Where does Georgia go from here? COVID-19 data improving, but risk for surge remains
Georgia has reported consistent weekly declines in COVID-19 cases and hospitalizations since hitting the top of a summer surge.
But physicians, public health and data experts who spoke with McClatchy expressed concern that state leaders and health officials have not implemented more stringent coronavirus restrictions and the necessary public health infrastructure that would prevent further spread.
They worry those gains could quickly vanish. Georgia, many experts said, is in a better place. But it’s still not a good place.
As of mid-September, the state is on track to report nearly half as many COVID-19 cases per 100,000 people than it did when it led the nation in infections. The number of patients with COVID-19 in Georgia hospitals continues to decline. Fewer of the state’s coronavirus tests are coming back positive. Public health and data experts following the pandemic closely have acknowledged Georgia has made progress.
Yet several factors complicate the state’s coronavirus picture.
Public health estimates show Georgia is performing roughly a third of the tests it should be, and deaths and the state’s positivity rate remain too high.
School reopenings and the aftermath of Labor Day could cause another coronavirus surge here, experts worry.
“I don’t know of a single person in public health who would characterize our public health response as successful,” said Dr. Amber Schmidtke, a public health microbiologist and a member of a state coronavirus data task force. “The state hosts the Centers for Disease Control and Prevention — one of the number one agencies for public health, and it seems so bizarre that we would be in this position. We host these leaders in public health, and we’re not following any sort of public health-driven strategy right now.”
Where has Georgia seen declines?
Several key metrics in Georgia’s coronavirus data continue to improve.
The latest White House coronavirus task force report states that Georgia reported 11,454 cases during the week of Sept. 5-11, an 18.1% decline compared to the week before. Georgia’s case rate for the most recent report was 108 per 100,000 people. It was the 14th-highest rate in the nation.
More recent data suggests case numbers are continuing around this level. The New York Times reports as of noon Sept. 17, Georgia reported 11,739 coronavirus cases over the last seven days, an average of 111 cases per 100,000 people. That’s the 17th-highest rate in the country. Georgia is close to moving out of the coronavirus red zone for cases.
Previous task force reports had Georgia with the seventh, second and first-highest rates in the United States over the course of a week. Georgia reported 216 cases per 100,000 people when it led the nation.
Test positivity rates in Georgia have fallen as well. The state reported rates above the 10% red zone for much of the summer, dipping to 8.2% from Sept. 3-9. The latest data from the Georgia Department of Public Health shows rates hovering around that same value.
“Georgia is making progress with decreasing cases and test positivity week over week. Over the past five weeks, Georgia has decreased the number of red counties from 109 to 47,” a portion of the latest report reads.
State health commissioner Dr. Kathleen Toomey told McClatchy, owner of The Telegraph and Ledger-Enquirer, in a 15-minute interview earlier this month that Georgia is seeing improvements in some important coronavirus metrics.
“I think our numbers are getting better. I’m very hopeful that this will be an ongoing trend, but it won’t continue unless all Georgians follow the guidance to wear a mask, social distance, continue to follow the public health guidelines and wash (their) hands,” she said. “This progress could be tenuous if Georgians don’t take this seriously.”
Testing remains a concern
The progress, however, comes with some caveats. While Georgia has seen a decline in its caseload and test positivity rate, fewer people in the state are getting tested.
The latest White House task force report states Georgia performed about 68,000 tests from Sept. 3-9 at a rate of roughly 639 per 100,000 people. That was a 44.6% decrease from the previous week.
As of Sept. 17, the New York Times reports that Georgia averaged 203 daily coronavirus tests per 100,000 people over the past two weeks, which is 33% of the state’s monthly testing goal, according to estimates from the Harvard Global Health Institute.
Toomey said the state’s testing capacity isn’t an issue, and demand for testing nationwide has declined. She pointed to other testing options and “myths” about the pain of getting tested.
