Oct 31, 2020 12:59 AM

COVID-19: My Story Episode 9-DJ Gering transcript

Posted Oct 31, 2020 12:59 AM

DJ Gering:

Since that time at the end of September to when we are talking now, there's been 600 cases in the community. So we have equaled our amount for six months in one month.

Nick Gosnell:

Welcome to COVID-19: My Story. I'm Nick Gosnell. This week, we're talking to DJ Gering data analyst with the Reno County Health Department about the new COVID-19 dashboard. The conversation with DJ refers to data from October 26th. However, the data is of course, constantly changing. Start with the Reno County case totals button. That's in the upper left-hand corner of the dashboard.

DJ Gering:

Right. The positive cases on the case total part of the dashboard are persons who have tested positive via PCR. Then we have deaths and these are COVID confirmed cases that died due to COVID-19. Recoveries are persons that have gone at least 10 days from their symptom onset date and have 72 hours without symptoms, without assistance from fever-reducing medications. Active cases are people that have not recovered or died. And then, the active community cases are those that exclude inmates.

Nick Gosnell:

Lower on the page, you break it down by ZIP code. What do those colors in that part mean?

DJ Gering:

The darker, the purple on the ZIP code map, means that there are more positive cases in that area. We show ZIP codes that have at least five positive cases, which is the majority of Reno County at this time.

Nick Gosnell:

There are some line graphs toward the bottom of the page that give you a bigger picture, right?

DJ Gering:

Yeah. It tells you really a day-to-day change in what is happening in the community by active cases and total cases. So you can see on the active case front, it has significantly gone up since the end of September, which means we're a lot busier than we were in the previous months.

Nick Gosnell:

There's a likely source of exposure piece. Plus, there's an under investigation bar. Can you explain what the under investigation bar is?

DJ Gering:

Yeah. The under investigation are cases that we are still trying to contact to find a source of exposure to do contact tracing.

Nick Gosnell:

Testing data is the next button over on the County dashboard. There are two positive test rate numbers. Let's explain what those are.

DJ Gering:

The statistics on the cumulative test numbers, these are unique individuals throughout the entire pandemic. So there's no person that's counted twice in this section. The overall positive test rate would include inmates as well. And then the community positive test rate is excluding inmates at the correctional facility.

Nick Gosnell:

Okay. And then the population tested is the total population. And that does include inmates because they live here, right?

DJ Gering:

Yeah, it does include inmates because they're also included in our census.

Nick Gosnell:

Then the Reno County alert levels button is where they talk about the alert level for the County. Can you try to explain what the difference is between the alert levels from a County perspective? The schools is a separate button.

DJ Gering:

Yeah. It's important to know that on the alert levels, the guidance on this is a lot more strict than the school gating metrics, which is why on a moderate alert level, it would probably equal the same translation as the school gating metric in the red level. The red level on the community alert level would be a time where we would have to seriously consider our limits to mass gatherings, whether or not businesses open or what types of businesses open. Those are conversations that we do not want to have. We do not want the county to get to that point that forces us to have those conversations, but it is a much more strict guideline compared to the school gating metrics.

Nick Gosnell:

Reno County cluster data. That's the next button across the top. We only have on your bar graph, nine bars. There are more clusters than that. Can you explain the difference?

DJ Gering:

There are less bars because we have multiple clusters in the workplace category, the religious gathering category and the long-term care facility category. The bulk of the clusters fall within one of those three categories. The other thing that we're seeing in clusters, of that 18, 7 of them are in South Hutchinson. The other 11 are in Hutchinson. There's one active cluster that will probably come off later this week, as there will be no new positive cases within 28 days--two intubation periods of--so 14 days is one intubation period. So we're looking at closing a cluster out there. There's been no cases by symptom onset date of two intubation periods.

Nick Gosnell:

Does hospitalization data include just Hutchinson Regional Medical Center, or does it include other hospitals, too?

DJ Gering:

The hospitalization date on the dashboard does include Reno County residents that are hospitalized outside of the county. I believe at the time of this conversation, there are 4 outside of Reno County that are hospitalized. The rest are at HRMC. The HRMC data that they put out includes residents that aren't living in Reno County. Most of those come from Rice County and McPherson County. And there has been some outside of that as well, but their data is including everyone outside of the county. And then, ours includes everyone inside the county, but might be hospitalized outside.

Nick Gosnell:

The fatality numbers are also county fatalities, not HRMC fatalities.

DJ Gering:

Yeah. Correct. And I'm not sure how many fatalities have happened at HRMC. I think it is important for people to realize that there are Reno County residents that have died due to coronavirus outside of the county, in hospitals outside of the county. There's also some that chose not to go to the hospital, so they died at home. And then there's some where the death certificates from KDHE doesn't give us an exact place where they died, but it's often a hospice or at home.

Nick Gosnell:

Let's go ahead and dive into the school gating metrics portion of the dashboard.

DJ Gering:

Now, the reason it's not in a real time, is because of how we calculate the 14-day PTR. If you use a rolling average, so you look at the positive test rate per day, and then you average that, you can go to a more real time metric. And it would give you roughly an accurate analysis of where the positive test rate is. We're using a cumulative positive test rates, so we're looking at the total people that have tested positive divided by the total people that have gotten a COVID-19 test. And these are unique individuals as well.

DJ Gering:

That's the difference, and that's why they're there is somewhat of a lag behind, is that we're using a cumulative total. The cumulative positive test rate will also weigh the community testing sites more. Whereas, a rolling average would not weigh the community testing as much.

Nick Gosnell:

What will the Reno County heat map mean once it's available?

