Has Georgia reached an inflection point in the outbreak of coronavirus in the state? Is there any evidence that a peak has been reached in the cumulative number of COVID-19 cases in Georgia? In this post, I’ll explore these questions.

Georgia has been one of the top news stories for a week. Georgia Governor Kemp announced earlier this week that many businesses, including restaurants could open by Monday. What will be the effect of this on the spread of the virus. One effect was the increase in traffic in my neck of the woods. Does this mean people are deciding to forgo social distancing and leave their homes for more than food and medicines?

The governor’s plan to open businesses has caused a storm among Georgia mayors, and business owners. Most mayors were never notified by Kemp that he was going to open businesses this week. Not only did this anger a number of Georgia’s big city mayors, but many restaurant owners are not willing to risk exposure of their staff and customers to the virus. To many, it’s too soon to open up.

So, the questions in this post relate to the effect of Kemp’s decision to open the state, and match that with the present status of COVID-19 in Georgia. In a previous post, I provided a variety of graphs and charts that described the status of the coronavirus in the state.

Let’s Not Repeat the 1918 Flu Epidemic

The first graph (Figure 1) shows the coronavirus cases each day in Georgia from March 10 to April 21. My concern here was what will happen to the number of cases in Georgia after the state has opened a good many of its businesses? Will the curve continue on its trajectory. Or will the curve flatten?

I also wondered if we would repeat history. In the 1918 Flu epidemic, many cities in the U.S. relaxed social distancing and shelter in place orders, and sent kids back to school. In every case where they did this, there was another outbreak, often resulting in so many infections that a new peak was realized, often higher than the first one. Figure 2 shows what happened during the 1918 Flu epidemic in Denver. After two months of social distancing and keeping kids out of school, the city relaxed, and sent kids back to school, and allowed public gatherings. The death rate increased again, and the second peak was higher than the first.

We don’t want this to happen, here, or in any city.

Prevent People from Getting Sick & Dying

There are still outbreaks of coronavirus in Georgia. Dougherty County and Fulton County are the two Georgia counties that have had the most cases and deaths. But that doesn’t mean that other counties are out of the woods. Not at all.

Figure 3 is one of Ed Johnson’s control charts. This chart shows the number of COVID-19 cases per 10,000 persons for each county in the state. In these charts, Ed has shown that a number of counties are experiencing an unusually high number of coronavirus cases. Ed has urged the state not to relax mitigation, but instead look at what might be causing these unusual number of cases.

Inflection Point?

Now we come to the third point that I want to make. I’ve made a graph of the coronavirus cases in Georgia from March 10 – April 25 using data from the Georgia Department Public Health. You will see in Figure 4, a bar graph. However, might there be something happening around the 18th of April? I’ve graphed the number of cases in seven day intervals. Then I’ve drawn a line along the edge of the bars. Note that the curve makes a slight turn in the interval of April 18 – 25. This slight turn, or turning point, is called an inflection point. You could call it a de-inflection point. In either case, there is a change. We might begin to think that is a flattening of the curve. (A special shout out to Don Peck for help on the graph).

It’s too early to call it.

An inflection point is period of significant change, or a turning point. However, we should interpret this with caution. We have to ask what will be the effect of Governor Kemp’s decision to open the state to business? Will people adhere to social distancing? We hope people will wear masks when they go outside. Will the inflection point be the beginning of some downward trend of coronavirus cases in Georgia?

This is the time when watching what might happen is not enough. People need to move cautiously as they open a business, or for customers, take all precautions before you decide to have your hair or toenails cut.

You can check the Georgia Department of Public Health website, and find out what the graph will look like in the weeks ahead. Link to the COVID-19 Daily Status Report.

In Summary

This is a serious situation. The evidence from past experiences is not very good if we relax restrictions on social mobility. We don’t want to repeat what happened in 1918.

The world is not the same as it was in 1918. Medical science is very different. Research has progressed so much in medical science that people have been kept alive by advances, understanding and how to deal with many diseases.

However, this virus is very dangerous. We are learning more about it each day. People who get this virus, especially if they have underly\ing conditions, have a high probability becoming very sick, and of dying.

Howard Markel, M.D., Ph.D, University of Michigan Center for the History of Medicine believes that keeping people at home is the best solution in the present situation.

He helped coin the phrase “flatten the curve,” and says that to keep the numbers low we need to work together to prevent the virus’ spread. He worries about a double peak, that I mentioned earlier. He doesn’t think that we should ease up on social distancing, and give the virus a chance to race back in.

So, for those of us who live in Georgia we have a responsibility to safeguard the health not only of ourselves, but the community at large. Perhaps, hearing what Dr. Howard Markel says about this would be helpful advice:

“If you ask me, I will always err on the side of the public’s health,” he says. “And I think that’s true for any of us who are on or near the front lines of this pandemic, and seeing the horrifying carnage it’s causing because we don’t yet have an effective treatment or vaccine. We need to stay the course, prevent more deaths and buy more time. We are better off safe than sorry.”

Kaara Gavin, With the COVID-19 Curve Flattening, It’s Time to Prevent a Second Peak, Health Lab, University of Michigan, April 15, 2020, Extracted April 26, 2020.