June 18, 2022 - Ahead of the Curve
Ahead of the Curve
June 18, 2022
The global pandemic follows a now-familiar undulating pattern of infection that rises and falls depending on where you are on the globe. When infection rates are low, I am willing to take risks that I will not take when infection rates are high. Perhaps this sounds like Captain Obvious, but that’s why it’s so important to stay on top of the data.
Take Europe, for instance. Ninety days ago, Europe was riding the crest of a wave that peaked at 104 cases per 100K population on March 23, just as the United States enjoyed its lowest ebb of 10 cases per 100K population. Thereafter, Europe’s infection rate plummeted while the rate in the U.S. started to rise. The two charts intersected only briefly on May 16, when both Europe and the U.S. saw 27 cases per 100K. After that date, per capita cases in the U.S. continued to exceed Europe … until yesterday, when both regions again reported the same rate of 28 cases per 100K. When making travel plans, trends are important.
Of course, different countries or regions are at different points on the curve at the same time. For instance, Alabama is clearly on the upward slope right now - as reported cases rose 15.5% from 1,190 per day a week ago to 1,374 per day this week. What’s more, the pace of infection is accelerating in Alabama - as reported cases over the last 3 days averaged 1,718 per day - 49% higher than the total for the same 3 days last week (1,156 per day). Only 4 states - Wyoming, Mississippi, Arkansas & North Dakota - have seen a faster rate of increase than Alabama over the last 7 days.
However, cases are rising in Alabama at a time when the infection rate in the entire U.S. has plateaued, or perhaps even started to tick down. In the last 7 days, reported cases in the U.S. declined 13% from 111,800 per day to 98,400 per day. Although 16 states have seen a weekly rise in reported cases, double that number - 32 states - have seen a decline. The State of Hawaii has the highest current per capita rate of infection in the nation (71 per 100K); New Hampshire has the lowest (15 per 100K).
Hospitalizations are starting to rise in Alabama at a faster rate. There are 389 statewide Covid patients today, an increase of 15% in one week, 40% in two weeks and 92% in 3 weeks. I wouldn’t be too alarmed - yet. Alabama’s level of hospitalizations is equal to the national average and remains well below the peak of 3,250 patients last January. We’ll soon see if high (but waning) levels of immunity from vaccinations and ubiquitous Omicron infections last winter, combined with the rapid deployment of Paxlovid, will be enough to keep hospitalizations down to manageable levels. (Note: if you are taking a blood thinner, Paxlovid may not be an option if you get Covid - ask your doctor).
Next week will mark the introduction of approved vaccines from Moderna and Pfizer for children under the age of 5. This is fantastic news for parents of young children. Still, the implementation of these two rollouts will be quite challenging, which requires pediatricians to play a critical role. If you are wondering which of the two vaccines you should choose, Dr. Katelyn Jetelina, a leading epidemiologist who has children under the age of 5, wrote that she will choose Moderna. Her analysis of the two vaccines, including her reasons for this choice, can be accessed here: https://yourlocalepidemiologist.substack.com/p/fda-meeting-for-5-covid-vaccine-q?utm_source=email&s=r.
I plan to monitor Alabama Covid data especially closely in coming weeks, hoping to see signs that the current surge is abating. Like many state public health agencies, ADPH does not release data on weekends, so I plan to adhere to a weekly schedule. Here are the latest totals:
6/5 - not reporting
6/6 - 3,679
6/7 - 1,184
6/8 - 1,065
6/9 - 1,221
6/10 - 1,183
6/11 - not reporting
6/12 - not reporting
6/13 - 2,960
6/14 - 1,506
6/15 - 1,625
6/16 - 1,685
6/17 - 1,844
6/18 - not reporting