Vaccines, mask compliance, weather credited with better Kansas COVID trends in February
Public health workers and medical doctors have several theories for why coronavirus pandemic indicators improved significantly in Kansas in February.
Despite the improvement, officials say COVID-19 continues to pose a serious public health threat, and it is too soon to stop wearing face masks.
“I’m afraid that we could be lulled into complacency and end up allowing this to plateau off when we could continue to drive the numbers down,” Dr. Lee Norman, the state’s health secretary, said during a Tuesday media briefing hosted by The University of Kansas Health System.
Health data from the start of February to the end of the month showed the state and local COVID-19 case rates have been slashed. The local positive test rate is the best it has been since the middle of June. The death rate has dropped.
Hospital overcrowding is no longer cited as an issue. The Sedgwick County Health Department’s hospital status moved from “cautious” to “good” as Wesley Medical Center and Ascension Via Christi St. Francis reported available ICU beds for the first time since October.
Statewide, the hospital situation improved so significantly that the KDHE and Kansas Hospital Association discontinued their weekly hospital report-outs.
Dr. David Wild, vice president of performance improvement at The University of Kansas Health System, spoke Feb. 16 about possible explanations for pandemic indicators trending better.
“No doubt vaccination of health care workers is having an impact,” he said. “No doubt the decrease in the number of long-term care facility clusters and transmission to the most vulnerable is having an impact. But we have not vaccinated enough of the general population to really have this degree of impact.”
Wild said people have been traveling less since the holiday season ended, adding that cold weather also kept people indoors and away from others.
State and local data showed COVID surges after Thanksgiving, Christmas and New Year’s Day. The cold weather featured three days in a row of record-breaking temperatures in Wichita.
“There’s also some evidence that masking and physical distancing, the compliance with those non-pharmaceutical interventions is better in some places,” he said. “And then there’s a growing theory that maybe the people that were going to get it, or the people who, I’ll say, continually behaving in a way that puts them at a higher risk, might have already had it. And so they’re still out doing the same things, but they have some degree of natural immunity now and the transmission rate is lower.”
“I’m sure there are other variables as well, but all of those things are feeding into why cases are lower.”
February COVID data
The Kansas Department of Health and Environment on March 1 reported 294,302 total confirmed and probable cases, an increase of 17,634 from Feb. 1. There were 4,743 total deaths, an increase of 934 in February.
There were also 801 new hospitalizations and 210 new ICU admissions statewide in February, raising the pandemic totals to 9,290 hospitalizations and 2,521 ICU admissions.
Sedgwick County as of March 1 had pandemic totals 53,679 cases, 694 deaths, 1,432 hospitalizations and 418 ICU admissions, according to the KDHE. The February increases were 3,409 new cases, 157 new deaths, 201 new hospitalizations and 70 new ICU admissions.
Monday’s KDHE report had eight new deaths statewide over the weekend.
“Every death is a huge loss, of course,” Norman. “But to have only eight, by comparison, in a three-day period, is the lowest we have seen for many months.”
February brought the first reported child death from COVID-19 in Kansas, though state officials said the 6-year-old had died in November. The death certificate was not finalized until last month.
Local, state and national death data are typically based on the date the death was reported, not the official date of death on medical records.
The state also recorded its first cases of a coronavirus variant in February. A student-athlete at Fort Hays State University tested positive for the United Kingdom variant at the start of the month. It was followed by a travel-related case in Sedgwick County.
On Monday, the KDHE announced eight more cases of the UK variant in Sedgwick County, all contained to a multi-generational family living in the same household.
“I’m sure that’s just the tip of an iceberg for that region and really probably for the state,” Norman said of the variant cases in the Wichita area.
The state has not had any known cases of the coronavirus strains from South Africa and Brazil, which have been identified elsewhere in the United States.
“These variants seem to spread more easily and quickly than other variants, which may lead to more cases of COVID-19,” according to the Centers for Disease Control and Prevention. “An increase in the number of cases will put more strain on health care resources, lead to more hospitalizations, and potentially more deaths.”
National rankings
While the state’s pandemic indicators are significantly better than they were during the November surge, the coronavirus is not gone. The White House COVID-19 Task Force’s Feb. 28 report for Kansas has the state’s death rate in the red zone, the case rate in the orange zone, the hospitalization rate in the yellow zone and the positive test rate in the green zone.
“Seriously, COVID is still out there,” Dr. Steve Stites, KU’s chief medical officer, said Tuesday. “Remember that even if you haven’t been vaccinated, and frankly even if you have been vaccinated, you still need to follow the rules of infection control because we keep each other safe, and that helps us all get back to normal.”
All four of the task force’s key indicators improved in Kansas, but the state’s national rankings were mixed. The White House’s weekly rankings include the 50 states, plus the District of Columbia and Puerto Rico.
The Kansas case rate ranked 27th-highest in the Jan. 31 report. It improved to the 40th-highest in the Feb. 28 report. The state’s case rate dropped 65%, from 276 to 97 new cases per 100,000 people.
The positive test rate ranked 28th-highest in both reports. The percentage change drop was 43%, from 8.1% positivity to 4.6% positivity.
The Kansas hospital admission rate decreased 38%, from 13 to eight confirmed or suspected COVID-19 admissions per 100 beds. But the state’s ranking worsened from 29th-highest to 28th-highest.
The ranking for the death rate also worsened, from 24th-highest to 17th-highest. Still, the state’s death rate decreased 32%, from 6.2 to 4.2 deaths per 100,000 people.
