GEORGIA STATE REPORT 08.30.2020 SUMMARY • • • • • • • • • Georgia is in the red zone for cases, indicating more than 100 new cases per 100,000 population last week, with the 7th highest rate in the country. Georgia is in the yellow zone for test positivity, indicating a rate between 5% and 10%, with the 18th highest rate in the country. Georgia has seen a decrease in new cases and stability in test positivity over the last week, demonstrating continued week-over-week progress. With continued aggressive mitigation and prevention of spread from universities to local communities, progress should continue and mortality should begin to decrease. The following three counties had the highest number of new cases over the last 3 weeks: 1. Fulton County, 2. Gwinnett County, and 3. Cobb County. These counties represent 23.6% of new cases in Georgia. 82% of all counties in Georgia have ongoing community transmission (yellow or red zone), with 45% having high levels of community transmission (red zone), demonstrating the need for continued mitigation. Nearly 30% of all nursing homes in Georgia had one or more staff newly diagnosed with COVID in the last week; 3.9% of nursing homes are reporting 3 or more new COVID-19 cases among residents per week over the last 3 weeks. Georgia had 148 new cases per 100,000 population in the last week, compared to a national average of 88 per 100,000. Current staff deployed from the federal government as assets to support the state response are: 62 to support operations activities from FEMA; 10 to support operations activities from ASPR; 21 to support epidemiology activities from CDC; 1 to support operations activities from USCG; and 1 to support operations activities from VA. The federal government has supported a surge testing site in Atlanta, GA. Between Aug 22 - Aug 28, on average, 210 patients with confirmed COVID-19 and 339 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Georgia. An average of 83% of hospitals reported either new confirmed or new suspected COVID patients each day during this period; therefore, this may be an underestimate of the actual total number of COVID-related hospitalizations. Underreporting may lead to a lower allocation of critical supplies.* RECOMMENDATIONS • • • • • • • • • • • • • • • • • Ensure both diagnostic and surveillance testing are rapid and comprehensive at all universities with students on campus. Expand testing support to Historically Black Colleges and Universities that may have limited testing capacity. Require all universities with RNA detection platforms to use this equipment to expand surveillance testing for schools (K-12, community colleges) universities and to support testing in communities surrounding universities. University students should have quarantine and care sites on campus or near campus and not be returned home to multigenerational households, where additional transmission could occur. Ensure all universities can fully test, isolate, and contact trace. Ensure all nursing homes, assisted living, and elderly care sites have full testing capacity in all towns with university students so staff can be aggressively tested weekly to prevent spread from students to residents through staff. Expand the protection of those in nursing home, assisted living, and long-term care facilities by ensuring access to rapid facility-wide testing in response to a resident or staff member with COVID-19, with the isolation of all positive staff and residents. Ensure social distancing and universal facemask use. Immediately conduct infection control surveys in all nursing homes with 3 or more new cases in the last week. Antigen testing capacity will continue to be supplied over the next 4-6 weeks to support routine LTCF testing from the Federal Government. In red zone counties, close all establishments where social distancing and mask use cannot occur, such as bars, nightclubs, and entertainment venues. Further limit to indoor dining to less than 25% occupancy and expand outdoor dining. Ask every citizen to limit social gatherings to 10 or fewer people and ensure proactive communication about the risks of gatherings over Labor Day. Increase messaging of the risk of serious disease for individuals in all age groups for individuals with preexisting medical conditions, including obesity, hypertension, and diabetes mellitus. Continue