Last October, the Tyler Loop wrote, “Is COVID-19 behind us? The numbers say otherwise.” As vaccinations go up and masks come off, we ask again,“Is COVID-19 behind us?” Again, the answer is,“The numbers say otherwise.”
A fair characterization of the numbers actually suggest that only the holiday surge is behind us and COVID-19 has gone back to spreading similarly to the fall. There may be some hope on the horizon, though.
In March, 2021, the City of Tyler had 163 extra deaths above the average for the past four years (2016-2019), bringing our total excess deaths since June 2020 to 1,004. March’s toll was about 50% higher than February’s 103 extra deaths.
Since June of 2020, data from the Local Registrar of the City of Tyler Vital Statistics Director reveals that deaths have been spiking far above normal.
Typically, there are 2,481 deaths between June and March. In the last year, there have been 3,485 — a difference of 1,004. Even not counting the average deaths, one out of every 232 Smith County residents has died since June 2020.
These are raw death numbers, simply reporting the number of deceased at hospitals and funeral homes within the City of Tyler. NET Health (Northeast Texas Public Health) reports only 290 deaths due to COVID-19, a significantly lower number.
To be included in NET Health’s count, someone generally must be diagnosed with a positive test result, go to the hospital, go to intensive care and ultimately succumb. Their death certificate will mention COVID-19 and they will show up in official COVID-19 statistics.
Two things seem to be driving the higher death numbers: undiagnosed cases and the uninsured. Many COVID-19 cases present asymptomatically or with symptoms that people don’t recognize at the time as COVID-19.
However, even if they do not require hospitalization, asymptomatic or atypical illnesses may make someone extremely ill. Some of these people with undiagnosed cases may be dying of related illnesses without being tested.
Secondly, Texas ranks last of all states in health coverage, with 18% uninsured, twice the national average. Tyler is even worse: it has a large healthcare system, but 21.7% of people are not able to access it.
These uninsured are more likely to not receive even nominally low cost or free care, such as COVID-19 testing and vaccines. It also makes it more likely that they will die of stress-related causes or delayed care for other diseases.
None of these deaths will appear in official statistics, but none of them would have occurred if not for the epidemic. It’s a deadly time to be without health insurance in Tyler.
Governor Abbot claims that we are “very close” to herd immunity. Herd immunity is defined as somewhere between 70% and 85% of the population either vaccinated or otherwise immune. Smith County is not even close.
About one in four adults in Smith County have been vaccinated; three in four have not. There are only 18,652 recovered COVID-19 cases. About half of those 65+ have been vaccinated; about half have not.
What about the data? Community Spread for Smith County, the 7-day average cases per 100K population, has declined from a January high of 95.3 all the way to a low of 7.49 at the end of March. Since then it has slowly creeped back into the “moderate” range.
After topping out at 22% in early January, COVID-19 hospitalizations have slowly declined to about 2-3%.
The decline is real, in a sense. The numbers hit a holiday surge high and then went back to levels similar to the fall of 2020. But COVID-19 didn’t go away. And it didn’t decline from where we were before the holidays.
Testing — and the lack thereof — is also contributing to the apparent decline. Tyler’s testing has been haphazard and sporadic, topping out in December at 558 tests per 100K population per day. Since then, testing has fallen to 50-100 tests per 100K population per day, similar to where Tyler was when the tests were in short supply.
But tests are no longer in short supply. They are now relatively widespread and appear easy to get, but they still depend on patients requesting one. Lack of systematic testing means we live with a widely asymptomatic, undercounted serious disease.
Still, there is hope for the next few months. Vaccines are becoming more widely available and daily vaccination numbers are increasing. Smith County is on track to achieve herd immunity around Thanksgiving.
If we can quickly get the other half of the elderly vaccinated, the death rate should start declining well before that. It is critical that people over 65 get the vaccine because they are the most likely to die from COVID-19.
The holidays and the February snowstorm provided interesting natural experiments. During the holidays, social distancing was widely disregarded and there was a massive surge. During the snowstorm, there was a weeklong quarantine due to weather, and cases fell rapidly afterwards.
Correlation is not causation, but both are strongly suggestive that the primary force driving the COVID-19 epidemic is our own actions at the county and personal level. Progress against COVID-19 is within our reach if we continue masking, social distancing and increase vaccinations.
Stephen Fierbaugh was lead IT Project Manager for a large hospital ship being built in China. He is director of informatics for The Tyler Loop. Now, he’s looking for new places to serve. Are these statistics helpful? Would you like to see similar information for your city or organization? Stephen has his Masters in Intercultural Studies with a focus on ICT4D (technology) and is PMI certified as a Project Management Professional (PMP). Check out his LinkedIn for more examples of his skills and experience.
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