What is a COVID-19 peak?

KELOLAND.com Original

SIOUX FALLS, S.D. (KELO) — Peak or surge. When public and medical officials use those words in relation to the COVID-19 pandemic what are they referring to?

COVID-19 will reach a peak “when the total number of new cases in a region or state have stopped rising and the daily number of new cases levels off, the descent on the back side of the peak is when the total number of new daily cases begins to decrease,” Dr. Kevin Post, the chief medical officer for Avera Medical Group, said in an email response to KELOLAND News questions.

Local and state public health officials have used modeling to project different peak dates for the Sioux Falls areaand the state of South Dakota. The peak in the Sioux Fall area is expected to be in mid-May and in the state, in mid-June. Those peak dates could change based on new information and data on COVID-19 including in modeling.

Maggie Seidel of Gov. Kristi Noem’s office said hospitalizations are key in projecting peak dates for the state. Hospitalizations are a consistent, reliable, data point, Seidel said.

“In our work we generally follow hospitalized or ventilated patients because it is most important to follow for knowing how many patients we have who are most ill, but generally the state or local reports are based on diagnosed cases,” Dr. Jeremy Cauwels, Sanford Health’ vice president of clinic quality, said in an email response to KELOLAND news.”The overall number of cases is how we determine the peak and we will know when we reach it only after the fact when it goes down and stays down over time.”

Even after the Sioux Falls area and the state peak with COVID-19 it will still be necessary to follow certain health and safety guidelines the two doctors said.

“…this will be an ongoing necessary effort even peaking to avoid another surge.  Even after the peak, only a small percentage of the population will be immune, thus many of will remain very susceptible to contracting the coronavirus,” Post said. “It will be very important that we all play are part, and will be especially important for our vulnerable population, such as the elderly and those with high-risk medical conditions.”

Noem has said in multiple news conferences that South Dakota’s peak time is projected to be in mid-June. Although Noem did not share a new peak date in today’s news conference she did say that a “back to normal” plan for the state would be announced tomorrow.

Noem said her plan is based on new modeling driven by update data, science and facts.

Mayor Paul TenHaken said on Monday that city and local public health officials continue to prepare for a COVID-19 surge.

While there has been a steady increase in COVID-19 cases since March 9, the increases in positive cases has been smaller on some days than others. There has even been a decline in active cases over two days as the number of recoveries has increased.

For example, on April 22, the state had 912 active cases and 883 on April 23. The total positive COVID-19 cases was 1,635on April 19 and 1,685 on April 20, a jump of only 50 compared to increases of 100 or nearly 100 on prior days.

Those fluctuations don’t indicate a peak or a valley, the two doctors said.

Day-to-day changes in positive cases or any COVID-19 data point must be considered in relation to existing case numbers and duration of change, Cauwels said.

“Any curve is smooth as you look at it over time and over large populations.  The closer you look at it, the more rough edges you see,” Cauwels said. “If the number of people you have in the total are 50 a change of five makes a big difference. If the total is 5,000, five makes very little difference visually.  It’s only after several days of increases or decreases that you begin to understand that that change of five really means something.”

Days of highs followed by decreases are “normal expected finding in a pandemic as this can be caused by small areas of ‘hot spots’ of new cases, or by a change in testing capacity leading to more or less test results returning at the same time,” Post said.

Noem’s executive orders that have outlined stay at home for those over 65 and social/physical distancing practices have helped reduce the number of hospital beds needed at peak time for COVID-19, Seidel said.

“We flatten the curve to allow more people to get health care, not to decrease the number of people infected,” Cauwels said.

Copyright 2020 Nexstar Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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