the scale-up of testing, moving to community-led neighborhood testing. Work with local communities to implement and provide clear guidance for households that test positive, including on individual isolation and quarantining procedures. Continue to enhance contact tracing and ensure the ability of cases and contacts to quarantine or isolate safely. Ensure every public health lab is fully staffed and running 24/7 and utilizing all platforms to reduce turnaround times. Institute 2:1 pooling of specimens on all high throughput machines as long as turnaround times are greater than 36 hours. Ensure all hospital testing capacity is being fully utilized to support additional community, nursing home, and school (K-12) testing as ER visits and hospital admissions decline and additional testing capacity is available. Specific, detailed guidance on community mitigation measures can be found on the CDC website. The purpose of this report is to develop a shared understanding of the current status of the pandemic at the national, regional, state and local levels. We recognize that data at the state level may differ from that available at the federal level. Our objective is to use consistent data sources and methods that allow for comparisons to be made across localities. We appreciate your continued support in identifying data discrepancies and improving data completeness and sharing across systems. We look forward to your feedback. * Psychological, rehabilitation, and religious non-medical hospitals were excluded from analyses. In addition, hospitals explicitly identified by states/regions as those from which we should not expect reports were excluded from the percent reporting figure. This value may differ from those in state databases because of differences in hospital lists and reporting processes between federal and state systems. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Continued feedback on improving these data is welcome. COVID-19 COVID-19 GEORGIA STATE REPORT 08.30.2020 STATE, LAST WEEK STATE, % CHANGE FROM PREVIOUS WEEK FEMA/HHS REGION, LAST WEEK UNITED STATES, LAST WEEK NEW COVID-19 CASES (RATE PER 100,000) 15,751 (148) -11.2% 82,967 (124) 288,743 (88) VIRAL (RT-PCR) LAB TEST POSITIVITY RATE 8.3% -0.5%* 8.5% 5.4% 126,970** (1,196) -9.7%** 921,457** (1,377) 5,305,529** (1,616) 477 (4) +13.0% 2,144 (3) 6,615 (2) 22.5% (29.2%) -1.5%* (-2.7%*) 22.2% (32.8%) 10.7% (18.6%) 10.7% +0.2%* 9.8% 5.0% TOTAL VIRAL (RT-PCR) LAB TESTS (TESTS PER 100,000) COVID-19 DEATHS (RATE PER 100,000) SNFs WITH ≥1 NEW RESIDENT COVID-19 CASE (≥1 NEW STAFF CASE) MOBILITY SNFs WITH ≥1 NEW RESIDENT COVID-19 DEATH * Indicates absolute change in percentage points. ** Due to delayed reporting, this figure may underestimate total diagnostic tests and week-on-week changes in diagnostic tests. DATA SOURCES – Additional data details available under METHODS Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through 8/28/2020; last week is 8/22 - 8/28, previous week is 8/15 - 8/21. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 8/26/2020. Last week is 8/20 - 8/26, previous week is 8/13 8/19. Mobility: Descartes Labs. This data depicts the median distance moved across a collection of mobile devices to estimate the level of human mobility within a county. The 100% represents the baseline mobility level prior to the pandemic; lower percent mobility indicates less population movement. Data is anonymized and provided at the county level. Data through 8/27/2020. SNFs: Skilled nursing facilities. National Healthcare Safety Network. Data are reported separately for cases among residents and staff. Last week is 8/10-8/16, previous week is 8/17-8/23. COVID-19 GEORGIA STATE REPORT 08.30.2020 COVID-19 COUNTY AND METRO ALERTS* Top 12 shown in table (full lists below) LOCALITIES IN RED ZONE METRO AREA (CBSA) LAST WEEK COUNTY LAST WEEK 19 72 Augusta-Richmond County Macon-Bibb County Savannah Warner Robins Dalton Milledgeville Dublin Statesboro Cedartown Douglas Vidalia Thomasville Bibb Richmond Chatham Henry Columbia Clarke Coweta Paulding Baldwin Bartow Bulloch Whitfield LOCALITIES IN YELLOW ZONE 20 Atlanta-Sandy Springs-Alpharetta Gainesville Columbus Athens-Clarke County Rome Brunswick Chattanooga Albany Valdosta Jefferson Calhoun Waycross 58 Fulton Gwinnett Cobb DeKalb Hall Clayton Cherokee Forsyth Muscogee Floyd Houston Douglas