DJ Gering:

Right now, we're trying to find a way to communicate this data to the public in a way that doesn't scare anyone, in a way that's informative. What this is going to be, there's going to be two maps. One's going to be of Hutchinson. One's going to be the areas outside of Hutchinson. It's going to tell you where we're seeing the most activity of community spread. And we're going to encourage people that are living in those areas that are experiencing any symptoms, to get tested, as well as some level of asymptomatic testing in those areas.

Nick Gosnell:

The Reno County symptom data as well, I believe, is still under development. And then you have statewide data and nationwide data. And to a certain degree, those numbers, you don't really have control over because they come from levels above you. Statewide data comes from KDHE. Nationwide data comes from beyond that. Where do you get the nationwide data from? I guess I haven't asked that question.

DJ Gering:

The very top map, the nationwide data, is linked to Johns Hopkins. So I have nothing to do with that data. I just put the Johns Hopkins map up. And when John Hopkins updates that it, it updates by itself.

DJ Gering:

There is a testing rate map below, and I'm getting the cases from Johns Hopkins. And I'm getting the tests from the COVID Tracking Project. And then, I'm just calculating the test rate.

Nick Gosnell:

The data is supposed to be about trends and not about individuals, right?

DJ Gering:

Yeah. You want to look at which way the data is trending. Really, the one statistic where you can measure probably 4 or 5 different ways, is the 14 positive test rate. And that does make it trickier to navigate sometimes. You get a lot of pressure from the public to make that positive test rate as low as possible, but methodologies that might make the positive test rate as low as possible, aren't necessarily a accurate representation of what is actually happening in the community.

DJ Gering:

So that's been a balancing act of how do we get a 14-day positive test rate to tell us what is happening in Reno County? And it's one reason why we use unique individuals, because we don't want to give too much weight to repeat negatives. When you add a bunch of repeat negatives into the test, the emphasis becomes on repeat negatives rather than individuals. So, I believe my 14-day positive test rate, the way that we're analyzing it, is more focused on the individual rather than repeat negatives.

Nick Gosnell:

Do you have the number of repeat negatives in the county, people that get tested multiple times? I'd imagine there are some employers that require multiple tests for their employees depending upon circumstances.

DJ Gering:

Yeah. The last time I ran an analysis, it was about more than a third of the repeat negatives were from long-term care facilities. And long-term care facilities, some of them have to test once or twice a week, based on a positive test rate due to CMS guidelines. And so, if we put too many of those repeat negatives in there, the data becomes more reflective of the long-term care facilities rather than the community.

Nick Gosnell:

So DJ, or those who are trying to follow the data and just look at the numbers going up and down, what is of concern to you, based on where we were at the beginning of the month and where we are as of this conversation.?

DJ Gering:

Yeah. Good question. If you were to count how many community cases we had from March to near the end of September, we had just a little over 600 community cases. Since that time, at the end of September to when we are talking now, there's been 600 cases in the community. So we have equaled our amount in the first six months in one month. That is concerning.

DJ Gering:

The per capita rate, so the 14-day incidents per 100,000, I never would have thought we would be above 350 per 100,000. The fact that we hit above 550, is really concerning. I'm hoping that number will go down, because not only do we want a lower positive test rate, we want there to be less sick people. And the per capita rate will tell you how many sick people there are in the county at a given time.

Nick Gosnell:

If we were to do everything right, how long would it take from a statistical standpoint to "clear" these numbers?

DJ Gering:

I think it would take two intubation periods. I think it would take 28 days. Real strict staying at home measures, where we're not going out as often, and we're trying to stay home, trying to keep our selves and family safe. With some going out, I don't think the positive test rate or the per capita rate at this point, is on track to be in the orange before the end of the year.

Nick Gosnell:

So if you were having to make decisions based upon the data at this point, for things like family gatherings, for Christmas or company gatherings for the holidays, would that be something that, purely based on the numbers, I'm not asking you to be the epidemiologist. That's not your job. I'm not asking you to be the health department director. That's not your job either, but based on the trends and the numbers alone, what would you say about those things and the relative risk level, assuming the numbers don't change?

DJ Gering:

Well, I think one of my recommendations would be to probably not drive far outside of town. I would try to stay with family that's closer and gather with family members that are closer. I would try to lower the group sizes I might be meeting. If it's a nice day, I would encourage more people to gather outside rather than inside. But those are just some basic things that we could do.

Nick Gosnell:

DJ, is there anything that we've missed that maybe people, if they really do want to follow the data closely, need to know?

DJ Gering:

On a level of interest, we have been experiencing over the last month, more people who refuse to talk to us. In the month of September, about 7% of our cases refused to talk to us, refused to name contacts. Before August, we had one person that didn't talk to us. In the month of October, it's been a little above 10%. And that is concerning because if we're not able to get contacts, if we're not able to figure out where a cluster activity is happening, we can't get people into quarantine, and we can't stop the transmission of the virus. So, it's important that people understand how risky it is to not give us information.

DJ Gering:

And a couple of examples of that, is the cluster activity that we currently have. Most of our church related clusters have turned into other types of clusters. So we've had two church clusters that turned into workplace clusters. We had two church clusters that turned into long-term care facility clusters. And so, we're not seeing that same type of transmission with other types of clusters. Doesn't mean it's not there, it just means we haven't found it. But it does show you how quickly the virus can spread from one area to another.

Nick Gosnell:

Our thanks to DJ Gering for being a part of this week's episode of COVID-19: My Story. If you'd like to be a part of COVID-19: My Story, email [email protected], and let us know why you think you have a story worth telling as part of COVID-19: My Story. Thanks for listening this week on hutchpost.com and your favorite podcast app.