Indiana COVID-19 update: 5 September 2021

About a month ago, I wrote that Indiana has surrendered to COVID-19. That remains the case. As you might expect, the trends have continued in the wrong direction. Since August 9, daily deaths are up 57%, hospitalizations 85%, and cases 150%. The lone comfort is that hospitalizations aren’t rising as fast as cases and deaths are rising even less. The vaccines work, if we can only get people to take them.

Recent trends

Not only have cases been increasing since early July, but the rate of increase has increased, too. Only in the last week or so has the week-over-week new case difference started to drop.

Hospitalizations had been showing an alarmingly exponential rise. In late July, we saw the highest week-over-week since records began on April 8 of 2020. This has slowed recently, although it still rivals the increases we saw last fall.

The death rate appears to be leveling off. However, this could be due to reporting delays, so it’s a little early to feel good about it yet. Especially since COVID-19 remains the number two cause of death in Indiana in the past week.

In a Twitter thread on Friday, I used November 9, 2020 as comparison to where we are right now. That date had a comparable number of hospitalizations as we currently have and it was on the upswing. At that point, we were about three weeks away from peak hospitalization. However, the rate then was higher, so we may peak earlier. Alternatively, we may have a broader peak since we have fewer mitigations in place as we did then and—while non-zero—our vaccination rate remains infuriatingly low.

I also looked at ICU bed usage and ventilator usage. The ICU beds devoted to COVID-19 patients is about the same (27.8% of total capacity then compared to 28.4% now). Ventilator usage is higher now (10.4% compared to 8.5% then), which is a cause for concern. What’s not clear to me is if capacity is reported as physical beds and ventilators or the number that can be appropriately staffed. I suspect the state is using the physical counts, which makes me wonder what the true utilization is. Local hospitals say they’re at a breaking point, and things are likely to get worse before they get better.

Future projections

The Institute for Health Metrics and Evaluation (IHME) have increased the daily deaths in the last few model runs. However, the most recent one dialed the forecast back a bit. The bad news is that we’re tracking it pretty well so far. The good news is that their model is running high on the hospitalizations, so that may mean the death toll is over-forecast, too. We should hope this continues, because both overall hospital and ICU bed usage is forecast to enter the “extreme stress” category later this month. We did not reach that category during last winter’s surge.

It feels like there are more uncertainties now than a few months ago. The IHME model does not explicitly account for school reopenings. The note that “[t]he second Delta surge in Scotland after a peak and a decline when schools opened is potentially a warning sign on the potential for school openings to drive increases in transmission.” Additionally, while mask usage has increased, we’re only at about 25% of adults saying they mask up when they leave the house. And the percentage of Hoosiers that say they have been or probably would be vaccinated remains steady just below 60%. If either of those numbers increase significantly, things could be much less bad than expected.

What to expect

It’s clear to me that Governor Holcomb will continue to do nothing. I’m not sure what it would take at this point. In fact, his recent executive order apparently reduced quarantine requirements for schools. Someone at the state health department had a moment of clarity, which was deleted.

I’m hoping to spend some time today adding Tippecanoe County school stats to my COVID-19 dashboard.

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