“We have lots of testing capacity. I think the demand has gone down, and is not something that is unique to Georgia,” she said. “There’s a lot of reasons for this.”
TJ Muhelman created the COVID Mapping Project, which examines coronavirus data for all 50 states. He said the declines in testing complicate Georgia’s picture.
“The way we are testing is such a scattershot approach that, in my opinion, you can make some assumptions,” he said. “But I ultimately think those are very broad assumptions in terms of what is happening. I think because of (Georgia’s) testing strategy, or lack thereof, making any of these assumptions is risky.”
Some portions of the state, like Fulton County, have 14-day test positivity rates below 5%, suggesting that an appropriate amount of testing is being done countywide. But more rural portions of the state such as Johnson and Emanuel counties in the southeast have rates above 20% for the last 14-day periods as of Sept. 16.
State officials closed a mega-testing site near the Atlanta airport Sept. 11 after conducting almost 17,000 tests, citing a lack of demand. Experts say opening these sorts of testing sites does little to help residents who have trouble accessing tests. This includes residents who might not have a car or other means to go to local health departments.
Experts recommend state health officials partner with communities for more neighborhood-level testing. This would be part of a more proactive approach to identifying potential outbreaks as opposed to responding to a situation once it’s already bad.
“One of the things we’ve consistently failed to do is put into place testing at the community and neighborhood level that is accessible, especially to those people at greatest risk,” said Dr. Harry J. Heiman, a clinical associate professor at Georgia State University’s School of Public Health. “Think about essential workers who don’t have a car and are working.”
Where are other areas of concern for Georgia?
Aside from testing, several pandemic data points continue to concern public health experts, including the high rate of deaths as well as concerns over school reopenings and Labor Day weekend.
The state’s current coronavirus conditions are like “a forest fire that’s 25% controlled” — one that could gather strength again if conditions allow, Heiman said.
“That’s a positive trend,” he said of the state’s recent decline in cases and hospitalizations. “But by the way, we expect high winds and drier temperatures over the next several weeks … And when I talk about warm temperatures and high winds, I’m talking about school reopenings … and things that we know are going to make this worse.”
Deaths remain high. Georgia reported 323 coronavirus deaths during the week of Sept. 5-11, a 29% decrease from the week before, according to the most recent White House coronavirus task force.
Over the last seven days, Georgia has reported roughly 2.7 deaths per 100,000 people. It’s the 10th-highest rate in the nation, the New York Times reports.
“Cases are decreasing but we remain in a precarious position,” said Dr. Melanie Thompson, a practicing physician and principal investigator of the AIDS Research Consortium of Atlanta. “Our case rate is two to three times higher than before the mid-June surge and hospital capacity has improved but we have less reserve now than then, especially outside of metro Atlanta.”
The most recent recommendations from the White House coronavirus task force have centered around efforts to prevent college and university students from spreading the virus to outlying communities. Some of those measures include routine testing with quick results and strict mask-wearing.
“We are seeing gains being reversed in other states due to university spread,” the task force report reads. “Georgia universities need to increase testing and isolation to prevent spread from students to local communities and hometowns.”
Some Georgia universities are already dealing with outbreaks. Some schools do extensive testing of students and publish detailed information about rates of infection. Others share little or no information about self-reported coronavirus cases, reports Georgia Public Broadcasting and the Georgia News Lab.
The University of Georgia had 1,417 positive coronavirus tests between Aug. 31 and Sept. 4, Georgia Health News reports. Of those, 1,402 were students. Those numbers dropped in a more recent report, according to university officials. From Sept. 7-13, 421 new positive tests were reported, a decrease of more than 70%.
Athens has seen a spike in positive COVID-19 cases since late August. The New York Times reports the Athens metro area has reported the fifth most daily COVID-19 cases per 100,000 people over the last week nationwide. Statesboro, home to Georgia Southern University, is 13th on the list.
“Those are things that in the face of this high of a level of COVID-19 in a community predictably will not only cause the outbreaks we are seeing schools and universities but then those outbreaks will be brought from children and university students back to their homes (and) back to older and more vulnerable people,” Heiman said.
