The stats for COVID in Texas for the last two weeks (ending November 14) continued to rise in most parts of the State, but  north Texas and El Paso are still suffering the most serious outbreaks.

Hospitalizations

Total hospitalizations and ICU bed usage continued their upward trend in the last two weeks, but somewhat less sharply than in the previous two weeks.  Total hospitalizations rose from 5,685 to 7.151 (+26%).  However, about a quarter of the increase came in a single day (November 11) in the DFW region, when hospitalization jumped by 315.  When you see this type of change that is this far outside the norm, it generally indicates some problem with the data or reporting.  I have not been able to find anything that explains this large single day increase, but I suspect they discovered there were beds they had not been previously counting.  Incidentally, DFW’s ICU bed usage did not show that kind of spike. My guess is that the actual increase for the week was more like 20%.  That would be more in line with ICU bed useage which was up by 21% for the two-week period (1,631→1,976).

One silver lining is that it appears hospitalizations in El Paso may have peaked.  They only rose 9% over the last two weeks and actually have declined for the last three days.   Interestingly, the other two large border regions (Valley and Laredo) have remained very quiet with hospitalizations at relatively low level and no increase.  There is some nascent sign of trouble in San Antonio and Austin where ICU bed usage increased sharply, albeit from fairly low levels.

Houston’s hospitalizations and ICUs increased by 10% and 16%, respectively, but again from fairly low levels.  Both are still down ~70% from their July highs.  However, there has been a more rapid increase in the last few days.

Fatalities

Average daily reported fatalities rose from 74 to 103.  That is about 40% of the high back in July when fatalities hit 278 per day.

For context, normally about 600 Texans die each day during this time of the year.  So, the reported COVID fatalities are about 20% of what is typical.

The 30-day lagging case fatality rate is still running about 2% but swings wildly from day to day.  I have begun running an analysis of the ratio between hospitalizations and ICU occupancies and fatalities.  In my view the case fatality rate is fundamentally flawed because the denominator (i.e., cases) is so unreliable.  As a result the case fatality has not been a good predictor of future fatalities.  It appears to me that the current hospitalizations and ICU numbers are suggesting that we are probably looking at 110-120 fatalities per day on average over the next couple of weeks.  We will need to see the hospitalization numbers improve before we see fatalities begin to come back down.

Testing Results

Daily test results for the two-week period increased again, this time by about 22% from the previous two weeks.  Positive results increased by 37%, suggesting that about two-thirds of the increase came from additional testing and about one-third from rising cases.  Generally, the increase in positive test results came from the same areas where hospitalizations increased.  The positivity rate based on the daily reports rose from 8.4% to 9.4%.

To reiterate once again, I have little confidence in test results as a reliable indicator and they clearly do not equate to “new cases.”  The numbers on a daily basis were all over the map.  Testing results continue to come in from previous periods and there are few standards to rationalize for false positive or false negatives or the same person being tested on multiple occasions.  At best, the test results are a very rough indication of the spread of the virus.

Conclusion

As I have related on many occasions, hospitalizations is the key metric to keep an eye on.  There was a very slight hint in the last couple of days hospitalizations might be easing.  Let’s keep our fingers crossed they do.