Texas, which made national news this week when Gov. Greg Abbot announced the end to the state’s mask mandate, ranks worse than Kansas in all four indicators. Texas has the 11th-worst case rate, the worst positive test rate, the 10th-worst hospital admission rate, and the ninth-worst death rate.
Vaccine numbers
In the past month, the Sedgwick County Health Department more than tripled the total number of doses administered. As of Feb. 1, the health department reported 12,643 first shots and 2,105 second shots administered. As of March 1, the numbers had grown to 31,183 first shots and 15,522 second shots.
Those numbers do not include other providers in the county, such as pharmacies. Voluntary reports to the health department show other providers in the county had administered at least 11,856 total doses between December and the end of February.
Statewide, Kansas more than doubled the total number of doses administered in February. The KDHE reported 584,468 total doses administered on March 1, up from 229,459 on Feb. 1.
The month started with 413,350 total doses distributed to the state. There had been 185,010 first doses administered, or 6.4% of population, and 44,449 second doses administered, or 1.5% of the population.
The month ended with 805,480 total doses distributed to the state. There had been 393,860 first doses administered, or 13.5% of the population, and 190,587 second doses administered, or 6.5% of the population.
The state vaccination numbers are believed to be an under-count, as the data on doses reported as administered continues to lag behind reality, Norman said. That data lag has been blamed for CDC data showing Kansas has country’s the fifth-worst rate of doses administered per capita.
“We still have a little bit of a data glitch in terms of reporting the percentage administered, but we’re between 70-80%, even with that data glitch, so I think that vaccine is getting into arms and inventory is overall low,” he said.
Norman said that when he speaks of vaccine inventory, he is referring to doses sitting on freezer shelves, “where the vaccine isn’t doing any good.”
The state has plenty of vaccination sites, but not enough doses. Norman said there are about 1,400 vaccinating sites registered with the state, including about 640 pharmacies.
The state’s allocation from the federal government has increased.
“A couple months ago, we had 45,000 doses a week, and now we’re at more like 145,000 doses a week,” Norman said on Tuesday.
The KDHE allocated 15,260 doses to Sedgwick County this week, up from 5,850 doses the week of Feb. 1.
After the sub-freezing cold in the middle of February delayed vaccine shipments, the state had to play “catch up,” Norman said.
Norman said the influx of Johnson & Johnson’s newly-approved vaccine will ultimately speed up the process of vaccinating the public and help move through the phases faster.
Some counties have moved faster than others through Phase 2, which includes the elderly, teachers and essential workers, among others. Norman said it has sometimes been unpopular that the state requires all 105 counties to move through the phases together, with some county officials saying they believe they are being penalized for finishing Phase 2 sooner.
“We are in this together as a state,” Norman said. “We want to move through the phases (together) because the high-risk people (in Phase 2), we don’t want to leave them behind. So we are redistributing, sometimes 20-30 counties at a time for a particular week. We are going to continue to do that. That’s a policy that we think makes sense for the greater good of all Kansas.”
Coronavirus clusters; nursing homes
Kansas has seen a significant drop in the number of COVID-19 outbreaks, a sign of both reduced community spread and increased vaccinations of high-risk populations.
The KDHE reports weekly coronavirus cluster data on Wednesdays. This week’s numbers showed state officials were tracking the fewest active outbreaks since August, when the department first made cluster data available to the public.
There have been 1,836 total clusters in Kansas as of March 3, which was an increase of 69 since Feb. 3. The biggest contributors to the increase were 29 new outbreaks at private businesses, 11 at long-term care facilities, seven schools and five private events.
The four categories also have the most total clusters, with 644 long-term care facilities, 362 private businesses, 156 private events and 130 schools.
In Sedgwick County, between Jan. 31 and March 3, the local health department reported new clusters at six businesses, five schools, five long-term care facilities and one religious institution.
During February, the state went from monitoring 272 active outbreaks to 112. The biggest contributor were long-term care facilities, which dropped from 144 active outbreaks to 37.
Nursing home clusters account for about 38% of all COVID-19 deaths in Kansas, according to KDHE data. Sedgwick County Health Department data show about 41% of deaths in the Wichita area were connected to a nursing home cluster.
While the state has had a total of 1,971 deaths connected to clusters — an increase of 211 over the last four weeks — the deadliest clusters have been long-term care facilities. With 204 new deaths, nursing homes in Kansas have had 1,833 total deaths. That mean an average of 2.8 deaths for every outbreak at a care home.
Kansas doctors have credited the vaccinations of the elderly, especially at nursing homes, for much of the drop in hospitalizations and deaths. Nursing home residents and staff were in Phase 1 of the vaccine roll-out, which started in December.
The American Health Care Association and National Center for Assisted Living said in a Tuesday news release that Centers for Medicare & Medicaid Services data show the effects of vaccinations.
The number of new COVID cases among residents peaked during the week of Dec. 20 and dropped 82% by the week of Feb. 7, hitting the lowest number since CMS started tracking in May. Nursing home COVID deaths dropped 63% during the same time frame.
“We still have a long road ahead, but these numbers are incredibly encouraging and a major morale booster for frontline caregivers who have been working tirelessly every day for a year to protect our residents,” said Mark Parkinson, AHCA/NCAL president and a former governor of Kansas, in a statement. “This new data showcases just how important it is for nursing homes residents and staff, as well as the general public, to get the vaccine because it is clearly working.”