Cases
Continuing vaccination efforts have continued the decline in cases since the mid-April mini-spike.   The 7-day average of new cases (145 per day) has reached the level achieved in Aug/Sep of 2020, which was our previous low point.   These new cases are primarily occurring within the remaining unvaccinated population.

Median Age of the infected

At the end of April, the median age of those infected   was   32.7 years old. Over the last seven days the average age has risen slightly to 33.8, and I expect this average age to increase as more children in the 12-16 age group are vaccinated.

Deaths
The number of deaths per day has held relatively steady at a reported 1.93 per day, (60 total) in May. (Compared to 2 per day in April.)   The summer peak (June 22nd 2020 to July 22nd, 2020)   had 6.97 average deaths per day (223 total deaths), so the number of deaths is around 25% of our worst month. Total reported COVID-19 deaths overall in Orange County   Florida is at 1309 as of June 1st 2021.

Percent Positivity
These numbers are significantly better than in April, with every day out of the last 14 under 5%, and 13 days under 4%.     Community spread is starting to be under control.

This is a significant improvement over the end of last month:

How many people have been vaccinated

The Florida department of health reports that as of May 27th 2021, 510,582 Orange County residents   (36.6% of the total population) have been fully vaccinated. Children under the age of 12 are not yet eligible for vaccination, but also have minimal direct health risks from catching covid-19 (other than the risk of transmission to others.)

The rate of vaccination uptake has slowed, large community vaccination sites are being shuttered and replaced by smaller pop-up clinics at targeted sites as well as distribution via local pharmacy’s.

Predictions for June:

I expect that daily case numbers will decline in June, hopefully going below 100-per day by the end of the month. Deaths are also likely to slowly reduce over time. My prediction would be between 30-45 deaths in June (1-1.5 per day).

[Charts/Numbers used can be found in this open document spreadsheet: orange_county_florida.ods   ]

Cases
Despite continued vaccination efforts, the small spike in cases in March continued into April, most likely due to new more contagious variants of the virus (B.1.1.7) and relaxing of social distancing by the population. It appears we reached the top of this peak mid-April as the the 7-day average of new cases (355 per day) is below the peak.   The number of new cases per day is still higher than Aug/Sep of 2020, which was our previous low point.

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In March of 2021, an outbreak of COVID-19 spread through a nursing home in Kentucky.   The “Skilled Nursing Facility” had 83 residents (assumed to be in the “older” demographic) and 116 Health Care Personal (HCP) [Which we will assume to generally fall in the “under 65” demographic].   They had all been offered the Pfizer-BioNTech mRNA vaccine.

75 residents (90.4%) and 61 HCP (52.6%) received two doses of the vaccine.

HCP at the nursing home were tested for SARS-CoV-2 twice weekly, so we have a good understanding of when the outbreak started and how it arrived in the facility.   After the outbreak was identified, residents were also tested daily with an antigen test.   The variant responsible (identified with whole genome sequencing) came from the R1 linage and had several spike protein mutations.

Overall, 26 residents and 20 HCP tested positive for a COVID-19 infection. 18 of those residents and 4 of those HCP had been fully vaccinated.

Lesson 1: Full vaccination does not offer 100% protection from infection, especially in the “older” demographic which may not mount a robust immune response.

Only 28 of these people showed symptoms, 8 of whom were vaccinated, and 20 of whom were un-vaccinated.] 18 people who tested positive did not show symptoms.

Lesson 2: Asymptomatic infections occur.

“Attack rates in unvaccinated residents (75.0%) were 3 times as high as those in vaccinated residents (25.4%)”

Lesson 3: Being vaccinated does provide significant protection from getting infected, even if you are “older”.

“[attack rates] in unvaccinated HCP (29.6%) were 4.1 times as high as those in vaccinated HCP (7.1%)

Lesson 4: Vaccines provide better protection for younger individuals.

Four “possible reinfections”   (a positive SARS-CoV-2 test result more than three months after a previous laboratory-confirmed infection) were identified, giving “evidence of limited or waning natural immunity to this [R.1] variant.” All four of these re-infections were symptomatic.

Lesson 5: It is possible to be re-infected by a different variant, even if you have already been infected.

“[Vaccine effectiveness] against hospitalization was 94.4% …among residents; no HCP were hospitalized.”

Lesson 6: Unless you are a nursing home resident, vaccination provides very good protection from hospitalization and death.

“estimated [Vaccine effectiveness] for COVID-19 symptom prevention (86.5% for residents; 87.1% for HCP) demonstrates a strong protective effect of vaccination.”

Lesson 7: Vaccination will protect most people from symptomatic illness.

“The index case occurred in an unvaccinated, symptomatic HCP [Health Care Personal]”

Lesson 8: The more people who are vaccinated, the less likely an outbreak is to occur in the first place.

Cases
Despite vaccination efforts, March had a small spike in cases, most likely due to new more contagious variants of the virus (B.1.1.7) and relaxing of social distancing by the population. It appears we may be reaching the top of this small peak as the the 7-day average of new cases (352 per day) is below the peak.   The number of new cases per day is still higher than Aug/Sep of 2020, which was our previous low point.

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