There is a lot of information about COVID-19, and it is presented by government agencies in a lot of different ways.
Just take perhaps the simplest piece of information: COVID-19 cases. The Georgia Department of Public Health is reporting cumulative cases since the pandemic started, cases over the last two weeks, cases by day, cases per 100,000 residents, cases by the date they were reported, cases by the date that a person first showed symptoms. Not to mention the various ways the agency reports and displays data about testing, hospitalizations, and deaths.
All this information is being used by local and state governments, schools, businesses, and ordinary people to make decisions about how best to live during the pandemic.
Dr. Amber Schmidtke recognized that regular Georgians might struggle to make sense of all the information. She also knew that public health officials, suddenly put in the spotlight to explain the pandemic, default to speaking in specific and complicated terms that might confuse the public.
Schmidtke lives in Houston County, just south of Macon, and is a member of the state’s task force for COVID-19 data management, which gives her access to the most updated information about how the pandemic is playing out across the state. Schmidtke has been using much of that data, and her background in public health and teaching in higher education, to help Georgia residents make sense of the pandemic through her Facebook account (with nearly 12,000 followers now) and email newsletter. She recently started a podcast, too, called “Public Health for the People.”
“I’m happy to be that bridge,” Schmidtke said.
On a daily basis, Schmidtke has a pulse on the state of the pandemic in counties across Georgia, from Glynn on the coast to Whitfield near Tennessee and everywhere in between.
So what about Forsyth County?
The Forsyth County News spoke with Schmidtke, who provided a snapshot of what the numbers say about COVID-19 in Forsyth County.
What numbers matter?
While the amount of COVID-19 data can be bewildering, it’s necessary to better understand the current state of the pandemic, Schmidtke said.
“You can’t look at just one metric alone,” she said. “It needs to be a combination of multiple things.”
Overall, Schmidtke has narrowed her focus to a set of data points to understand how the pandemic is playing out on a local, state, and national level:
● Case positivity rate;
● 14-day rates of disease for cases;
● Current hospitalization rate;
● New hospitalization rate;
Schmidtke also has a few rules that she follows.
First, she prefers looking at recent trends in the data -- like the last 14 days -- rather than cumulative totals, which aren’t as useful to making decisions today four months into the pandemic.
Second, for some data points, like cases, it’s more insightful to adjust for population to compare the state of the pandemic from one county to another.
Schmidtke also notes important caveats to some of the most noteworthy data reported by state agencies:
● The reporting of almost everything -- cases, hospitalizations, deaths -- is delayed. Deaths have the longest lag in reporting;
● The number of deaths from COVID-19 is likely higher than the number reported by the DPH, Schmidtke said, which is true with many infectious diseases;
● Hospitalizations reported by the DPH and Georgia Emergency Management and Homeland Security Agency (GEMA) are strictly related to COVID-19, but data about bed capacity and ventilator usage in hospitals is not.
Case positivity rate
What it is: The percentage of people who test positive for the virus.
Why it’s important: The case positivity rate is an indicator of how well a state is testing for the virus and whether the virus is being contained.
Forsyth County: 13.9% (July 17-23), according to data provided by the DPH to the Forsyth County News. That’s well above the 5% threshold set by the World Health Organization for communities to successfully contain the virus. The week before, from July 7-16, it was 12.6%.
Forsyth County is right in line with Georgia as a whole, according to Schmidtke. After hovering around 5% in June, Georgia has been around 12%-13% more recently, she said.
When case positivity rates are higher than 5%, it means not enough tests are being conducted to catch asymptomatic carriers, who could potentially spread the virus in a community.
Georgia has also been plagued by long delays at specimen collection sites and in laboratories conducting the tests. Schmidtke said there is a nationwide shortage of the chemicals used in the test kits, which is leading to people waiting two to three weeks for their test results.
“It’s rough,” Schmidtke said.
14-day rates of disease for cases
What it is: The percent increase in confirmed cases over a 14-day time period.
Why it’s important: The percent increase provides a clearer picture of the virus’s recent history of transmission.
Forsyth County: 36.9%, as of Thursday, July 30.
When combined with Forsyth County’s case rate of 189 per 100,000 residents, Schmidtke said the county “is in relatively good shape right now” when compared to counties across Georgia.
For instance, Evans County, in southeast Georgia, has seen a 180% increase over the last two weeks.
And here’s how Forsyth County’s case rate, as of Thursday, compares to bordering counties:
● Hall -- 536.5
● Gwinnett -- 418.6
● Fulton -- 417.4
● Cherokee -- 267.4
● Dawson -- 266.5
● Forsyth -- 189.3
Still, Schmidtke cautions Forsyth County residents from getting comfortable.
