Ed Sanchez died last week. If you drove up 4th Avenue on a Sunday morning in the last 30 years, you probably saw Ed and his wife walking to or from church. He was 83, lived in a house and puttered along living with the usual health and life issues that 83 years of age brings. But then he got COVID and died two weeks later. Just a guy in the community like anyone else. That’s community spread.
In this article, we look at the actual record of COVID19 cases in Palm Beach County and how they affected different age groups. For you, getting COVID may not mean a death sentence. But it could mean a hospitalization. It could mean a couple sick days. But for some, it’s deadly. THAT is the unfortunate reality of COVID. THAT is why city, county, state and national leaders urge you to do the things that stop community spread of COVID19; to step up to your adult societal responsibility; to love your neighbor as yourself; to keep it from reaching the Eds in your life and ours.
If you can’t measure it, you can’t manage it
It’s a truism of any project or crisis. Data is important. Good data is even better. But as hard working and well meaning as everyone is, the news last week brought to light data management phenomenon that’s inflated case counts and percent positivity. And if case counts had any value left in managing the pandemic, the news deflated their value more. Ditto for percent positive.
Did we really have spikes in cases and deaths or were those just dumps of data from labs that had been collected for days or weeks then reported to the state? Should people getting retested each day be counted one time or once per test? Should retests be included in the “Percent Positivity” calculation? SMH.
So we measure
At BocaFirst, we collect data every day from the Florida Department of Health (FDOH) dashboard and various PDF reports in order to keep our three COVID trackers for Boca and PBC up to date. Every source we use has a caveat that the data is “provisional” and can change. The problem is that when the data is sent to the state from labs and counties, the counts are tallied for that day and reported as if they happened that day; so a test result, hospitalization or death that might have happened days or weeks earlier are counted on the day they are reported to the state. For example, for hospitalizations, the language of the report says:
Hospitalization counts include anyone who was hospitalized at some point during their illness. It does not reflect the number of people currently hospitalized.Florida Department of Health Daily Report
Those daily “data dumps” make the day to day numbers, ummmm, imprecise. For this reason, our daily tracker graphics have a rolling 7 day average to smooth out the dump effect. The dumps are good for headlines with the word “Spike” by those who want you to be afraid instead of informed. Anyway, wherever the state provides previous days/weeks of revised numbers, we update our previous tallies so our graphics are as accurate as possible. Not so with headline seeking news. So beware.
We don’t have access to internal reports or data that county and state leaders have. Broward County has a nice dashboard of metrics (see it here) to help folks make informed decisions. Palm Beach County has nothing. So we keep collecting and publishing. If you have a minute, send your County Commissioners an email asking why they don’t publish a dashboard like Broward does (see below). Here’s a button to call or email them:
Anyway, since we’re in the midst of a “Sunbelt Surge” and we’re all having to make decisions about work, school and play, we wanted to see if we could come up with an assessment of the COVID pandemic in Palm Beach County that was based on more precise data than the daily numbers.
Mining Palm Beach County data from the FDOH database
My head spins thinking what it was like for my grandfather to survive the trenches of WWI France and return home to Philadelphia, one of the epicenters of the 1918 Spanish Flu pandemic. He survived both.
Our future is also fragile. In spite of the data reporting glitches, we’re fortunate in Florida to have public access to A LOT OF DATA. One of those gems is the “Case Line” data from the FDOH Open Data website containing information on each confirmed positive COVID test reported in the state of Florida. Of the various bits of information on each test, there’s a test date and a YES/NO for hospitalization and fatality.
What’s the current state of illness in our area?
It’s a question many are dealing with. For example, CDC guidance for re-opening schools includes this statement:
Make decisions that take into account the level of community transmission.CDC “Preparing K-12 School Administrators for a Safe Return to School in Fall 2020“
BocaFirst reader Brad Folkers recently asked if we had any data on Palm Beach County that might help assess his risk as someone living in a “Sunbelt Surge” hotspot. He’s a good numbers guy so we worked on the analysis together.
In the interest of helping our community with the best information we could find, we analyzed the “Case Line” data from the FDOH Open Data Website for May, June and July. Taking note that the surge in positive tests started the first week of June, we saw that the cases in May were too early for the surge and would skew the results when mixed with June. Similarly, the July data was incomplete because there were more hospitalizations and deaths to come. So June was the “Goldilocks month” of cases to examine and extract a picture of how the “Sunbelt Surge” of COVID19 was affecting Palm Beach County.
The “Goldilocks Month” of June
Pulling data from the census bureau on the demographics of Palm Beach County, we know how many people are in each age group. Using the June Case Line data, we then calculated the percentage of people in each age group who were hospitalized and died. The graphic below shows the results. Out of the 172,000 people in PBC aged 35-44, .041% were hospitalized and .001% died. What do those numbers mean? Read on.
What happens if I get COVID?
We know that many things affect outcomes; especially our health and medical care. It’s also apparent that age is a factor in COVID19 outcomes. But how so? At what age, does it have a greater effect on the population? So we looked at outcomes for just those who tested positive. That is, how did COVID actually play out once you caught it?
The graphic below first calculates the percentage of people in each age group that tested positive in June. The median age for PBC in June was 43 compared to 50 back in Mar-May. Breaking down each age group further, we analyzed what percentage of people who tested positive were also hospitalized and what percentage died. This data would give a picture of how COVID was affecting the population. The graphic below shows the percentage of hospitalization or death once you test positive. Except for the 0-4 age group, it’s a pretty straight forward increasing percentage of people being hospitalized the older they are. Uncanny actually. Anyway, for the age group of 35-44, 4.3% of them were hospitalized and .123% died. Still kinda fuzzy.
What are your odds?
The percentages are hard to grasp. So we took one more stab at the numbers. How things play out for any one person is affected by age, health, behavior, community and those around you. As far as what’s driving the “Sunbelt Surge” in Palm Beach County, this is how it played out in June in terms of odds. So for our example 35-44 age group, one in 106 people tested positive, one in 2,459 were hospitalized and one in 86,052 died.
The COVID19 virus is very social but doesn’t care about you one bit. It replicated and spread from host to host until it finally found Ed Sanchez and as of yesterday, 795 others in PBC. That’s what it does. And it’s going to keep doing it until we stop it. Early on in the pandemic, Dr Birx described it well:
“This begins and ends with community. It’s the community that has to do the things it has to do to make a difference.”Dr Deborah Birx, Response coordinator for the White House coronavirus task force
And more recently Dr Fauci:
“You have to have responsibility for yourself but also a societal responsibility that you getting infected is not just you in a vacuum. You’re spreading the pandemic.”Dr Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases
Our efforts as a country and community succeeded in flattening the curve and we’re trying to re-open things, but we’ve had a flare up here. That is ultimately on us, not COVID19.
We all have a vested interest in tamping it down so we can finish re-opening. In PBC, our frontline workers and hospitals are busy handling the “SunBelt Surge” (see our “Hospital Bed Tracker” for daily reporting). However, a look at the week to week positive test demographics shows a trend back toward the older age groups. In June, the median age of infection was younger than it had been. But here, at the end of July, it’s crept back up. More concerning is the increased infections in the 65 and older groups. These are the Ed Sanchezes in your community. The numbers tell us how that’s going to end. All of us need to be safe out there. It’s on us.