Week 86: 11/1 - 11/7/2021

This week's report includes a short review of the Covid-19 Over-the-Counter Covid-19 Test, Quick View, the data bridge to cutover Vaccination Status from 12+ to 5+ population numbers, and the usual hospitalizations, cases, and fatalities overlays.

Product Review: All of you will remember last year's lead up to the Holiday Season: case numbers drifted up from the 2020 Fall Recovery. I read the data as people getting tested in advance of travel to be with family for Thanksgiving and all the other the end-of-year Holidays. This year will be different insofar as Vaccinations (+), In-person Classes (+), and Masks(-). In addition, over-the-counter personal tests have become de-rigueur as we return to more face-to-face activities with larger groups of people - especially indoors.

For me, last week's concert with a coughing patron seated behind us and Halloween Carnivals with exposure to unmasked children were both risks that were on my mind when I came down with a sore-throat last Monday. Over-the-counter tests can help manage such uncertainty. Quick View kits were conveniently stacked at the check-out station of my Pharmacy, so I picked one up during a recent trip for dry mouth lozenges and hair-straightening shampoo. Each kit comes with swabs, testing strips, and reagent for two tests priced at $25. On a per test basis, this is the same as the going rate for Over-the-Counter pregnancy tests. There may be savings to be had online except these are cancelled out by shipping charges.

The kit had clear instructions which I could read (without prescription glasses). These were straightforward, especially if you had been through one of those drive-thru PCR tests. The total time from taking out the swab to reading the final results was under 30 minutes. I recommend no multi-tasking and performing the strip read in the best light possible.

Probably the hardest task was to get the testing strip out of its packaging. It was very small for my piano-strong, muscle bound fingers. There is a notch along the edge for opening the wrapper. Be sure to tear in the longitudinal direction (as opposed to sidewise). I had to finally use scissors to make another tear and I was worried about cutting up the strip. But, this did not happen. Figure 1 shows the scale of the strip and my negative result, a single blue bar. Had another red/pink bar appeared, I would have performed the second test to make sure that the result was repeatable.

Of course, the most important criteria is accuracy. For this, I refer you to a NYTimes article which came out this past August: https://www.nytimes.com/wirecutter/blog/at-home-covid-antigen-tests/ . Note that the Ellume brand has been removed from shelves since the number of false-positives was unacceptably high despite its high specificity rating in the article. Specificity, defined as the probability that you have Covid-19 if the test results are positive. The Quick Vue kits are rated for 2% (absolute) higher than the discontinued Ellume's and .5% higher than Abbot Lab's BinaxNow.

My plan is to have 5 kits on hand over the next two months. I predict a high demand for testing with so many people planning to see relatives, party, and begin to push the envelope with our back-to-normal routines. For myself, I went to my monthly Poetry Reading at the Public Library in person and was happy to see that the audience was ten people with the rest on zoom. Later on in the week, I will be giving a talk at the Temple and going to my hair salon for an additional hair straightening treatment.

Texas Vaccination Rates: Bridge between 12+ to 5+ Total Eligible Population:

This week, Pfizer's vaccine was approved for Children between 5 and 12. As a result, the tables I have been reporting these last few months are no longer current. They are instead obtained from the 12+ number of people in each region as calculated on a county-by-county basis. Figure 2 reports the Week 85 results in terms of this expanded population. The bridge shows the effect of the change without introducing the week's new incremental additions to full vaccinated status.

As shown, there is a 63.0 to 56.2% Statewide before-and-after bridge in Vaccination Status for adding children to the Eligible Population Pool. Whereas, the range of fully-vaccinated individuals for the Before Case fell between 47.4% (Panhandle) to 80.6% (Border), these numbers are now lower (41.9% to 70.3%) for the After Case due to the relative ratio of children to the number of 12+ individuals (10.8% statewide with numbers varying between 10.1% of the population newly eligible for Central Texas and 12.8% for the Border). (Note: in all of its per population data, the DSHS uses 2019 Population estimates rather than the recently 2020 Census numbers).

Despite the step reduction in % Vaccinated, the 70% Milestone is still the target for the next few months. My friend took her three children to the doctor this past Saturday for their shots and was out in a very short amount of time (less than one hour). According to her, the practice was well organized and families were moving through the office in a streamlined fashion. If this experience is repeated throughout the state, all should be able to obtain their first round of shots before the end of the month. And, this means by the end of the year, we should see a recovery of 60+% in the yellow-highlighted updated weekly update.

Figure 3 demonstrates that the week's results are low because most of the individuals treated were on their first dose. According to DSHS numbers, the figure went from 17.8 to 17.9 M, or 100,000 out of the 400,000 total weekly doses (33.9M - 33.5M). With further deliveries, the Vaccination Rollout for Children will increase from 25% to a higher number and such increases will go up from this level once second round is completed. Therefore,

I do not expect it to take over 30 more weeks to achieve 70% Vaccination coverage throughout the state, as this week's calculations imply.

Hospitalizations, Cases, and Fatalities: Trends of the previous few weeks continue. These are: a drop in regional Hospitalizations (all regions except for Border and Panhandle where leveling out occurs); a drop in regional Cases (all regions except for Border and Panhandle where increases were measured); a drop in regional Fatalities during September (all regions; October data will be available and reported starting next week).

Figure 4 provides the Hospitalization/Cases overlay for all five regions.

It is interesting to see the overlay effect and how it varies from one region to the next. Where the Panhandle cases and hospitalizations line up, a 1-2 week lag is pronounced for the Border and Gulf Coast. Part of this may be due to my practice of only reporting "newly reported" cases and neglecting updates associated with backlogs. Part of it may be that the larger population regions have bigger hospitals (see different scales on vertical axes).

Figure 5 is an update from last week's hypothesis on the increased cases measured in El Paso and elsewhere in far West Texas. As discussed in the Week 84 and 85 Reports, such trends come from Colorado and New Mexico which is well into their Winter Surge. Given that El Paso recreation, business, and families associate more with these areas than the rest of the state, spread Covid-19 spread occurs from this direction. The effects in North Texas, the Southern part of the Border, and the Gulf Coast will not be realized until later in the Holiday Season. With Holiday Travel, Colder Weather, and increasing Vaccination metrics, it may be difficult to separate out the different causes three to four weeks from now. However, the results will be the same: a Winter Surge. Whether it will be as bad as last year is for those with credentials to predict.

My takeaway, which is not evident on a statewide snapshot, is that the upcoming spread will be West to East. In this case, Texas is depicted as all one color (yellow based on an overall state average) while Colorado and New Mexico are other colors based on how they are doing relative to Texas. When individual counties are followed in sequence, color changes can be representative of how cases (and subsequently hospitalizations) move like a wave across the state.

The NYTimes source for such snapshots is located at: https://www.nytimes.com/interactive/2021/us/covid-cases.html

And, for comparison with the counties which fall on West Texas's Northern Border: Dona Ana County (11.3 Cases per 100,000 population/week; down from Week 85), Otero County (71.9 Cases per 100,000 population/week; up from week 85) vs. El Paso County (27.4 Cases per 100,000 population/week; up from week 85).