much sorrow remains yet to come.

At no time during Kentucky’s version of the pandemic has the number of inpatient Covid-19 patients in our hospitals and ICUs been greater. As ICU utilization has increased, so has the number of patients on ventilators– 338 yesterday. (In May and June that number was usually under 50.) There are no signs of increasing hospital utilization slowing down. By all reports, Kentucky’s hospitals are collectively overwhelmed. Patients are younger, sicker, and unvaccinated. Virtually all of the ICU and ventilator patients have not been vaccinated. Analysis of deaths around the world following surges tells the story of “excess deaths” due to the undercounting of cases, and avoidable non-Covid deaths of individuals encountering lack of access to medical care for both preventative or acute conditions.

KY Hospital and ICU Covid-19 Utilization as of 25 Aug 2021

Is there any good news?
Many Kentuckians have on their own began to apply the successful public health measures that broke the back of the mid-winter disaster. I am seeing more masking on the street and in stores. Some private and governmental requirements for vaccination or masking are in place but these are vulnerable to change. At least one vaccine has received full FDA approval. Some school districts see the tidal wave coming and are requiring masks. (However masks alone will not do what is needed. Some schools or districts are already having to shut down in-class teaching because of the inevitable intrusion of Coronavirus in the classrooms. This is what unavoidably happens in schools, workplaces, nursing homes, and prisons.)

A semi-log plot of daily new cases since August 1 shows a tantalizing drift toward a lower rate of exponential growth, but we are still in an exponential growth phase. The Test Positivity Rate has not changed much the last three days after a relentless climb. Daily tests reported have been rising since July. People are playing attention! However, any sign of stabilization of new disease spread could evaporate over the course of this week. It is premature to declare a “plateau.” The full events of the Summer-surge on hospital utilization and deaths have yet to play out.

The politicization of epidemic health care is not playing out well. Kentucky’s Governor and our public health system’s ability to effectively intervene is being hamstrung by Republican party legislative and other opposition that has so far not offered alternatives other than to let the fire burn out. I suggest that the nation is burning up in more ways than failed management America’s epidemic of Covid-19.

The usual full updated of interactive data visualizations can be viewed on KHPI’s Tableau Public website.

Peter Hasselbacher, MD
Kentucky Health Policy Institute
Emeritus Professor of Medicine, UofL
25 August 2021

[Addendum 26 Aug 2021:
Wednesday evening’s update from Frankfort was not encouraging. The 4,849 new cases reported was the highest for any Wednesday since a single aberrant day in January. Thirtyone percent of the new cases were in individuals younger than 18. The 7-Day average of new cases was only 200 fewer than the maximum on January 12. The reported 65 new deaths is the highest daily tally ever excepting those days in which a backlog of deaths was added all at once. (There was no such qualifier notice on yesterday’s report sheet. The Test Positivity Rate as presently calculated of 13.2 is the highest ever . Hospital and ICU and Ventilator utilization are still at record highs. All this is decidedly not good. Pizza and circus is not going to help.

Less awful numbers include a steady gradual climb in the number of people getting tested. The rate of exponential rise (still high) may be marginally decreasing but hardly enough to turn any corner.

Wednesday’s numbers have been updated on KHPI’s Tableau Public website using the link just above.]

One thought on “Unbridled Individualism Overwhelms Kentucky Hospitals With Covid-19 Admissions.”

  1. Comment on Thursday’s Numbers (Aug 26, 2021)
    They were even worse than Wednesday’s with 5,401 new cases reported. Highest Thursday ever. Weekly cases will rival the highs of December and January. New record highs for hospital and ICU utilization and Test Positivity Rate. Deaths rising sharply.

    Will wait for this evening’ numbers to wrap up the week. No updates available from the state until next Monday. Meanwhile we sit on our hands in an organized response to this terrible epidemic.

    Peter Hasselbacher

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