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Snapshot of COVID-19 in Kentucky

 

Since the 6th of April, the United States’ daily number of deaths from the coronavirus has surpassed the average number of daily deaths from all other causes of death in the country. All indications are that this rate of death from COVID-19 will continue for some time.

 

 

Predicting Hotspots

 

 

Atypical Fever Spikes

These are measures of atypical fever spikes recorded by Kinsa’s electronic thermometer. Kinsa has now shown that typical spikes in fever precede a spike in COVID-19 deaths by about 15 days.  These measures cover March 28 – April 4. Notice the high level of abnormal activity centered in the rural central and Eastern portions of Kentucky. 

 

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And now we are seeing a hotspot emerge in Western Kentucky (green circle).  Four of the six counties with the highest per capita rate in Kentucky are located in this region. Hopkins County (purple circle) has the highest number of COVID-19 patients and coronavirus-related deaths in the Commonwealth, with 191 cases per 100,000 residents. Nearby Adair County (blue circle) has the second highest rate.

 

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Map highlighting Kentucky COVID-19 case hot spots.

 

Social Distancing Measures

 

 

Using GPS data, scientists can track our movements not only to see whether we are in fact sheltering-in-place, but also to see how many (potential) contacts we might be having with other people. Kentucky is not doing so well on this metric, with an average score of “D.” 

 

 

While we have cut our “encounter density” in about half, we do still have room for improvement. Nevada and Vermont, for example, have cut their encounters by over 90%. The United States as a whole has cut its encounter density by about 75%.

 

 

Rate of hospitalization for COVID-19 patients with underlying conditions

 

 

How intently we distance ourselves from one another – the only sure way to guarantee that the disease will not spread – is particularly important for Kentucky’s health. We are learning that people with underlying health conditions are about ten times more likely to be hospitalized than those without. Those with heart disease seem to be those who are most likely to have a severe case of COVID-19.

 

 

Percent Medicaid recipients hospitalized for heart disease

 

 

As you can see from the illustration below, the percentage of Medicaid recipients who are hospitalized for health disease is around 30% -- almost a third. This is perhaps one reason why a greater percentage of Kentucky residents who have been diagnosed with coronavirus fare poorly relative to other parts of the country.

 

 

Cumulative number of confirmed COVID-19 cases

Beginning when state reported rate of 1:100,000 cases

 

 

All States; US Average in Green

Here we see the relative spread of COVID-19 in all states, starting when states reported a rate of 1 case for every 100,000 residents. The green line indicates the US total of 160 cases for each 100,000 residents.

 

Spread of COVID-19 in US

 

All States; KY Average in Pink

The pink line in this chart shows COVID-19’s movement into Kentucky was later than much of the nation and our curve is lower than most other states.

 

Spread of COVID-19 in KY

 

Here are the same data represented on a linear scale instead of a logarithmic one.  A linear representation makes it easier to see that our curve is significantly smaller than the US average. It is important to keep in mind that these charts likely grossly underestimate the number of cases in the US, as our testing is both sporadic and sparse.

 

Spread of COVID-19 in KY

 

KY Comparison to Other States

 

 

If we normalize the charts to all start on the same date, we can compare the speed of the spread between New York and Kentucky. We can also see that our primary border states of Ohio and Tennessee have many more confirmed cases than we do (even though their curves are lower than the US as a whole), which explains why Governor Beshear is restricting travel to and from these states.

 

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New York COVID-19 Cases
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Ohio COVID-19 Cases
Kentucky COVID-19 Cases
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Tennessee COVID-19 Cases

 

Predicting the Peaks

 

 

According to one analysis, we have already hit our peak medical resource usage for the United States as a whole, but Kentucky will not experience its peak usage until April 24. This analysis also indicates that Kentucky should in theory have sufficient hospital resources to manage its surge – as long as the resources can be moved to be close to where most of the patients are. This is one reason the fever indicator in the previous image is troubling, as this is an area with constrained medical care.

 

 

United States

 

US Hospital Use Resource Chart

 

Kentucky

 

Kentucky Peak Medical Use Chart

 

However, another analysis shows that Kentucky will not hit its peak hospital usage until the middle of June, and it gives different estimates of usage depending on how successful we are at social distancing. The dark green projection illustrates moderate social distancing and the lighter green strict social distancing. The previous graphic assumed continued and successful social distancing throughout the pandemic.

 

Projected hospitalizations in Kentucky chart

 

Projections

 

 

Estimates made by fitting our outbreak to the weighted average curves of Wuhan, Western Europe, and the United Kingdom suggest that our peak number of deaths per day is still about two weeks off, while we have already passed that date in the United States as a whole. It is important to notice how large the error bars are around these estimates. The range of potential deaths per day at our peaks  range from less than 10 and almost 80 for Kentucky and from 500 to over 5,800 for the United States. These spreads tell us that our data from which we all are trying to make decisions are still incomplete and rather poor.

 

 

United States

 

US Projected Daily Deaths

 

Kentucky

 

Kentucky Deaths Projections

 

We see the same uncertainty in total number of death projections, which range from 26,000-155,000 for the United States and from 200 to 2,800 for Kentucky.

 

 

United States

 

US Projected Total Deaths

 

Kentucky

 

Kentucky Projected Total Deaths