All Red CBSAs: Augusta-Richmond County, Macon-Bibb County, Savannah, Warner Robins, Dalton, Milledgeville, Dublin, Statesboro, Cedartown, Douglas, Vidalia, Thomasville, Summerville, Jesup, Bainbridge, Fitzgerald, Toccoa, Tifton, Cordele All Yellow CBSAs: Atlanta-Sandy Springs-Alpharetta, Gainesville, Columbus, Athens-Clarke County, Rome, Brunswick, Chattanooga, Albany, Valdosta, Jefferson, Calhoun, Waycross, LaGrange, Hinesville, St. Marys, Moultrie, Cornelia, Thomaston, Americus, Eufaula All Red Counties: Bibb, Richmond, Chatham, Henry, Columbia, Clarke, Coweta, Paulding, Baldwin, Bartow, Bulloch, Whitfield, Barrow, Laurens, Polk, Coffee, Toombs, Effingham, Thomas, Chattooga, Emanuel, Appling, Catoosa, Wayne, Liberty, Decatur, Ben Hill, Stephens, Peach, Jeff Davis, Burke, Tattnall, McDuffie, Tift, Grady, Jefferson, Morgan, Jones, Madison, Monroe, Franklin, Greene, Evans, Haralson, Hart, Pulaski, Banks, Dodge, Seminole, Clinch, Screven, Crisp, Treutlen, Bacon, Wilkinson, Candler, Brooks, Miller, Butts, Johnson, Towns, Montgomery, Jenkins, Lincoln, Twiggs, Wheeler, Taylor, Early, Hancock, Crawford, Randolph, Wilcox All Yellow Counties: Fulton, Gwinnett, Cobb, DeKalb, Hall, Clayton, Cherokee, Forsyth, Muscogee, Floyd, Houston, Douglas, Glynn, Newton, Fayette, Carroll, Jackson, Walton, Rockdale, Chattahoochee, Lumpkin, Gordon, Lowndes, Troup, Dougherty, Dawson, Camden, Spalding, Bryan, Colquitt, Putnam, Habersham, Gilmer, Bleckley, Washington, Pickens, Charlton, Upson, Lee, Murray, Pierce, Oconee, Sumter, Elbert, Meriwether, Stewart, Berrien, Atkinson, Cook, Harris, McIntosh, Pike, Dade, Brantley, Mitchell, Worth, Heard, Macon * Localities with fewer than 10 cases last week have been excluded from these alerts. Red Zone: Those core-based statistical areas (CBSAs) and counties that during the last week reported both new cases above 100 per 100,000 population, and lab test positivity result above 10%. Yellow Zone: Those CBSAs and counties that during the last week reported both new cases between 10-100 per 100,000 population, and a lab test positivity result between 5-10%, or one of those two conditions and one condition qualifying as being in the “Red Zone.” Note: Lists of red and yellow localities are sorted by the number of new cases in the last 3 weeks, from highest to lowest. Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. DATA SOURCES – Additional data details available under METHODS Cases and Deaths: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through 8/28/2020; last week is 8/22 - 8/28, three weeks is 8/8 - 8/28. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 8/26/2020. Last week is 8/20 - 8/26. POLICY RECOMMENDATIONS FOR COUNTIES IN THE RED ZONE Public Messaging • Wear a mask at all times outside the home and maintain physical distance • Limit social gatherings to 10 people or fewer • Do not go to bars, nightclubs, or gyms • Use take out or eat outdoors socially distanced • Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene, including handwashing and cleaning surfaces • Reduce your public interactions and activities to 25% of your normal activity Public Officials • Close bars and gyms, and create outdoor dining opportunities with pedestrian areas • Limit social gatherings to 10 people or fewer • Institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors • Ensure that all business retailers and personal services require masks and can safely social distance • Increase messaging on the risk of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place • Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing • Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours • Provide isolation facilities outside of households if COVID-positive individuals can’t quarantine successfully Testing • Move to community-led neighborhood testing and work with local community groups to increase access to testing • Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates • Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 2-3 individuals in high incidence settings and 5:1 pools in setting where test positivity is under 10% • Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device POLICY RECOMMENDATIONS FOR COUNTIES IN THE YELLOW ZONE IN ORDER TO PREEMPT EXPONENTIAL COMMUNITY SPREAD Public Messaging • Wear a mask at all times outside the home and maintain physical distance • Limit