The number of confirmed COVID-19 cases in Orange County last week was 2,018, as low as in mid-December of 2021. The Omicron surge is mostly over, and the new case positivity rate has dropped to 6.9% (close to the < 5% threshold that indicates community spread is under control).

While the total number of cases in the Omicron surge was significantly higher than in the Delta surge, the number of hospitalizations (orange line) was slightly lower, and the number of deaths (blue area) is significantly lower. This is partially due to a larger percentage of the population being vaccinated, partially due to the nature of Omicron (infecting the upper respiratory tract more than the lungs), and partially due to survivor bias from prior waves.

According to the CDC, a total of  3,089 covid-19 related deaths have occurred in orange county , or 212 deaths per 100,000 residents.  The total number of confirmed cases is at 371,647, with more than 1 in 4 residents having been infected over the course of the pandemic.

I am hopeful that by next week the test positivity rate will fall below 5%. The CDC community status tracker just recently changed from orange to yellow:

The Omicron surge is now on a downward trend in Orange County Florida. However, the number of cases per week is still close to the peak of the delta surge.   Our case positivity rate is “only” 18.2%   (after a peak of 36.2% the week of Jan 7th). That same week there were 27,941 confirmed cases out of a population of 1,457,445, or two people out of every hundred were infectious that week.

The CDC data from Florida in general show that the total deaths from the omicron surge is significantly lower than that of the delta surge.   This is partially due to the fact that more people have been vaccinated (or previously infected with an earlier variant, or already dead), and mostly due to the fact that the omicron variant is generally less deadly than prior variants of the virus.

According to the CDC since the beginning of the pandemic, Orange County has had a total of 2,933 deaths where COVID-19 was involved (11.8% of 24,786 total deaths from all causes in the same time period).   This is a covid-19 death rate of 201 individuals per 100,000 population.

Needless to say, the orange county public schools had a significant number of their students and staff catch COVID-19 as they returned from winter break. However, the total number of cases in the schools has been falling in line with the above county level graph.

Data from the Florida Hospital Association shows that the peak of hospitalizations occurred in mid January. Although almost 20% of ICU beds are occupied by covid-19 positive individuals, there are ICU beds still available and the number of hospitalizations are going down. The total number of hospitalizations for COVID-19 is trending gradually downwards, but the percentage of ICU patients with COVID-19 has slightly increased from this time last month.   Luckily, the majority of patients hospitalized with the Omicron variant do not need to be moved to the ICU.

Adding an orange line showing total hospitalizations in Florida to the number of deaths chart shown above clearly shows that while a significant number of people are being hospitalized, the number is smaller than with the Delta surge, and the proportional number of deaths (when compared to hospitalizations) is also lower.

Over the last three weeks the Omicron variant has proven to be highly contagious. The number of cases and speed of their growth has far surpassed the delta surge. In the last week, almost 1 out of every 50 individuals in Orange County has tested positive for COVID-19.   According to the latest FDOH report, Orange County Florida has had 27,941 new cases in the last week, with a test positivity rate of 36.2%.

This number would be completely terrifying except for the fact that many of the infections are breakthrough infections of vaccinated individuals, who for the most part are protected from serious disease.   However, many vaccinated individuals are also having asymptomatic infections, so the number of infected is certainly higher than the number of positive tests, and the virus is endemic to the population.

The case numbers and test positivity rate tell you that it will be very difficult to avoid exposure to the virus, but the case numbers may not directly correlate to deaths. Currently data from the CDC for the state of Florida indicates that with the omicron surge, so far deaths have not been directly related to cases. This may be due to delays in reporting (or delays in deaths, as the omicron surge really only started a month ago), but it does appear that the omicron variant is less deadly than earlier variants of the virus.

Hospitalization and ICU bed usage numbers are likely to be more directly correlated to future deaths than straight case numbers. According to the Florida Hospital Association, as of Jan 7th, COVID-19 patients made up 16.2% of ICU bed usage.   This is almost double the number (8.7%) a week ago. Adult hospitalizations with covid-19 has gone up from 4,484 on Dec 31st to 7,305 today, again, an almost doubling over the last week.   At the peak of the delta surge, Florida COVID-19 hospitalizations were at 17,121, so it is possible the omicron surge will kill fewer individuals than the delta surge.

