It’s July 2nd 2021, how is Orange County Florida doing with Covid-19?

Well, it’s hard to tell for sure, as the Florida Department of health has stopped issuing daily reports, and has switched to weekly reports. They have also stopped releasing per-county death numbers, among other omissions and simplifications.  You may notice that the graph I have to display is simplified this month.


What we do know is that the number of cases per week had been decreasing since mid-April, but in the last two weeks the number of cases per week has started to increase again. On June 1st the 7-day average was 145 cases per day, while as of July 2nd it is 171 cases per day, and the case positivity rate has raised to 5.3%.

Historically, Orange County had a case fatality rate of near 1%, so that would indicate about 1.7 deaths per day, but those numbers are no longer part of the FDOH weekly reports so I have no way of knowing if the case fatality rate has started to drop due to vaccinations of high-risk groups or has increased due to the Delta variant.

We have vaccinated (at least a first dose) 718,103 people (out of a population of 1,457,445, or 49% of the total). If you discount children 12 and under who are not yet eligible for vaccination, Orange County has vaccinated 58% of the eligible population.  We vaccinated  65,206 people in the month of June. (Compared to 88,482 in May and  154,176 in April.)

The rate of vaccination has slowed and I expect it to continue to slow, while the total number climbs upward slowly. I expect that fewer than 60 thousand people will be vaccinated in July.

I believe the uptick in case numbers is primarily among the un-vaccinated 51% of the population, due to a combination of the more infectious Delta variant and relaxation of mask usage and social distancing.

[Charts/Numbers used can be found in this open document spreadsheet: orange_county_florida.ods ]

It’s June 1st 2021, how is Orange County Florida doing with COVID-19?

Cases
Continuing vaccination efforts have continued the decline in cases since the mid-April mini-spike.  The 7-day average of new cases (145 per day) has reached the level achieved in Aug/Sep of 2020, which was our previous low point.  These new cases are primarily occurring within the remaining unvaccinated population.

Median Age of the infected

At the end of April, the median age of those infected  was  32.7 years old. Over the last seven days the average age has risen slightly to 33.8, and I expect this average age to increase as more children in the 12-16 age group are vaccinated.

Deaths
The number of deaths per day has held relatively steady at a reported 1.93 per day, (60 total) in May. (Compared to 2 per day in April.)  The summer peak (June 22nd 2020 to July 22nd, 2020)  had 6.97 average deaths per day (223 total deaths), so the number of deaths is around 25% of our worst month. Total reported COVID-19 deaths overall in Orange County  Florida is at 1309 as of June 1st 2021.

Percent Positivity
These numbers are significantly better than in April, with every day out of the last 14 under 5%, and 13 days under 4%.    Community spread is starting to be under control.

This is a significant improvement over the end of last month:

How many people have been vaccinated

The Florida department of health reports that as of May 27th 2021, 510,582 Orange County residents  (36.6% of the total population) have been fully vaccinated. Children under the age of 12 are not yet eligible for vaccination, but also have minimal direct health risks from catching covid-19 (other than the risk of transmission to others.)

The rate of vaccination uptake has slowed, large community vaccination sites are being shuttered and replaced by smaller pop-up clinics at targeted sites as well as distribution via local pharmacy’s.

Predictions for June:

I expect that daily case numbers will decline in June, hopefully going below 100-per day by the end of the month. Deaths are also likely to slowly reduce over time. My prediction would be between 30-45 deaths in June (1-1.5 per day).

[Charts/Numbers used can be found in this open document spreadsheet: orange_county_florida.ods  ]

It’s May 1st, how is Orange County Florida doing with COVID-19?

Cases
Despite continued vaccination efforts, the small spike in cases in March continued into April, most likely due to new more contagious variants of the virus (B.1.1.7) and relaxing of social distancing by the population. It appears we reached the top of this peak mid-April as the the 7-day average of new cases (355 per day) is below the peak.  The number of new cases per day is still higher than Aug/Sep of 2020, which was our previous low point.

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What can we learn from a nursing home COVID-19 outbreak?

In March of 2021, an outbreak of COVID-19 spread through a nursing home in Kentucky.   The “Skilled Nursing Facility” had 83 residents (assumed to be in the “older” demographic) and 116 Health Care Personal (HCP) [Which we will assume to generally fall in the “under 65” demographic].  They had all been offered the Pfizer-BioNTech mRNA vaccine.

