The statewide response from Louisiana’s Governor and Public Health apparatus is refreshingly crisp, on point, and faithful to science-based principles.
The Department of Health website is clear, informative and easy to access. The data are updated twice a day, morning and COB, and so far, they have not missed a best. Sadly, my home state has made it onto the US Covid-19 state charts with a bang going from nowhere last week to the number 7 position in the US, based on total cases reported.
That said, there was no dithering on the part of state officials here. The first positive case was announced Monday, March 9th. Wednesday the Governor declared a public health emergency, and Friday closed all schools for a month, and reinforced serious social distancing recommendations.
The state is transparently reporting the number of patients tested, and cases by parish in 12-hour cycles, about as close to real time reporting as is possible.
Credit is Due. If my fellow citizens take heed, the ultimate effect of the epidemic here will be significantly blunted.
Data from the last two days are given below.
The major take-aways from these earliest results are two. First the test positivity rate is hovering at 36%. These are very early, rather small numbers. But contrast this to the rough nationwide data that as of March 13 there had been 2,134 US positives out of approximately 19,744 tested, a positive rate just under 11%.
Why is the positive rate in our fair state so high early? Are we sicker than average or more susceptible? Doubtful in this context. So far as I can tell, Louisiana has been following the CDC guidelines for who should be tested, and all tests so far have been run in the state public health lab. There is however one rather significant environmental difference between Louisiana and the rest of the US in the last three weeks.
We are Mardi Gras, and New Orleans is Mardi Gras Central. Mardi Gras was held on Tuesday February 25 this year. As best we can tell from studies elsewhere, about 97% of Covid-19 cases have symptom onset between 5-12 days after exposure. 13 days after Fat Tuesday the first Louisiana case was diagnosed in a Jefferson Parish resident, right in the middle of the New Orleans metropolitan area. Are these events connected? There is no proof positive. But Arkansas state health officials think their first case arose from New Orleans Mardi Gras festivities.
For those who have been or participated in this grand event, you know that Mardi Gras is a mass audience up close and personal party, in many instances heavily fueled by alcohol, and a surprising number of rather uninhibited encounters with friends and strangers alike. One would rightly be suspicious there may be a significant nexus between New Orleans’ major blow out party and the close behind the party viral attack.
This notion is reinforced by the observation that a huge proportion of all Louisiana cases so far is concentrated in the New Orleans area. So far, there has not been a comparable outbreak in Baton Rouge just 70 miles up the road, and another major population center (about 800,000 in Baton Rouge metropolitan area) and the state capital.
Can we blame our state outbreak on Mardi Gras? No, but it likely played an accelerating role, helping explain why Louisiana jumped so high onto the US states affected list. It also is a cautionary tale about the potential leavening effect of mass social gatherings in propelling an epidemic outbreak.
This past weekend, due to the Governor’s Emergency Declaration the next after Mardi Gras large Louisiana party, St. Patrick’s Day parades and events, was largely cancelled. There was a fair amount of grumbling from many locals about this, but it may turn out that this was a truly lifesaving decision for all our citizens. The St. Patrick’s parade extravaganza was great in 2019 and will be again. No real harm done to skip a year. As expected there were stubborn knots of Who Cares revelers here in Baton Rouge daring the thrill. An advertisement for Reckless and Stupid.
One other early point of reference. Very early days, but even with small numbers (100 cases), the statewide death rate among diagnosed cases is still about 2%, very similar to the current US national average. And 10 times higher than the season flu mortality rate. We have a very long way to go before out state rate will approach that low target number on a stable basis.
Finally, on a more general note. Federal official s have been at considerable pains in the last several days to suggest that the new mass testing practice runs have found only a 1-2% positivity rate among those tested. This is code for lots of low-level unimpressive infections to be found real soon. The earliest Louisiana rate of 36% is clearly going to fall substantially. But the current national positive rate of 10% has held through more than 3,000 cases as of today. Mass testing is at least a week away, and full implementation is a month or more distant at best. For the immediate future (say 4-6 weeks) the national test positive rate may well continue to be in the range of 10%, not 1%.
This also means that Dr. Fauci is ever so right when he says there will be a sharp spike as we transition to high throughput test methods (with continuing limitations to health providers, first responders, and symptomatic elderly people). The healthy low risk washout phenomena they are hoping for is likely weeks away. Just an educated guess, not a hard prediction.
It is what it is. Just don’t be surprised. Trump’s Rosy Billed scenarios are still more fluff than substance.
Stay Safe America
