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Transcript: 

Theresa Freed 00:00

Johnson County Department of Health and Environment closely follows the science and the data when it comes to making public health decisions. On this episode hear about the latest COVID-19 trends and some new enhancements to our dashboard to help residents get a clear picture of disease transmission and vaccine use in the county.

Announcer 00:18

Whether you live in or just love Johnson County, Kansas JoCo on the Go has everything Johnson County, here's what's happening and what's coming up in the community you call home.

Theresa Freed 00:31

Thanks for joining us for JoCo on the Go, I'm your host Theresa Freed, a Johnson County resident and employee of Johnson County government, in an ongoing effort to keep residents up to date on disease transmission and vaccines in the county, this week, we launched some COVID-19 dashboard updates. And to talk more about that is JCDHE director of epidemiology Elizabeth Holzschuh. Thanks for being here.

Elizbeth Holzschuh 00:53

Thanks for having me, Theresa.

Theresa Freed 00:55

Well, just to start off with, can you talk to us a little bit about what we're seeing in terms of COVID-19 transmission in the community right now.

Elizbeth Holzschuh 01:02

So we have sort of plateaued in terms of our cases. And we are still seeing a high number of cases every day, about 150 confirmed cases getting reported each day to us here at Johnson County. And a lot of that transmission is being driven in kids, far more than we've really seen it since the beginning of this pandemic, particularly our children under the age from zero to four, and kids five to 11 have higher rates of infection now than they've had throughout the entire duration of the pandemic.

Theresa Freed 01:31

There were some questions about is that the disease that we're seeing, is that because those children are unvaccinated? Or is it because they're not using masks? I mean, what's the what's driving all of that?

Elizbeth Holzschuh 01:42

You know, I think it's really honestly a combination of things. Obviously, this age group, those under the age of 12, are still not eligible to be vaccinated. So they are the most susceptible at this point. But honestly, with Delta, the variant that's been circulating really predominantly in our community since July, we are seeing just far more infections in these age groups than we've ever seen. And, you know, to sort of highlight this point, if we look at daycares, right, in the first part of the pandemic, with the original virus that came out of China, we really never or very rarely shut down daycares, because of transmission, you know, basically one kid getting it another and another with Delta. And we're seeing a lot of transmission in childcare settings. And I think really, that's because Delta is just far more infectious. And there's more viral, there's more virus in individuals systems, who are infected with it. And it's being transmitted more easily in these kids, unlike what we saw in the first year of the pandemic here.

Theresa Freed 02:41

Got it. And then also in terms of the the vaccine distribution, I know, Johnson County is doing better than a lot of other communities. So we're definitely over the 50% mark. But can you talk about sort of what the trends are related to that?

Elizbeth Holzschuh 02:55

Absolutely. Johnson County is doing quite well compared to our surrounding counties, and really the rest of the region. However, it's just not enough, particularly when we talk about the fact that our entire population under the age of 12, is unvaccinated. But that's a lot of kids. That's about a sixth of our entire population here in Johnson County, who are susceptible to this disease. And you know, because we don't live in an isolated community, people come in to Johnson County, we go other places in the metro or you know, really around the country, it still is allowing the virus to spread. And I think that's really evident with this sort of plateauing of cases that we're seeing, at least we're not increasing. We're not seeing that exponential growth that we saw at the beginning of July or mid July, but still too many cases and too much transmission in our community.

Theresa Freed 03:44

So as an epidemiologist, obviously, following the data and understanding it, interpreting it, living it, breathing it, all of that good stuff, that's your world. And so can you talk about why it's so important that we have good data to make informed decisions?

Elizbeth Holzschuh 03:59

Absolutely, you know, data should drive all of our decisions. And unfortunately, we all aren't always able to have the best data. We rely on our residents to get tested when they're sick. And we rely on those laboratories to report that to the state health department so that we can see those, we rely on our hospital partners to report individuals were hospitalized to us. And unfortunately, because of public health, that is oftentimes a manual process. So for example, our hospitals generally have a staff member who has to compile all of the Johnson County residents who are hospitalized at that time, then they send that over to us. Sometimes via fax, even though it's 2021. And then we have to manually enter it. So you know, we do our best here at the Department of Health and Environment to make sure our data are as updated and as robust as it can be. And then being able to share that with our community members, our elected officials, our stakeholders, so they're able to use that data to make informed decisions about masking and vaccine policy and all With those different pieces.