The number of detected COVID-19 cases has been flat or going up for the last five weeks. The latest week had a 50% increase (from 1002 cases to 1503 cases), up from a low of 673 cases in the second week of November.
Orange County FL’s new case positivity rate is 4.5% (below the Florida State average of 5.4% in the same time period), but is almost certainly going to go above 5% next week.     This increase can be attributed partially to the new Omicron variant, and partially to the Thanksgiving and Christmas holidays.

Continue reading →

We have reached the end of the Delta Surge. The October 29th 2021 weekly DOH report shows that Orange County only had 834 infections in the last week, and the case positivity rate has dropped to 2.9%.   The OC Mayor has dropped the state of emergency, and the OC Public School District has removed the mask mandate in schools. (Faculty, Staff & adult Volunteers are still required to wear masks, as are students, but now a parent note is enough to excuse students from the mask requirement.)

In the last month the OCPS dashboard has reported only 690 new cases.

We have had nine weeks of decreasing case numbers and are now back to a level similar to that of the June/July timeframe before the Delta variant surged.   Orange County currently has 75% of the 12+ population vaccinated, and the Pfizer vaccine has just been approved for use by children aged 5-11 years old.

Deaths

In the last month, Orange County has only had 140 deaths from COVID-19. Overall, Orange County FL   had 2,185 COVID-19 deaths out of a population of 1,457,445 (149 deaths per 100,000 residents). This is better than the state of Florida average of 285 deaths per 100,000 residents. However, 149 deaths per 100,000 residents is a per-capita death rate higher than the countries of South Korea (5), Australia (6), Iceland (9), Japan (14), Norway (16), Egypt (17), India (33) and the Philippines (36) combined.

We are nearing the tail end of the Delta surge. The October 1st 2021 DOH report shows that orange county had “only” 2,365 cases in the last week, and our 7 day test positivity rate has dropped down to 5% (for the first time in 3 months…).

The number of cases per day are still as bad as in January/Feb, April/May, so COVID is definitely spreading in the community, but “74% of those 12 and older have received at least one dose of the vaccine” according to Mayor Jerry Demings.   Although breakthrough infections are possible, being vaccinated gives strong protection against infection, and extremely strong protection against getting sick enough to need hospitalization or dying.

Orange county schools have reported 5909 student cases (and 1,114 employee cases) since August 2nd, and are still enforcing a mask mandate through the end of October.

Deaths

So far, Orange County FL has had 2,045 COVID-19 deaths out of a population of 1,457,445, or (140 deaths per 100,000 residents), which is a per-capita death rate higher than the countries of South Korea (5), Australia (6), Iceland (9), Japan (14), Norway (16), Egypt (17), India (33) and the Philippines (36) combined.

For the week ending August 27th, 2021, Orange County Florida had an average of 1,292 new cases per day. This is worse than the highest previous peak in January.   The exponential growth can be blamed on the Delta Variant and the relaxing of masking and social distancing.

However, the number of new cases each week appears to have plateaued, and the test positivity rate, at 14.9%, while still very high, has gone down from a peak of 20%, so it appears that we may have reached the peak of this delta variant surge.

Historically, Orange County has had a case fatality rate of near 1%, so that would indicate we are due to see about 12-13 deaths per day in the near future, but as death numbers are no longer part of the FDOH weekly reports for counties I have no way of knowing if the case fatality rate has started to drop due to vaccinations of high-risk groups or has increased due to the Delta variant.

We have vaccinated (at least a first dose) 858,281 people (out of a population of 1,457,445), or 59% of the total. If you discount children 12 and under who are not yet eligible for vaccination, Orange County has vaccinated 69% of the eligible population.   We vaccinated 77,829 people in August (Compared to 62,349 people in July, 65,206 in June, 88,482 in May and 151,176 in April.)

Hospitalizations

Although the FDOH is not reporting county level hospitalization numbers, we can assume that the admissions curves for Orange County are similar to the entire state of Florida. We currently have more people hospitalized with confirmed covid-19 cases than ever before. Elective surgeries are postponed,   hospital morgues are full   and portable morgue units are being deployed.