social gatherings to 25 people or fewer • Do not go to bars or nightclubs • Use take out, outdoor dining or indoor dining when strict social distancing can be maintained • Protect anyone with serious medical conditions at home by social distancing at home and using high levels of personal hygiene • Reduce your public interactions and activities to 50% of your normal activity Public Officials • Limit gyms to 25% occupancy and close bars until percent positive rates are under 3%; create outdoor dining opportunities with pedestrian areas • Limit social gatherings to 25 people or fewer • Institute routine weekly testing of all workers in assisted living and long-term care facilities. Require masks for all staff and prohibit visitors • Ensure that all business retailers and personal services require masks and can safely social distance • Increase messaging on the risk of serious disease for individuals in all age groups with preexisting obesity, hypertension, and diabetes mellitus, and recommend to shelter in place • Work with local community groups to provide targeted, tailored messaging to communities with high case rates, and increase community level testing • Recruit more contact tracers as community outreach workers to ensure all cases are contacted and all positive households are individually tested within 24 hours • Provide isolation facilities outside of households if COVID-positive individuals can’t quarantine successfully Testing • Move to community-led neighborhood testing and work with local community groups to increase access to testing • Surge testing and contact tracing resources to neighborhoods and zip codes with highest case rates • Diagnostic pooling: Laboratories should use pooling of samples to increase testing access and reduce turnaround times to under 12 hours. Consider pools of 3-5 individuals • Surveillance pooling: For family and cohabitating households, screen entire households in a single test by pooling specimens of all members into single collection device COVID-19 GEORGIA TESTING NEW CASES STATE REPORT 08.30.2020 TOP COUNTIES Top counties based on greatest number of new cases in last three weeks (8/8 - 8/28) DATA SOURCES – Additional data details available under METHODS Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. Cases: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through 8/28/2020. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 8/26/2020. COVID-19 TOTAL DAILY CASES Top 12 counties based on number of new cases in the last 3 weeks DATA SOURCES – Additional data details available under METHODS Cases: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through 8/28/2020. Last 3 weeks is 8/8 - 8/28. COVID-19 GEORGIA STATE REPORT 08.30.2020 CASE RATES AND DIAGNOSTIC VIRAL LAB TEST POSITIVITY DURING THE LAST WEEK NEW CASES PER 100,000 DURING LAST WEEK VIRAL (RT-PCR) LABORATORY TEST POSITIVITY DURING THE LAST WEEK WEEKLY % CHANGE IN NEW CASES PER 100K WEEKLY CHANGE IN VIRAL (RT-PCR) LABORATORY TEST POSITIVITY DATA SOURCES – Additional data details available under METHODS Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. Cases: State values are calculated by aggregating county-level data from USAFacts; therefore, the values may not match those reported directly by the state. Data is through 8/28/2020. Previous week is 8/15 - 8/21. Testing: CELR (COVID-19 Electronic Lab Reporting) state health department-reported data through 8/26/2020. Last week is 8/20 - 8/26, previous week is 8/13 - 8/19. COVID-19 National Picture NEW CASES PER 100,000 LAST WEEK VIRAL (RT-PCR) LAB TEST POSITIVITY LAST WEEK DATA SOURCES Note: Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. Cases: County-level data from USAFacts through 8/28/2020. Last week is 8/22 - 8/28. Testing: Combination of CELR (COVID-19 Electronic Lab Reporting) state health department-reported data and HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs) through 8/26/2020. Last week is 8/20 - 8/26. COVID-19 METHODS STATE REPORT 08.30.2020 COLOR THRESHOLDS: Results for each indicator should be taken in context of the findings for related indicators (e.g., changes in case incidence and testing volume) Metric Green Yellow Red <10 10-100 >100 <-10% -10% - 10% >10% <5% 5%-10% >10% Change in test positivity <-0.5% -0.5%-0.5% >0.5% Total diagnostic tests resulted per 100,000 population per week >1000 