Theresa Freed 05:02

So our dashboard has been tremendously popular during this pandemic, it is one of our highest visited pages on jocogov and it's for good reason. It's very extensive. And I know that you will, are continuing to make updates to it to make sure that people have the information they need to make good decisions. And so we of course, launched a new update just this week. So can you talk about some of the highlights of that?

Elizbeth Holzschuh 05:29

Absolutely. So, I will be honest, if you'd asked me when we launched this thing, in I think late March, early April of 2020, if it would be as popular, I never would have imagined. Um, but I think it really goes to show how well informed our our population is our residents are here in Johnson County, they want the data, they want to be able to see what's happening, they want to be able to, to understand the different pieces of this pandemic. And so, because of that, we have made several updates over the last 18 months in order to better serve our community make the data clearer, make the the technical pieces the so you can have a better understanding of what how the data are compiled and published. And so this is no different, right? The pandemic has continued to change, the things that we need to be looking at has continued to change. And quite honestly, you know, we are one small entity and a large public health system. And so we have KDHE, who presents their data, and CDC presents their data. And so there's some level of we want to make sure that we're aligning on different pieces so that if you are going to their websites, and you're coming to ours, you're not confused about why those numbers are different. And so that was one of the really the big reasons that we have moved to update our dashboard is to align some of our data points, and then also to really focus on those things that are really pertinent to the current state of our pandemic, which is vaccine, certainly our vaccine progress. And those age groups that are getting vaccinated as well as different components of the disease transmission here in Johnson County.

Theresa Freed 06:56

So there are some new tabs on there, and then some rearranging of some information. So can you talk about some of the more significant changes.

Elizbeth Holzschuh 07:04

So when you come to our dashboard, it's going to look different than it has before. On the first time that you come to or the homepage is our key community metrics tab. And at the top of that, you're going to see a several very important metrics that we monitor on a daily basis, or weekly basis. One is our community risks. So we have changed some of our data points, particularly incidence rate and percent positivity from a 14 day to a seven day and that is to align with CDC. CDC has set out community risk levels. And so we wanted to really reflect those they have recommendations based on those community risk levels, and so wanted to align. So on the top of our homepage, you'll see our community risk, which currently we are in a high community risk, the highest level, our seven day incidence rate as well as our seven day percent positivity. Now again, this has changed from a 14 day so it will not be exactly the same, the graphs won't look exactly the same as they looked before. But they have been just adjusted down from a 14 day to a seven day. Also on this front page, you will see our vaccine progress. Again, understanding how much of our population is vaccinated at this time is a key piece that we're looking at in terms of where we are in the pandemic. And so keeping this on the homepage, as well as keeping our vaccine progress page that people are used to seeing. And on this main page, you'll also find the two graphs that if you went to our schools tab to look at the graphs, the incident rate and the percent positivity, where we have the different colors and the different levels, you'll also find those on our homepage. Another piece that you may be interested in. If you're anything like me, one of the things I look at every single day is how many cases we've added and some of that, for me is is our workload here in the Department of Health and Environment. And on the front page, you can find that if you go to our incidence rate graph, you can just hover over the most recent data point and it will tell you what the incidence rate is for the past seven days, as well as how many new confirmed cases and new probable cases, we have. And that's another change that you're gonna see on several of our tabs, our case summary and our case demographic data tabs, you'll now see an option to change from confirmed cases to probable only or all of our cases. Now when we talk about confirmed and probable cases, those are what we call a case definition for us in public health. It's a way that all of the different public health agencies across the country can count cases the same way. You know, we want to make sure that we're comparing apples to apples when we're talking about our cases compared to say Wyandotte County to Kansas City, Missouri. So this is how we do it. Confirmed cases, which is what you've seen on our dashboard up until this point, are those that are PCR positive. So polymerase chain reaction, a type of test, and so those are confirmed cases. We've now also added an option to see probable cases and these are people who have tested antigen positive. So it's a different kind of test, a little less reliable than our PCR test, or individuals who have been tested. close contacts to somebody who has COVID-19, who then go on to develop symptoms within 14 days of their last exposure. And so these individuals are probable cases. And so now you'll have an opportunity to see again, confirmed cases only just PCR positive probable cases only. So antigen or the what we call epi linked or close contacts, we develop symptoms in that 14 day period, we can see all of them combined. And again, people who are antigen positive as those tests become better over the course of the pandemic, this gives you a better picture, they're used more often now. So if we're just showing confirmed cases only, like we have been, you're really not getting a full picture of how many people in Johnson County have likely been infected with COVID-19.