“That is not to say that people should go out and have barbecues together,” Schmidtke said. “Please don’t.”
A lower case rate, closer to 20%, would help local hospitals maintain adequate capacity for COVID-19 patients and make the virus easier to track and contain, she said.
Current hospitalization rate
What it is: The rate of people currently in the hospital with COVID-19.
Why it’s important: Current hospitalization rate reveals the length of hospital stays for patients with COVID-19.
Forsyth County: Current hospitalizations are only reported on the state level, though some local hospitals are reporting their own data.
Gainesville-based Northeast Georgia Medical Center reported that it had 176 confirmed patients with COVID-19 between its four hospitals and long-term care facility on Friday, July 31, including 107 at its Gainesville location, while 81 patients were still awaiting test results.
Just across the border in Fulton County, Emory Johns Creek hospital updates a graph showing current COVID-19 hospitalizations, along with the number of patients discharged after recovering from the disease.
Northside Hospital Forsyth has declined repeated requests by the Forsyth County News to provide information about its COVID-19 numbers; Northside officials say doing so might discourage residents with other health complications from seeking help.
Schmidtke said it’s helpful for hospitals to be transparent about their COVID-19 patient burden. Regular communication from Phoebe Putney Memorial Hospital, in Albany, the area of one of Georgia’s earliest COVID-19 hotspots, helped that community understand the seriousness of the pandemic and adjust its behavior. It is now considered a relatively cold spot, Schmitke said.
There are times when a hospital shouldn’t be transparent, Schmidtke said, particularly if doing so would violate HIPAA privacy laws.
“I think there are ways to [be transparent],” Schmidtke said, “to communicate to the public what the burden is for your community but also reassure them that we are here … we don’t want anybody to suffer at home through something that a hospital could help with.”
New hospitalization rate
What it is: The rate of new hospital admissions due to COVID-19.
Why it’s important: New hospitalization rate hints at the potential strain on hospitals from an influx of patients.
Forsyth County: The DPH has been reporting cumulative hospitalizations by county since April 27, making it possible to track the rate of new hospital admissions.
Forsyth County saw a 31.2% increase in hospitalizations, as of Thursday, July 30, over the past 14 days.
Without information from Northside Hospital Forsyth, it’s impossible to know how much strain those new hospitalizations have had on Northside’s critical care and ICU bed capacities, which are the ones needed for the most severe COVID-19 cases, or ventilator usage.
GEMA has been reporting hospital bed capacity on a regional level. Forsyth County is in Region D, along with seven other counties, including Fulton, Gwinnett, and DeKalb. The region tends to have a lot of capacity, Schmidtke said. On Friday, GEMA reported that 84.3% of Region D’s 1,198 critical care beds were in use, which was lower than the overall state number.
“But we don’t want to push those limits,” Schmidtke said.
What is it: The number of people who have died due to COVID-19.
Why it’s important: Schmidtke says deaths are the ultimate indicator of “the severity of the pandemic.”
Forsyth County: 19 cumulative, as of Friday, July 31, or 7.5 deaths per 100,000.
While remembering that the reporting of deaths is delayed, and the number overall is likely undercounted, Schmidtke said Forsyth County is doing “fairly well,” especially when compared to bordering counties:
● Hall -- 37.3
● Fulton -- 35.4
● Gwinnett -- 24.5
● Cherokee -- 20.3
● Forsyth -- 7.5
● Dawson -- N/A
Forsyth County’s relatively lower death toll likely means the community has a better general level of health in the first place, Schmidtke said, but also greater access to “more robust health care,” which helps create better outcomes in more severe COVID-19 cases.
“I hesitate to say Forsyth County’s in great shape so they can go back to doing whatever they were doing,” Schmidtke said. “They’re doing great, and they need to stay the course because we really need to knock transmission down to a level that we can adequately cope and track.”
Two things about the future of the pandemic worries Schmidtke.
The first is school. Georgia did not take the necessary steps to lower COVID-19 transmission enough to safely open schools, she said. Instead, outbreaks are likely to occur in schools and parents should have plans in place for when their child’s school closes.
“Don’t go into this thinking your kid is going to be in school from now until the winter holidays,” she said. “It’s very unlikely.”
The second is the cold and flu season. People can be infected with more than one thing at a time, like the common cold or influenza and COVID-19, which have similar symptoms.
Schmidtke says “we need this to be the very best year we’ve ever had with influenza vaccines.”
People should stay home if they have cold- or flu-like symptoms “because you could just as easily be transmitting COVID,” Schmidtke said. Same goes for sending kids to school, she said. Regardless, Schmidtke expects the pandemic to surge again during the cold and flu season.