Case numbers of COVID-19 are up in Kaufman County and across Texas, and it is safe to say that it is a trend since it has been over three weeksof daily increases.

In Kaufman County, we have 118 active cases as of Oct. 19, up from around 40 or so active cases just about 10 days ago. As a refresher, the case numbers spike first, and then COVID positive hospitalization numbers will be next: as predicted, hospital inpatients with confirmed COVID-19 are now on the rise in Texas and also in Trauma service Area E, which includes Dallas-Fort Worth and most of our immediate area.Why is this happening now? Many reasons, but generally the answer is that our distancing is not as consistent or as effective as it was in the summer. Masks are not perfect but they can be very helpful, and I think we can agree they are used less often, at least in my circles. My limited personal observation was that compliance with masking was pretty good after our peak of cases and deaths this summer --and since then...not so much.

Another obvious reason has been the return to school for all ages. Cases at schools have been limited but are certainly happening, and many of our ISDs have modified schedules and some have even closed for a few days to clean and identify those who need to quarantine. Effects are hard to quantify, as most kids who get coronavirus tend to not have symptoms, but are still likely to spread the virus to more family members.

One more difference from late summer is the number of gatherings has increased. Informal friend groups and family events have been much more common. When the prevalence of community transmission was even just a bit lower as recently as last month, these gatherings could occur but would be much less likely to create a super-spreader event. (They can still happen, of course, just ask the White House.) But now that prevalence is spiking up, and gatherings have gained favor due to our complacency, we can expect more clusters of cases to result.

So, what does this mean? Well, I guess it depends on who you listen to...

Personally, I am choosing to listen to a consensus of epidemiologists and infectious disease experts. Yes, there is a consensus.I know it may not seem that way, depending on your newsfeed of choice. But my reading (and the opinion of the several experts I follow) is that the vast majority of medical and epidemiologic opinions are true to the data and trustworthy, since they are consistent with each other.

Despite the public and political beating some experts have taken, they have been proven largely correct in their advice and responses to the data we knew at the time. Certainly some things have been updated as we learned more, but by and large, the expert advice has remained neutral and certainly accurate enough to merit our trust. Some of the media-driven reports of errors were essentially errors in messaging: case number predictions, use of masks, etc. Those exceptions from early on in the pandemic have been addressed here already, but I would be glad to re-direct those interested to the sources and data on those topics.

As a whole, despite the sometimes hostile environment the disease experts have been subjected to, I’ve been amazed at their collective ability to break down the data and make it understandable to me. Pandemics are not my specialty, so the best way to describe my own level of expertise is that I know enough of the terms and information that I am acutely aware of my LACK of knowledge on the subject. My hope in writing these posts is that I can remove myself from the message, stick to the job of translating science-y information into plain English for my readers.

ANYWAY: all that to say that based on the knowledge we have, we can expect to see an increase in cases, hospitalizations, and soon we will also see more deaths in the next few weeks and months. This should be apparent both nationally and in Texas. There are some hopeful caveats that *may* mitigate this: 

1. The population of those infected has skewed younger than the early days of the pandemic.

2. We continue to see better outcomes with medical advances in treatment for hospitalized patients. 

3. There may be less reluctance to wait too long to seek care.

4. We know what works (distancing, masks, hygiene, testing, contact tracing, quarantine) so maybe we will get back to those basics and hit the brakes a bit quicker this time?

Each of these factors taken alone should predict a slightly better death rate than what we saw over the summer, so we can hope that all three together will mean lower peaks and fewer deaths overall. I know I’ll be praying for that outcome!

In the meantime, stay safe, wear those masks, and let's all look out for each other!

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