COVID-19: Breaking Down The Numbers

By: Alan Pollock

Topics: COVID-19

New COVID-19 cases in Barnstable County, shown for three-day periods.  BARNSTABLE COUNTY / VAIRA HARIK

At noon on Monday, church bells on the Lower Cape and around the country pealed for 17 minutes to mark a somber occasion. The nation’s death toll from COVID-19 has topped 100,000 people.

“Not a good milestone to make,” Chatham Health and Natural Resources Director Robert Duncanson said. By Monday evening, the national death toll had already reached 104,799. The statistics are at once alarming and numbing, but they reveal some important trends.

First, remember that case numbers are cumulative, and don’t go down. In Barnstable County, the number of confirmed cases is 1,424, but the vast majority of those people have recovered, county Health and Environment Director Sean O’Brien said. Across the state, the case numbers jumped Monday, but not owing to any change in infection rates. Starting Monday, the Massachusetts Department of Public Health began including both confirmed and probable COVID-19 cases and deaths, to keep with CDC reporting guidance. Monday’s newly reported totals are a result of a retrospective review of probable cases and deaths dating back to March 1. The figures also show people who have tested positive based on antibody tests, which show if they had the illness in the past.

On Cape Cod, that meant a spike of 112 new cases, bringing the total to 1,424. That anomaly aside, the number of new cases in Barnstable County has been reliably below 20, and has been below 10 on several days.

Statewide, the three-day rolling average of COVID-19 hospitalizations has been sloping down steadily for the last month, dropping almost 50 percent since the start of May.

“That’s a really good sign that things are waning and changing,” O’Brien said. The state also tracks the number of COVID patients who are admitted to intensive care or who are intubated to help with their breathing, and those trends follow a similar trajectory. As of Monday, there were seven COVID patients at Cape Cod Hospital, two of whom were in intensive care.

“We’re on the back end of this,” he said.

In Chatham, the cumulative number of known cases is 15, Health and Natural Resources Director Robert Duncanson said Monday. “Most of those cases have now cleared or recovered,” he said. The number of active cases in town is now three or four, and the town has one death registered from COVID-19. In Orleans, the latest available data showed 15 cases with no deaths.

Harwich has a much higher cumulative case count of 121, with 22 related deaths, Health Director Meggan Eldredge reported. But it’s not simply because Harwich has more residents than Chatham or Orleans.

“Seventy-one of the...cases are associated with staff and residents at the Wingate Assisted Living Facility,” she reported. Of the 50 cases outside of Wingate, 31 have recovered and four have died. The other 12 to 15 active cases are people who are in isolation and are being monitored by visiting nurses. Of them, four active cases are associated with other long-term care facilities in town.

In mapping the strategy to reopen the state’s economy, Gov. Charlie Baker monitors five different metrics, rating each one with red, yellow or green traffic signals to show progress. Two of those measurements, the COVID positive test rate and the state’s testing capacity, are marked green for positive trends. The three other metrics are the death rate, the hospitalization rate, and the state’s capacity to conduct contact tracing; all of these are marked yellow for “in progress.” None of the metrics show a negative trend. If progress slips in any of the five areas, the next phase of the state’s reopening plan will be delayed.

Public health officials all agree, however, that there’s a single effective strategy for keeping all these numbers trending positive, and it’s a message they’ve been sharing from the beginning.

“We continue to stress the importance of social distancing, hand-washing and monitoring your health as effective ways to remain safe and healthy during this pandemic,” Eldredge said. Despite the positive trends, public health officials believe that the vast majority of people, perhaps 80 percent, avoided infection by social distancing. That means it wouldn’t be hard for the novel coronavirus to get a new toe-hold for a second round of COVID-19, possibly in the fall when people begin to congregate indoors again.

But speaking on CNN last week, White House Health Advisor Dr. Anthony Fauci said the second wave of the illness is not inevitable, provided that the nation continues to expand its testing capacity and people take personal responsibility for controlling the spread of the illness.

“Don’t start leapfrogging over the recommendations of some of the guidelines because that’s really tempting fate and asking for trouble,” he said.

And while Barnstable County is creating a small stockpile of personal protective equipment for Cape towns just in case there is a second wave of COVID-19 in the fall, O’Brien sees reason for optimism.

“It’s very interesting to look at all these numbers and where we’ve been at for all these months,” he said. The pandemic came to a clear peak as predicted, “and now we’re climbing down.” Preventing a second peak means continuing to wash hands, wear masks, stay home when sick, and stay six feet away from others.

“If we can continue that for a little while more, I think as a county and as a Cape, we’ll be in good shape,” he said.