Theresa Freed 10:43

Yeah, that's, that's good information. And so, you know, some might might see that as potentially padding the the case count, but that's not the case, because you can actually look at it in different ways and, and interpret that information. And it's giving you just a better way to look at the information, right?

Elizbeth Holzschuh 11:00

Absolutely. And KDHE has been reporting, probable and confirmed cases combined for counties. And so a lot of times I've gotten questions about why is it that KDHE's website has 16,000 more cases than your website, and they were both updated on the same day. And really, that is the reason. And so this way we align and so it helps see, again, the fuller picture, but also to hopefully reduce confusion about the KDHE website versus our website versus CDC because CDC only reports confirmed cases. Our brilliant AIMS team who has developed this dashboard for us has given you an opportunity to see everything right? So you know, you can now see our data and it will align with CDC is you can now look at confirmed and probable and see how we alignments with KDHE. Or you can break it out separately and see for yourself where we are.

Theresa Freed 11:46

And another place we see a little bit of we'll see some differences, perhaps as in the number of deaths. And so can you talk a little bit about that, and also the hospitalization information if you could touch more on that.

Elizbeth Holzschuh 11:57

So KDHE's Office of Vital Statistics reviews every single death certificate in order to code them appropriately, and they do this, for every death certificate even outside of COVID-19, right should classify something as a suicide or classify something as a cancer death, for instance. And so in doing this, what they look for for COVID-19 related deaths are death certificates, that list COVID-19, or SARS-CoV-2, the virus that causes COVID-19 as an underlying cause of death, or a significant condition contributing to death. And so this, they have been doing this, which is why KDHE has been reporting more deaths than we have. And so again, really to reflect the truth, the entire burden of COVID-19 on our community, we thought it was important to update our data to align with KDHE to include these additional deaths. And so that is why you'll see more deaths reported for Johnson County than you had seen on our previous dashboard.

Theresa Freed 12:51

Okay, and then if you just want to talk a little bit about the hospitalization issue.

Elizbeth Holzschuh 12:55

So hospitalizations continue to be a really important piece for us in monitoring this pandemic, and the effect on our community and our hospitals. I'm sure you've heard that hospitals are, have been overwhelmed and are short staffed. And so some some hospitals are doing in other parts of our country, and in some degree here, have really been struggling with their capacity. So we do our best to identify every single Johnson County resident who was hospitalized due to COVID-19. So this is what you will find on our Case Summary tab, as well as our Case Demographic data tab. Now, there's been a lot of conversation about how accurate these data are. And I will say that, that we are not always receiving reports from every single one of our hospitals, particularly hospitals on the Missouri side that have Kansas patients, hospitals there. And so we still are including this data, even though it may not be as robust or as complete as we would like it to be, because I think it's really important to see sort of that trend. So you see sort of the increase, and when it decrease and we come down hopefully. And so we certainly look at this every day. But if you want to see a more complete picture of what hospitalizations look like in the region and in Johnson County, you can go to the MARC dashboard, and that link is right below all of our hospitalization data. And so that will look at hospitals in Johnson County or hospitals in the region and the burden on their ICU and the number of COVID patients. Again, we're gonna continue to keep the hospitalizations on our dashboard. Because this is truly Johnson County residents who are hospitalized and that piece of information is hard to come by on any other dashboard. But again, if you're really looking for the most complete picture, I would recommend you go to COVID...uh...the MARC COVID hub and the reason why theirs is just more complete is because they get their data from the federal government which is requiring all hospitals to report the number of COVID patients, the number of non COVID patients the number of open ICU beds The number of open hospital beds every single day and so it's just a more robust picture and more mature.

Theresa Freed 15:07

Alright, there's certainly no shortage of data in our region and the COVID-19 dashboard for Johnson County is is better than ever with with great information. So if people are curious or they want some, some details so they can make some good decisions for their family or others. That's a great place to start for sure. Well, thank you so much for joining us today. And I do want to mention that we got some news about boosters also this week, and so be sure to tune in next week we will have a full episode on when and where you can get your booster shot if you're eligible. Thanks for listening.

Announcer 15:44

You just heard JoCo on the Go, join us next time for more everything Johnson County. Have a topic you want to discuss? We want to hear from you. Follow us on Facebook and Twitter at JoCoGov. For more on this podcast, visit Jocogov.org/podcast. Thanks for listening