Data published by the Georgia Department of Public Health in its “School-Aged COVID-19 Surveillance Report” shows cases per 100,000 people in the 18-22 age range previously surged. Case rates nearly doubled from around 250 to 500 per 100,000 people over the course of roughly two weeks to the end of August, the latest date for data in the report.
Confirmed infections among school-age children rose in late July but were decreasing as of Aug. 31. Test positivity rates among all those age groups were above the recommended 5% threshold.
State health department data published elsewhere on its website shows September case numbers are decreasing for all age groups. However, some larger school districts, such as Columbus’ Muscogee County, have just returned to in-person instruction.
Toomey, the state’s health commissioner, said earlier this month that state officials are in constant contact with school districts and university officials regarding COVID-19. Young students could spread the disease to communities.
From Sept. 6-12, the state identified 93 outbreaks, 39 of which occurred in Georgia schools, according to a state health department news release.
“Though (young people) themselves might not be at high risk for serious disease, we’ve already seen students coming home and infecting their parents who may be at higher risk,” she said.
Labor Day gatherings could also be a potential source of future spikes in the coming weeks. A report authored by Schmidtke and reported on by the Atlanta Journal-Constitution linked Georgia’s summer coronavirus surge to travel and gatherings over the Memorial Day weekend and a failure to wear masks and socially distance.
“The report really just helps us to see the painful consequences of not taking this virus seriously,” she said. “While cases and hospitalizations are trending downward, we still haven’t returned to our pre-Memorial Day levels. So our momentum could turn very quickly if we aren’t careful.”
What could keep progress going?
Schmidtke, Thompson and others said Georgia leaders could implement further coronavirus restrictions recommended by the White House in an effort to more aggressively stop the virus’ spread.
Previous recommendations included the closure of bars, nightclubs and other close-contact venues where mask use and social distancing isn’t possible as well as a statewide mask mandate. The most recent recommendations from the task force ask state leaders to consider a further reduction in occupancy limits and hours of operation for bars and restaurants in college towns and places where students might gather. Social gatherings for students and residents should be limited to 15 or fewer people.
“Bars and clubs should be closed and indoor restaurant dining banned in college settings where cases are rising as well as in red zone counties,” Thompson said. “I get it that bars are part of the college experience, but COVID shouldn’t be. Keeping gatherings to 10 people or less in red zone counties should be mandated.”
Kemp extended existing coronavirus restrictions through the end of September with his latest executive order. Businesses and other entities must adhere to sanitation, distancing and other safety-related guidelines.
Local governments can continue to enforce local mask mandates provided their county reports more than 100 cases per 100,000 residents over a two-week period. Georgia’s gather limit remains at 50 people unless social distancing is practiced. Kemp’s latest order also paves the way for in-person visits at nursing homes and long-term care facilities across the state, provided certain public health guidelines are met.
When asked earlier this month why Georgia didn’t implement some of the White House’s earlier recommendations, Toomey said Georgia’s current restrictions aren’t being enforced throughout the state.
“When I hear there have been weddings with 150 people, someone is ignoring those guidelines,” she said. “We can make recommendations but if they are not being followed, it’s hard to have that impact that we could with that executive order.”
While Kemp and state leaders may not implement more stringent recommendations, local governments and Georgia residents can take some actions to stop the spread of COVID-19, Schmidtke said.
“I don’t know that this is the right time for optimism. I think this is the right time for identifying the problems and correcting them,” she said. “When people hear that things are getting better, they take risks that they otherwise wouldn’t. Maybe they don’t wear a mask the next time they go to an event. ...We can’t let off the gas right now.
“We need to be aware of how fragile our current situation is, and it can turn the other direction very fast.”
This story was originally published September 17, 2020 at 11:36 AM with the headline "Where does Georgia go from here? COVID-19 data improving, but risk for surge remains."