75 residents (90.4%) and 61 HCP (52.6%) received two doses of the vaccine.

HCP at the nursing home were tested for SARS-CoV-2 twice weekly, so we have a good understanding of when the outbreak started and how it arrived in the facility.  After the outbreak was identified, residents were also tested daily with an antigen test.  The variant responsible (identified with whole genome sequencing) came from the R1 linage and had several spike protein mutations.

Overall, 26 residents and 20 HCP tested positive for a COVID-19 infection. 18 of those residents and 4 of those HCP had been fully vaccinated.

Lesson 1: Full vaccination does not offer 100% protection from infection, especially in the “older” demographic which may not mount a robust immune response.

Only 28 of these people showed symptoms, 8 of whom were vaccinated, and 20 of whom were un-vaccinated.] 18 people who tested positive did not show symptoms.

Lesson 2: Asymptomatic infections occur.

“Attack rates in unvaccinated residents (75.0%) were 3 times as high as those in vaccinated residents (25.4%)”

Lesson 3: Being vaccinated does provide significant protection from getting infected, even if you are “older”.

“[attack rates] in unvaccinated HCP (29.6%) were 4.1 times as high as those in vaccinated HCP (7.1%)

Lesson 4: Vaccines provide better protection for younger individuals.

Four “possible reinfections”  (a positive SARS-CoV-2 test result more than three months after a previous laboratory-confirmed infection) were identified, giving “evidence of limited or waning natural immunity to this [R.1] variant.” All four of these re-infections were symptomatic.

Lesson 5: It is possible to be re-infected by a different variant, even if you have already been infected.

“[Vaccine effectiveness] against hospitalization was 94.4% …among residents; no HCP were hospitalized.”

Lesson 6: Unless you are a nursing home resident, vaccination provides very good protection from hospitalization and death.

“estimated [Vaccine effectiveness] for COVID-19 symptom prevention (86.5% for residents; 87.1% for HCP) demonstrates a strong protective effect of vaccination.”

Lesson 7: Vaccination will protect most people from symptomatic illness.

“The index case occurred in an unvaccinated, symptomatic HCP [Health Care Personal]”

Lesson 8: The more people who are vaccinated, the less likely an outbreak is to occur in the first place.

It’s March 31st, how is Orange County Florida doing with COVID-19?

Graph showing infections & deaths
Cases
Despite vaccination efforts, March had a small spike in cases, most likely due to new more contagious variants of the virus (B.1.1.7) and relaxing of social distancing by the population. It appears we may be reaching the top of this small peak as the the 7-day average of new cases (352 per day) is below the peak.  The number of new cases per day is still higher than Aug/Sep of 2020, which was our previous low point.

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It’s February 1st 2021, how is Orange County Florida doing with Covid-19?


Cases

The 7-day average of new cases (628 per day) has fallen from the post Holiday peak, and is comparable to that of the summer surge. I am hopeful that this decline will continue.

Deaths
The number of deaths per day are going up, but as physicians have learned better ways to treat patients we are not yet having as many deaths as in the summer peak.
In December 2020, Orange County Florida had an average of 3.35 covid-19 deaths per day (104 total deaths). In January 2021, the average had risen to 6.7 deaths per day (208 total deaths). The summer peak (June 22nd 2020 to July 22nd, 2020)  had 6.97 average deaths per day (223 total deaths).

In the state of Florida overall, the number of people hospitalized with COVID-19 has started to decline, indicating that we may be close to the peak of deaths.
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It’s January 3rd 2021, how is Orange County Florida doing with Covid-19?

Seven day averages of new cases and new deaths in Orange County FL.

Cases
The 7-day average of new cases (848 per day) has reached levels only seen at the peak of the summer surge, bringing us firmly into “2nd wave” territory. There were dips in reported cases around the Thanksgiving and Christmas holidays as many testing sites were closed, but it is clear that these holidays drove a continuing increase in infections.

Deaths
The number of deaths per day are going up, but as physicians have learned better ways to treat patients we are not yet having as many deaths as in the summer peak. (Also, deaths lag infections by several weeks, so I expect these numbers to increase.) 
In November, Orange County Florida had an average of 2.87 covid-19 deaths per day (86 total deaths). In December 2020, the average had risen to 3.35 deaths per day (104 total deaths).  This is still 50% of the deaths reported in the summer peak (June 22nd 2020 to July 22nd, 2020) which had 6.97 average deaths per day (223 total deaths).

