For the seven countries with the highest absolute number of deaths, the colored lines in the upper chart illustrate the cumulative number of deaths reported by that country for each date in time. Note how different the U.S.’s trajectory is relative to the other highly infected countries. The steep rise might be troubling. However, as shown in the second chart, because our population is larger than most countries, our number of deaths per 100,000 residents is the third lowest among the top ten countries. Indeed, the third chart illustrates that our death trajectory is similar to that of Europe’s taken as a whole. This might be a better way to compare the statistics, as the total population number and social interventions are similar. However, as seen in the fourth chart, we have likely not yet reached our peak, while at least some other countries are moving beyond theirs.
Scientists from the Chan School of Public Health at Harvard have developed a complex model of SARS-CoV-2 transmission. The model reproduced here assumes no seasonality to the illness. The charts A-E illustrate different lengths of time for social distancing. The various colored lines represent how successful we are in reducing transmission of the disease. The researchers are interested in how best to achieve “herd immunity,” where a sufficient percentage of a population has antibodies for the disease such that transmission is radically slowed (represented by the straight grey line in graphs F-I) with the smallest disease surges. What this analysis shows is that the most effective way to achieve herd immunity with the fewest number of cases is a 20 weeks of shelter-in-place with moderate success in reducing transmission (20%-40% effective).
If we look at select activities in Kentucky, we can see that outdoor recreation has increased since Governor Beshear’s shelter-in-place order, while visits to shops and our workplaces have been cut in half and going to school hovers around 40% of normal. In none of the activities monitored have we consistently achieved less than 40% visitation, except for college and universities.
Researchers at Harvard estimate that we need to administer at least 152 tests per 100,000 residents each day to be able to open our country up again safely. Right now, the nation is testing about 146,000 people a day; to open safely, we would need to test on average about 600,000 people a day. Kentucky currently has the lowest rate of testing in the country, at 19 tests/100,000. (Rhode Island has the most, at 185/100,00, followed by New York at 118/100,000.) Kentucky must increase its testing capacity significantly if it will follow its own guidelines to re-opening and plans on loosening some restrictions by the end of the month.
While Kentucky has been able to offer few tests relative to other states, trying to reserve them for those who might need them most, only 8% of those tested in Kentucky have had a positive COVID-19 result, much less than the U.S. average of 20% testing positive. With only 6.8 positive tests per 1,000 residents, Kentucky is ranked 46th in the nation, ahead of Ohio, California, Virginia, Texas, and Kansas (the metrics include D.C.). Rhode Island, New York and Louisiana have the highest ratios, each with approximately 30 positive tests/1,000.
STAT has developed a preparedness metric for counties, by combining at five variables: physical capacity (the number of licensed hospital beds within a 40-minute drive); human resources (the number of critical care staff within a 40-minute drive); community vulnerability (percentage of population over 65); community resiliency (measure on CDC’s social vulnerability index); and estimated bed shortages (using IMHE’s projections). Shown are the scores for Kentucky counties, with green representing the highest score and red the lowest. With the exception of Louisville, the rural areas in Eastern, Central, and Western Kentucky are the most vulnerable. The Northern Kentucky region has the highest measures for coronavirus preparedness.
Kentucky is ranked second in the country for percentage of at-risk adults (those over the age of 65 or with underlying health conditions), with 44% of our adult population at risk. The U.S. average is 38%. Unfortunately the percentage of those at risk are also highest in the Kentucky counties least prepared to manage an outbreak.