Chesterton Tribune



What we know and don't know about the COVID-19 pandemic in Porter County

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The Porter County Health Department has done a superb job informing residents, on a daily basis, of the extent of the COVID-19 pandemic in the county.

Its C-19 dashboard, updated seven days a week, usually before 10 a.m., is state of the art, and provides essential data in a wide range of categories:

-- Total cases, hospitalizations, recoveries, and deaths by county and township and in long-term care facilities.

-- Cases and deaths by demographic as well.

-- And six separate charts: new and total C-19 cases by day, beginning on March 17; new cases by day with a seven-day rolling average; total tests versus total positives; breakdown of total cases; new cases by week; and new cases by week excluding congregate living facilities, which include the Porter County Jail and long-term care facilities.

So we know, for example, that the week ending Saturday, May 16, saw 80 new cases in the county, inclusive of congregate living facilities: the highest number of new cases in any seven-day period of the pandemic to date. And that this week was followed by four consecutive weeks of falling numbers--73 new cases, 67, 33, and 25 respectively--before new cases began to spike again beginning the week ending Saturday, June 20.

We know that the week ending Saturday, July 4, saw 68 new cases in the county: the highest number of new cases--exclusive of congregate living facilities--in any seven-day period of the pandemic to date.

We know that the highest number of deaths reported in a single week is six, in the week ending Saturday, June 6.

We know that current hospitalizations over the course of the pandemic peaked on Wednesday, May 20, with 28; but that over the last 19 days--Thursday, June 18, through Monday, July 6--they dropped to three, then to two, until rising to four on Tuesday, June 30, where they remained through Monday.

We know that all 37 patients who’ve died of C-19 were 50 or older; that 28, or 76 percent, were 70 or older; and that 26, or 70 percent, were residents of long-term care facilities. We also know that 101 of all 765 cases reported as of Monday--13 percent of them--have occurred in long-term care facilities.

Even so, we know too that 56 percent of all 765 cases were or are infections in people younger than 50. Thirty-nine children or teenagers have been infected; 141 persons in their twenties; 122 in their thirties; and 125 in their forties.

More disconcertingly, we know that 65 percent of the 71 new cases reported since Monday, June 29, are infections in people younger than 50.

We know that the two most populous townships in Porter County--Portage and Center--account for 523, or 68 percent, of all the cases; that Duneland--Westchester, Liberty, Jackson, and Pine townships--accounts for 98 cases, or 13 percent; that the predominantly rural townships of Pleasant, Morgan, Porter, and Union account for only 72 cases, or 9 percent; and that Washington Township, with 56 cases, is a special exception, because that tally includes the 43 cases reported at the Porter County Jail.

We know that Porter County’s test-positivity rate--the percentage of positive test results--was only 7.0 percent on Monday, down from 19 percent on April 20. Test-positivity rate is a crucial indicator of the penetration of testing in a community, since the lower the test-positivity rate is, the more tests are actually being conducted. The State of Indiana’s test-positivity rate on Monday, in contrast, was more than two points higher than Porter County’s: 9.2 percent.

Finally, we know that, as of Monday, there were 146 active C-19 cases in Porter County: the total number of cases less deaths and recoveries. Put another way, 37 of those infected, or 4.8 percent, have died; while 582, or 76 percent, have recovered.

What We Don’t Know

The Porter County Health Department’s COVID-19 dashboard, accordingly, has proved to be an excellent resource. Yet there remain other categories of data not included on the dashboard, which if provided would give us an even clearer picture of the pandemic’s impact on the county.

Begin with hospitalizations:

-- We do know, on any given day, how many patients are currently hospitalized. But we don’t know how many total hospitalizations there’ve been over the course of the pandemic.

-- We don’t know the demographics of those hospitalized: how many are in their twenties, their thirties, and so forth.

-- We don’t know how many of those hospitalized have been treated in ICU.

-- And we don’t know the average length-of-stay in hospital.

The Chesterton Tribune recently put these issues to Letty Zepeda, administrator of the Porter County Health Department, who spoke to several of them.

The total number of hospitalizations Zepeda did not address.

The demographics of hospitalized patients: “Most who have been hospitalized are over 60 and with underlying health issues and a few tested positive due to confinement, as in a nursing home or the jail,” Zapeda said.

The number of hospitalized patients in ICU: “We haven’t had many, just a few,” Zapeda said.

The average length-of-stay in hospital: “It is hard to determine the average length of stay because that is based on the patient. We have had some hospitalized for months (3+) while others may be in for a couple of days,” Zapeda said. “The length of time is based on the patient, their health condition, age. Those with underlying issues such as diabetes, respiratory, or heart issues may have a harder time at recovering as well as those over 60.”

Zapeda also addressed the Tribune’s use of the term “spike” when discussing the 80 new cases reported in the week ending May 16 (inclusive of congregate living facilities); and the 68 reported in the week ending July 4 (exclusive of congregate living facilities): “What you may be stating as ‘spikes’ we are look at as possible increase in numbers due to more testing being done,” Zapeda said. “The state has tried hard to set up testing throughout the state so that more can be tested, and even decreased some of the requirements for testing, making it more available to those who could not afford to pay for testing or did not have insurance that covered the cost. The state has also made great strides in placing testing locations in areas of most concern, specifically in areas where we are seeing higher numbers of positive cases. Hence, more testing, more results.”

Contact Tracing

There is one other category of data not included on the dashboard which--while probably difficult to quantify--could powerfully inform local public health policy as well as the decisions being made by Porter County residents: namely, the ways and means of community transmission. How many cases of stranger-to-stranger infection have been identified? How many multiple cases in the same household, office, or place of business? How many superspreader events--graduation parties, weddings, funerals, church services--have been reported? How many cases associated with particular businesses or particular kinds of business?

This information goes to the heart of our behavior in a pandemic: whether or not we choose to wear masks, visit the beach, attend or throw parties, dine inside a restaurant, allow ourselves to grow lax when it comes to social-distancing among family and friends. It is also information which policymakers would find vitally useful, when deciding whether to re-open schools in the fall, resume virtual meetings, or re-close government offices and buildings.

It’s precisely the kind of information, in other words, culled by contact tracing, which Zapeda said the Health Department has been diligently pursuing since the very beginning of the pandemic. Presumably, the Health Department has reached some conclusions about the various vectors of transmission in Porter County.

It has not, however, opted to share those insights with the public.

“I would like to say that the Porter County Health Department was involved with contact tracing from our first positive,” Zapeda said. “Our nurses, consisting of eight full-time and three part-time, all stepped in to help with that. One of our Board of Health members is a retired nurse and she reached out to the Health Department, stating she can provide us with retired nurses who are familiar with contact tracing, should we need it.”

“I find it amusing to hear other states mention that their new method of control for COVID is by doing contact tracing, when the nurses at the Porter County Health Department were conducting the tracing from Day One of our first positive,” Zapeda added. “Not all counties conducted contact tracing. Some were unable, due to staffing issues, others for various reasons. The Health Department participated in weekly Zoom meetings in which all the other department heads were in participation, along with the Commissioners, County and Health Department Attorney, Courts, Judges, and County and City council members. Our purpose was to collaborate as a team and to share information. Keeping 911, EMS, or the Sheriff’s Office up to date on positive cases was important as this helped in guiding and protecting their staff from possible exposure.”


Posted 7/7/2020




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