COVID-19 Forecast for El Paso County — Nov. 23
Plus, an Infectious Disease Fellow explains some shortcomings of Colorado’s pandemic response
Good morning, and happy Monday. On this pre-pandemic date in 2017, Colorado College students on campus for Fall Break were gathering in Bemis Hall for a Thanksgiving meal. (This year, the college is urging students not to travel over the break.)
Today’s newsletter is going to look a little different.
Don’t worry, Phoebe Lostroh still returns today to give an abbreviated version of her weekly COVID-19 forecast for El Paso County. But for the rest of the newsletter, we interview Dr. Katherine Peterson, a Colorado College alum and current Infectious Disease Fellow at the University of Vermont Medical Center, about the shortcomings of Colorado’s virus response, at-home COVID tests recently approved by the FDA, and the difference between effectiveness vs. efficacy in vaccine candidates.
➡️ICYMI: On Wednesday, we reported on how a positive COVID-19 case led to a team quarantine for Colorado College men’s ice hockey, and we explained the status of Winter Celebration and May Commencement ceremonies.
🚨CURRENT CC COVID ALERT LEVEL: Level 2. This means the college is now randomly selecting 37-50% of the student body to test weekly, and employees should work from home unless their job requires them to be onsite.
Phoebe’s Forecasts
NOTES: Phoebe Lostroh is a professor of molecular biology at Colorado College on scholarly leave who is serving as the program director in Genetic Mechanisms, Molecular and Cellular Biosciences at the National Science Foundation. These forecasts represent her own opinion and not necessarily those of the National Science Foundation or Colorado College. She used the public El Paso County dashboard for all data. Lostroh prepared these forecasts on Nov. 21.
⚖️How her predictions last week shaped up: Nov. 21 was the last day of Morbidity and Mortality Weekly Report week 47 in the national public health calendar. It is the 37th week since the first case was detected in El Paso County. Since March 13, 249 El Paso County residents have died of COVID-19. Last week, Lostroh predicted about 21,739-22,009 cumulative COVID-19 cases in El Paso County as of Nov. 19. There were actually 21,407 cases.
Cumulative reported cases of COVID-19 for El Paso County
🗝️Key points: The exponential curve-fit predicts a total of 26,951-26,987 reported cases by Nov. 26, or 5,544-5,580 new COVID-19 cases predicted this week. This amount is 9-10 times more new cases than during the worst week of the summer wave.
🏥Regarding hospitalization, the El Paso County COVID-19 dashboard says: “Hospital Capacity – Poor/Strained, using surge capacities, limiting surgeries/procedures, resource constraints.” Over the last two weeks, the county has seen about a 2.9% hospitalization rate. If this trend continues, El Paso County should plan for 147-168 new hospitalizations next week, Lostroh predicts. That is 4-7 times more weekly hospitalizations than occurred during the peak week of the summer wave. And unlike this summer, the regional hospitals are already almost full.
14-day rolling incidence and 14-day rolling percent positivity in Front Range counties from the Colorado COVID-19 Dial Dashboard
🗝️Key points: The 14-day rolling incidence is on the Y-axis, while the percent positivity is on the X-axis. Counties named in red will move to safety precautions for “Level Red: Severe Risk” by Nov. 22 at the latest. In every case, both metrics for all the depicted counties have gotten worse over the last week. The only county on the graph that is not moving to red safety precautions by that date is El Paso.
And on that note...
👀Our Recommended Read of the Week: “Colorado’s county-level COVID restrictions a result of politics, not just data, officials say,” reports Denver Post journalist Alex Burness.
‘If people are doing things differently in every county, that’s a problem’: Q-and-A with Infectious Disease Fellow Katherine Peterson
Dr. Katherine Peterson is currently an Infectious Disease Fellow at the University of Vermont Medical Center. Peterson majored in biology and graduated from CC in 2011 before completing medical school at the University of New England College of Osteopathic Medicine in 2017 and completing her residency in Internal Medicine at the University of Vermont Medical Center in 2020. This interview has been edited for length and clarity. These represent her own opinions and not necessarily those of her employer.
CC COVID-19 Reporting Project: What are the implications of the COVID-19 response in places like Colorado, which has taken a county-level approach on disclosing the risk of the virus and generally handles mitigation tactics separately in each county?