500-1000 <500 Percent change in tests per 100,000 population >10% -10% - 10% <-10% COVID-19 deaths per 100,000 population per week <1 1-2 >2 Percent change in deaths per 100,000 population <-10% -10% - 10% >10% 0% 0.1%-5% >5% <-0.5% -0.5%-0.5% >0.5% New cases per 100,000 population per week Percent change in new cases per 100,000 population Diagnostic test result positivity rate Skilled Nursing Facilities with at least one resident COVID-19 case, death Change in SNFs with at least one resident COVID-19 case, death DATA NOTES • Some dates may have incomplete data due to delays in reporting. Data may be backfilled over time, resulting in week-to-week changes. It is critical that states provide as up-to-date data as possible. • Cases and deaths: County-level data from USAFacts as of 12:30 EDT on 08/30/2020. State values are calculated by aggregating county-level data from USAFacts; therefore, values may not match those reported directly by the state. Data are reviewed on a daily basis against internal and verified external sources and, if needed, adjusted. Last week data are from 8/22 to 8/28; previous week data are from 8/15 to 8/21. • Testing: The data presented represent viral COVID-19 laboratory diagnostic and screening test (reverse transcription polymerase chain reaction, RT-PCR) results—not individual people—and exclude antibody and antigen tests. CELR (COVID-19 Electronic Lab Reporting) state health department-reported data are used to describe county-level viral COVID-19 laboratory test (RT-PCR) result totals when information is available on patients’ county of residence or healthcare providers’ practice location. HHS Protect laboratory data (provided directly to Federal Government from public health labs, hospital labs, and commercial labs) are used otherwise. Some states did not report on certain days, which may affect the total number of tests resulted and positivity rate values. Because the data are deidentified, total viral (RT-PCR) laboratory tests are the number of tests performed, not the number of individuals tested. Viral (RT-PCR) laboratory test positivity rate is the number of positive tests divided by the number of tests performed and resulted. Resulted tests are assigned to a timeframe based on this hierarchy of test-related dates: 1. test date; 2. result date; 3. specimen received date; 4. specimen collection date. Resulted tests are assigned to a county based on a hierarchy of testrelated locations: 1. patient residency; 2. provider facility location; 3. ordering facility location; 4. performing organization location. States may calculate test positivity other using other methods. Last week data are from 8/20 to 8/26; previous week data are from 8/13 to 8/19. HHS Protect data is recent as of 12:00 EDT on 08/30/2020. Testing data are inclusive of everything received and processed by the CELR system as of 19:00 EDT on 08/29/2020. • Mobility: Descartes Labs. These data depict the median distance moved across a collection of mobile devices to estimate the level of human mobility within a locality. The 100% represents the baseline mobility level prior to the pandemic; lower percent mobility indicates less population movement. Data is anonymized and provided at the locality level. Data is recent as of 13:00 EDT on 08/30/2020 and is through 8/27/2020. • Hospitalizations: Unified hospitalization dataset in HHS Protect. This figure may differ from state data due to differences in hospital lists and reporting between federal and state systems. These data exclude psychiatric, rehabilitation, and religious non-medical hospitals. In addition, hospitals explicitly identified by states/regions as those from which we should not expect reports were excluded from the percent reporting figure. The data presented represents raw data provided; we are working diligently with state liaisons to improve reporting consistency. Data is recent as of 15:00 EDT on 08/30/2020. • Skilled Nursing Facilities: National Healthcare Safety Network (NHSN). Data report resident and staff cases independently. Quality checks are performed on data submitted to the NHSN. Data that fail these quality checks or appear inconsistent with surveillance protocols may be excluded from analyses. Data presented in this report are more recent than data publicly posted by CMS. Last week is 8/10-8/16, previous week is 8/17-8/23.