In the state of Florida overall, the total number of people hospitalized for covid-19 is slightly over 6,000 (but rising), while the summer peaked at almost 10,000. The deaths per day is also currently lower than the summer peak.

Hospitalization and Death trends for the entire state of Florida. (Hospitalization data was not reported by the Florida DOH until July 10th.)

Percent Positivity
The percent positivity metric has been above 6.55% in 14 of the last 14 days, indicating that community spread is not under control.

How many people have been vaccinated

The Florida department of health reports that as of January 3rd 2020,  19,356 Orange County residents have received their first dose (out of two) of a COVID-19 Vaccine. 

This is 1.3 % of the population (primarily front line healthcare workers and residents of long term care facilities) who have begun the vaccination process.  [Note that full protection is not achieved until two weeks after the second dose, but some protection begins to appear within 10 days of the first dose.]

How many people have been infected

The US Census bureau estimated that Orange County Florida has a population of 1,393,452 people (July 1st, 2019).   The Florida Department of health reports today that  78,512 cases of COVID-19 (confirmed by either a positive PCR or Antigen test result) have occurred in Orange County so far.   That means at least 5.6 percent ( 78512/ 1393452 = .05634352 ) of the population has been infected. The actual percentage is likely to be much higher as many asymptomatic cases may never be detected.

How many people have been hospitalized or died

Of those confirmed infected, 1,953 or  2.5 percent ( 1953 / 78512  =  .02487517) have been hospitalized, and 750 have died.  The death toll is currently 0.96 percent of all detected cases ( 750 / 78512 = 0.00955267).

Florida average percentages for hospitalizations and deaths are 4.7% and 1.6% so Orange County has done better than the rest of the state of Florida for hospitalizations and mortality so far.

Median Age of the infected

Last month the median age of those infected was 35, while 42 was the median age over the last 7 days.  [The median age of Florida residents is 42.2 ] While infections had trended towards the younger demographics in Sep/Oct/Nov, it appears that the age profile of those infected is now matching that of the overall population.

Orange County Schools
Orange county schools closed for winter break after December 18th. On November 27th they had 1,154 confirmed cases, while they had 2,096 on December 18th, a gain of 942 cases.  School will resume on January 4th.  The number of cases in the K-12 schools has reflected community spread primarily outside of the schools, which did not appear to be a major driver of new infections.

Predictions for January:
Case numbers have risen quickly in December. I expect them to continue to rise, especially in the next 7 days after New Year’s eve festivities. I expect the numbers for hospitalizations and deaths to increase in January.

I do not anticipate enough vaccinations to occur in January to have a significant impact on the number of new cases, which I expect to stay at or above current levels. However, I hope to see deaths begin to drop near the end of February as the most vulnerable population (those over 65) are prioritized for vaccinations.

[Charts/Numbers used can be found in this open document spreadsheet:  orange_county_florida.ods ]
 

It’s November 27th, 2020, how is Orange County Florida doing with COVID-19?

The rate of  new cases had a slight rise in September, and continues to be on a slight upward trend in October. This upward trend accelerated in November. Orange County is averaging 469 confirmed new cases per day over the last two weeks (compared to 224 in the same period in October). While not quite as bad as the summer peak of 600-800 per day in July, these numbers are  going in the wrong direction.

We had 96 people die from Covid-19 in Orange County in the last month (slightly better than the 105 in the prior month) and the total death count is at 642.
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October 28th 2020: Orange County Florida COVID-19 Report

It’s October 28th, 2020, how is Orange County Florida doing with COVID-19?

The rate of decline in new cases had grown sluggish at the end of August, plateaued and then had a slight rise in September, and continues to be on a slight upward trend in October. Orange County is averaging 224 confirmed new cases per day over the last two weeks (compared to 147 in the same period in September). Compared to an average of 14 new cases per day in the first two weeks of April, the number of people infected each day is 16 times higher than in April.

We had 105 people die from Covid-19 in Orange County in the last month (slightly worse than the 79 in the prior month) and the total death count is at 549. Continue reading