Deaths

The FDOH is not reporting death numbers directly for Orange County, but judging from the graphs for the entire state of Florida, deaths are also at an all time high.

The “actual date of death” data lags behind the “reported date of death” data, but as you can see from historical trends, the reported death data is indicating that the actual date of death data will set new records in Florida.

Orange County Public Schools

In the entire 2020-2021 school year (when around half of the students were remote) OCPS reported a total of 5,072 student cases of Covid-19.   (and 2,216 employee cases).

So far, in the first three weeks of the 2021-2022 school year (with the majority of students in-person) the OCPS dashboard has reported 2,599 student cases of Covid-19. (And 624 employee cases.)

Have we reached the peak?
In other countries surges driven by the Delta Variant have peaked hard and then receded quickly (after natural immunity is reached in the un-vaccinated population via infections) so we we may see a sharp decline in cases, hospitalizations, and deaths in September.

For the week ending July 29th 2021, Orange County Florida had an average of 1,130 new cases per day. The test positivity rate over the last week was 18.2%.
This is worse than the highest previous peak in January.   The exponential growth can be blamed on the Delta Variant and the relaxing of masking and social distancing.

Historically, Orange County has had a case fatality rate of near 1%, so that would indicate we are due to see about 11 deaths per day in the near future, but as death numbers are no longer part of the FDOH weekly reports for counties I have no way of knowing if the case fatality rate has started to drop due to vaccinations of high-risk groups or has increased due to the Delta variant.

We have vaccinated (at least a first dose) 780,452 people (out of a population of 1,457,445, or 54% of the total. If you discount children 12 and under who are not yet eligible for vaccination, Orange County has vaccinated 63% of the eligible population.   We vaccinated 62,349 people in July (Compared to 65,206 in June, 88,482 in May and 151,176 in April.)

Hospitalizations

Although the FDOH is not reporting county level hospitalization numbers, we can assume that the admissions curves for Orange County are similar to the entire state of Florida.

AdventHealth has entered ‘black’ status and postponed all non-emergency surgeries confirming that they have more hospitalizations than in January, which matches the state level graph.

Nursing Homes

We are seeing a small uptick in covid-19 cases in nursing homes. According to the AARP, in Florida’s nursing homes “Roughly 3 in 10 nursing home residents and 3 in 5 health care staffers are not fully vaccinated. The state’s nursing home vaccination rates are well below national averages”.

End in sight?

In the United Kingdom, which was hit by the Delta variant earlier than the US, daily case numbers are starting to drop.   It may be possible that through vaccinations and “naturally obtained immunity” that the UK is reaching the herd immunity threshold. As the delta variant tears through the remaining unvaccinated population in the US we may see a corresponding drop in infections next month.

Well, it’s hard to tell for sure, as the Florida Department of health has stopped issuing daily reports, and has switched to weekly reports. They have also stopped releasing per-county death numbers, among other omissions and simplifications.   You may notice that the graph I have to display is simplified this month.

What we do know is that the number of cases per week had been decreasing since mid-April, but in the last two weeks the number of cases per week has started to increase again. On June 1st the 7-day average was 145 cases per day, while as of July 2nd it is 171 cases per day, and the case positivity rate has raised to 5.3%.

Historically, Orange County had a case fatality rate of near 1%, so that would indicate about 1.7 deaths per day, but those numbers are no longer part of the FDOH weekly reports so I have no way of knowing if the case fatality rate has started to drop due to vaccinations of high-risk groups or has increased due to the Delta variant.

We have vaccinated (at least a first dose) 718,103 people (out of a population of 1,457,445, or 49% of the total). If you discount children 12 and under who are not yet eligible for vaccination, Orange County has vaccinated 58% of the eligible population.   We vaccinated   65,206 people in the month of June. (Compared to 88,482 in May and   154,176 in April.)

The rate of vaccination has slowed and I expect it to continue to slow, while the total number climbs upward slowly. I expect that fewer than 60 thousand people will be vaccinated in July.

I believe the uptick in case numbers is primarily among the un-vaccinated 51% of the population, due to a combination of the more infectious Delta variant and relaxation of mask usage and social distancing.

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

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   ]