Dr. Katherine Peterson: So I think we can compare counties being treated differently, almost on a smaller scale, to states being treated differently in this country. I think that most news reports that you read, when they're talking about states that have had success, are places like Vermont. And I think leadership has been crucial in our success in the state, and it’s been unified leadership. So it's coming from the governor. It affects all of our counties. … A place like Colorado, where counties are being treated differently, I think that you run the risk of the effect that some counties can have if they’re doing a great job with mandates and restrictions and contact tracing. Because people mix between the counties, it’s kind of a false sense of security. I mean, we know people who cross county lines all the time. And so I think, if you’re right next to a county that has no restriction, for example, that really weakens the restrictions of the fellow neighboring counties. And so I think, again, the leadership on a broader scale is what’s super important for these things to be effective. I’m sure if people are doing things differently in every county, that’s a problem.
CCRP: The FDA recently approved at-home nasal swab tests for COVID-19 that can be self-administered. What impacts might this development have on the spread of the virus and overwhelmed hospital capacities?
Peterson: I think that’s a really important development, because depending on where you’re located in the country, whether your county is overloaded with cases, or perhaps you’re in a more rural area without access to nearby facilities, I think access is a huge issue on both sides of that. Our undergrads at the University of Vermont and our medical students every week do a self swab. And there’s an app that they follow the results. They go to a center to do it. It’s not at home, but they do it themselves, they submit it, and then they find the results on their mobile phones. And so I think any testing capacity to increase access and remove the barriers to doing so is fantastic. And then on top of that, removing interactions between people getting tests, and folks who have to either administer them or process them is also an advantage I would see from an at-home test. And I would presume you can get it delivered to your home, and it’s not like you have to go somewhere and pick it up. So I think that removes a lot of the barriers. And asymptomatic testing ... if you’re asymptomatic, I know some places are kind of reserving their tests more for symptomatic people. But asymptomatic ... if we can capture those people, I think that will help control the spread. I think that anything we can do to inform people of their virus status will give them the knowledge and probably more motivation to stay quarantined, to stay isolated. I think human nature is what you don’t know can’t hurt you. And so if you don’t know that you’re positive and you’re feeling perfectly fine, it’s probably easier to justify, ‘Oh, I’m just going to go for this quick thing with a friend,’ or, ‘You know, I feel totally fine, I’m going to have Thanksgiving with my family.’ I would hope that the gravity of being positive, even if you’re asymptomatic, would give people pause in participating in activities that contribute to the spread. And I think in a place like Colorado, where you have much more prevalent spread than a place like Vermont, hopefully that would help decrease the transmission and decrease the rates and see that impact down the line in terms of hospital admissions and people seeking care for severe symptoms.
CCRP: Pfizer and Moderna have both announced promisingly high efficacy rates for the COVID-19 vaccines they’ve developed, currently in clinical trials. A key difference between vaccine efficacy and vaccine effectiveness is that the former measures how well a candidate performs in ideal circumstances and 100% vaccine uptake, while the latter measures how the vaccine performs once it’s distributed throughout the community. To what extent do you think it might be misleading to release that your vaccine has a 95% efficacy rate when that can be misinterpreted by followers?
Peterson: I think in today’s media in general, you can come up with a statistic that sounds appealing for almost anything when you compare data sets. I can’t speak specifically for this application, but I think that in general, you see a lot of statistics in the media that are attention-grabbing. And the average person isn’t reading the primary literature and reading the studies and understanding where those numbers came from. But I do think, from what I understand, there has been quite good success and data that’s coming out of these vaccine trials. I can’t speak to the actual number, but it does sound promising. Keep in mind, the flu shot is anywhere from like, in the teens to 60% in terms of efficacy, and most years seem to be in the 30-40% range. But we still always encourage everyone to get the flu vaccine because even if, say, one year it’s 30% effective, theoretically if everyone in the country got vaccinated, that’s a third fewer influenza cases. A lot of our childhood vaccines are in the 80-90% range. And if this is really in the 90% rate effectiveness, that will be a big deal. But again, we’re talking such massive numbers. There’s millions of people with this infection. If we could make a dent even in a portion of that, I think that will be really important.
About the CC COVID-19 Reporting Project
The CC COVID-19 Reporting Project is created by Colorado College student journalists Miriam Brown, Arielle Gordon, Isabel Hicks, and Esteban Candelaria in partnership with The Catalyst, Colorado College’s student newspaper. Work by Phoebe Lostroh, Associate Professor of Molecular Biology at CC and National Science Foundation Program Director in Genetic Mechanisms, Molecular and Cellular Biosciences, will appear from time to time, as will infographics by Colorado College students Rana Abdu, Aleesa Chua, Sara Dixon, Jia Mei, and Lindsey Smith.
The project seeks to provide frequent updates about CC and other higher education institutions during the pandemic by providing original reporting, analysis, interviews with campus leaders, and context about what state and national headlines mean for the CC community.
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