Tag: hospitalizations

COVID-19 hospitalization by age in Maryland

Since mid-July 2020 in Maryland, we understood that the 20-59 yr age group was problematic, especially the 20-29 yr age group that is racing to overtake all age groups in terms of number of COVID-19 cases (relative to their population, see top chart below).

In terms of COVID-19 hospitalizations, we also saw a small rebound (see chart below; it seems that it subsides since beginning of August).

But what we didn’t know (for this small peak as well as since the beginning) was what is the age of these hospitalized populations. Did these hospitalizations impacted more the older adults? The younger ones? Or the children? The Maryland Department of Health COVID-19 dashboard doesn’t report that information (nor in the API).

Despite the recent issue about switching hospitalization reporting from CDC to HHS, it seems that CDC is still reporting hospitalization data at COVID-NET (Coronavirus Disease 2019-Associated Hospitalization Surveillance Network), at least until the end of July. There, it is interesting to note that Maryland is the only state which reporting represents 100% of the population (24 counties) – that’s good!

Screenshot of COVID-NET method description showing that 100% of the Maryland population is represented

Now, the CDC also has an interactive graph where you can see and filter the data by yourself. Here is the situation up to August 9, 2020, for Maryland:

The peak of April-May is well represented, with the 85+ population reaching a peak at nearly 100 weekly hospitalizations per 100,000 pop. All the other age groups increased during that time, the older the higher (unfortunately).

Now, since July, we see some of these age groups increase again. At the end of July:

Age groupWeekly hospitalization rate
65-74 yr16.0
75-84 yr21.6
85+ yr17.6
Weekly hospitalization rates for the week of July 27, 2020 in Maryland, MD, USA

This, in my opinion, reinforce the view that, cases might be increasing in the younger population (also thanks to testing being more available) and children and young adults might be less impacted when infected. But the older population is the first impacted by any increase in cases. It was true in April-May. It is again the case with this small peak. If we should take preventative measures to contain COVID-19, it is for us – but especially for the older population, our parents.

To be continued …

As usual, you’ll find other graphs on my page about COVID-19 in Maryland (and figures above are updated with new data as they appear) and the data, code and figures are on Github (including these ones).

Is Maryland ready to reopen?

A visual analysis of Governor Larry Hogan’s decision to enter Stage 1 of reopening Maryland.

(This will be a post based on a thread of tweets I posted on May 14 with updated graphs for today – one days after the start of Stage 1 – and more)

Maryland is in state of emergency since March 5, 2020 due to COVID-19. Governor Larry Hogan announced on May 14 that Maryland will “gradually reopen with flexible community-based approach” (the official declaration is here). The MD Strong plan said “a 14-day downward trajectory of benchmark metrics – or at least a plateauing of rates – is required before recovery steps can begin“. This Phase 1 started yesterday, May 15, 2020. So, are we there already?

Regarding testing … After a peak in testing (up to 8k/day) and the arrival of tests from South Korea, testing is stagnating ~ 4k/day in Maryland. The daily % of positive tests seem to stagnate ~ 22% since May started and decline a bit, ok. Despite a peak, today, we are still far from the daily number of tests we could reach with the tests from South Korea. And there is still a high percentage of daily positive cases.

Regarding hospitalizations … Thanks to a drop in acute care during the last weekend and this one, the number of patients hospitalized seems to decrease since beginning of May. This sudden drop was followed by a slight re-increase. Hopefully this will continue to decrease (even if in waves like this).

Regarding deaths … Despite a record number of daily reported deaths, early May, and wide variations in this daily metric, it seems that we are plateauing/decreasing here.

So, we can cautiously understand the decision taken, based on data. Note it’s not a total opening: the “flexible community-based approach” means that counties (the government level below the state of Maryland) are empowered to make decisions regarding actually opening or not. And some counties took that opportunity. For instance, Montgomery, Prince George’s and Charles (on the East / South-East of Maryland, surrounding Washington DC and bordering Virginia) decided to remain closed. Baltimore City also decided to remain closed. It is understandable as all these counties are among the ones with most cases and most deaths. Here is a small infographics summarizing the Stage 1 reopening:

It will be interesting to see how the next 2 weeks evolve, and especially if counties that remain closed will have a different evolution than the ones that opened.

To be continued …

As usual, you’ll find other graphs on my page about COVID-19 in Maryland and the data, code and figures are on Github.

Trend in Coronavirus cases in Maryland (3)

Following up on my two previous posts (here and here), I am writing a third post on COVID-19 in Maryland because I believe we enter a new phase.

Before continuing, please note that the same disclaimer as in my previous post applies here (in short: read the CDC and MDH websites for official information).

In the first phase, the importance was to detect and make sure COVID-19 patients were treated (also: make sure not to overwhelm the healthcare system, flatten the curve, lower the baseline, & stay at home!). My two previous posts were following these efforts, thanks to daily data released by the Maryland Department of Health (MDH) on its dashboard. My second post will still be updated with the latest data from there, go read it!

This first phase is not over yet but we started to see metrics states and governments will consider in order to “reopen”. Hence this second phase is adding specifically these metrics, again thanks to the Maryland Department of Health (MDH) on its dashboard (and probably other data sources that will be linked as I use them).

In Maryland, the Governor issues a Roadmap to Recovery on April 24, 2020. In this (easy to read) document, a lot of aspects are introduced and here is what will be tracked and for how long:

  • “state public health officials should review the numbers of new COVID-19 daily case counts, hospitalizations, and deaths carefully” and “The results of reopening decisions will take 2 to 3 weeks to be reflected in those numbers.“
  • “the White House’s gating guidelines state that a 14-day downward trajectory of benchmark metrics – or at least a plateauing of rates – is required before recovery steps can begin, and before each additional recovery step can move forward“

That’s why Governor Larry Hogan tweeted his focus on April 24:

Governor Hogan’s focus was informed in part by the Johns Hopkins Center for Health Security’s Guidance for Governors about Public Health Principles for a Phased Reopening During COVID-19 (PDF). There the proposed principles for action are:

States should consider initiating the reopening process when (1) the number of new cases has declined for at least 14 days; (2) rapid diagnostic testing capacity is sufficient to test, at minimum, all people with COVID-19 symptoms, including mild cases, as well as close contacts and those in essential roles; (3) the healthcare system is able to safely care for all patients, including providing appropriate personal protective equipment for healthcare workers; and (4) there is sufficient public health capacity to conduct contact tracing for all new cases and their close contacts

Public Health Principles for a Phased Reopening During COVID-19: Guidance for Governors, Johns Hopkins Center for Health Security, April 17, 2020.

On April 27, 2020, this is what we currently have … On the first chart, the number of positive tests is increasing (probably due to the increase of testing done), hospitalizations and deaths are slowly going up, overall. On the third chart, it seems the number of people in ICU is plateauing. Below these charts, I’ll post the updated charts as days are passing …

Updated charts (look at the date at the bottom right):

To be continued …