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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
COVID-19 in New Mexico: Epidemiologic and Modeling
UpdateJune 30, 2020
1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
New Mexico has the 32nd highest prevalence in the United States
As of June 30, 2020
1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
COVID-19 prevalence per 100,000 population has increased across all regions
Source: Infectious Disease Epidemiology Bureau, Epidemiology and Response Division 6.28.2020, New Mexico Department of Health. Population estimates, UNM Geospatial and Population Studies Program.
2409.5
125.3288.1
122.6
468.3 502.7
0
500
1,000
1,500
2,000
2,500
3,000
June 22, 2020
2624.7
145.3323.7
161.8
537.3 561.9
0
500
1,000
1,500
2,000
2,500
3,000
June 29, 2020
1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
0
50
100
150
200
250
300
350
New Mexico COVID-19 Cases by Date of Specimen Collection – 6/30/20Positive samples collected during this time
may not yet be reported.
Source: Infectious Disease Epidemiology Bureau, Epidemiology and Response Division 6.30.2020, New Mexico Department of Health.
1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
0
50
100
150
200
250
300
350
0
50
100
150
200
250
300
350
Detention Center Impact: New Mexico Case Count by Collection Date - 6/30/2020
Without Detention Centers Detention Center 7 per. Mov. Avg. (Without Detention Centers)
Positive samples collected during this time may not yet be reported.
Source: Infectious Disease Epidemiology Bureau, Epidemiology and Response Division 6.30.2020, New Mexico Department of Health.
1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
Statewide R-effective continues to climb.
Courtesy of Presbyterian Healthcare Services – June 29, 2020.
1.21
1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
Northeast R_effective 1.25 ↓
CentralR_effective 1.48 ↑
Southeast R_effective 1.56 ↑
SouthwestR_effective 1.06 ↓
NorthwestR_effective 1.12 ↑
Low Level Endemic <1.0
Approaching Low Level Endemic1.0-1.05
Requiring further mitigation >1.05
Key
Courtesy of Presbyterian Healthcare Services – June 29, 2020.
As of June 23, 2020
1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
56.3
38.8
29.5
11.3
3.6 2.7 1.1 1.6 2.2 3.8 3.4 2.94.9
7.49.5 8.9
0
10
20
30
40
50
60
Prop
otio
n
Reported in the week beginning
Proportion of New Mexico resident COVID19 cases who traveled outside of New Mexico in the 14 days before symptom onset by reported week
(excluding state, federal and ICE prisoners, and out of state residents)
These data are based on self report and may be an underestimate*This report was generated before the week was finished, so not all cases have been counted
Source: Infectious Disease Epidemiology Bureau, Epidemiology and Response Division 6.26.2020, New Mexico Department of Health.
1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
Most Commonly Cited Out-of-state Travel Locations
TexasArizonaMexico
ColoradoCaliforniaNew YorkNevada
Source: Infectious Disease Epidemiology Bureau, Epidemiology and Response Division 6.26.2020, New Mexico Department of Health.
1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
0
10.9
2.8 2.4
5.5
9.2
6.16.7
10.6
6.5
8.4
13.4
10.3 10.211.1
9.1
0
2
4
6
8
10
12
14
16
Prop
ortio
n
Reported in the week beginning
Proportion of COVID19 cases reported to NMDOH who are out-of-state residents by reported week, NMEDSS
(excluding state, federal and ICE prisoners from denominator)
*This report was generated before the week was finished, so not all cases have been counted
Source: Infectious Disease Epidemiology Bureau, Epidemiology and Response Division 6.26.2020, New Mexico Department of Health.
1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
0
10
20
30
40
50
60
70
80
90
Metro Region Case Count by Collection Date with 7 Day Moving Average – June 30, 2020
Positive samples collected during this time may not yet be reported.
Source: Infectious Disease Epidemiology Bureau, Epidemiology and Response Division 6.30.2020, New Mexico Department of Health.
1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
0
2
4
6
8
10
12
14
16
18
20
Northeast Region Case Count by Collection Date with 7 Day Moving Average – June 30, 2020
Positive samples collected during this time may not yet be reported.
Source: Infectious Disease Epidemiology Bureau, Epidemiology and Response Division 6.30.2020, New Mexico Department of Health.
1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
0
20
40
60
80
100
120
140
160
180
200
Northwest Region Case Count by Collection Date with 7 Day Moving Average – June 30, 2020
Positive samples collected during this time may not yet be reported.
Source: Infectious Disease Epidemiology Bureau, Epidemiology and Response Division 6.30.2020, New Mexico Department of Health.
1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
0
5
10
15
20
25
30
35Southeast Region Case Count by Collection Date with 7 Day Moving Average – June 30, 2020
Positive samples collected during this time may not yet be reported.
Source: Infectious Disease Epidemiology Bureau, Epidemiology and Response Division 6.30.2020, New Mexico Department of Health.
1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
Source: Infectious Disease Epidemiology Bureau, Epidemiology and Response Division 6.30.2020, New Mexico Department of Health.
0
50
100
150
200
250
0
50
100
150
200
250
Southwest Region Case Count by Collection Date with 7 Day Moving AverageJune 30, 2020
Without Detention Centers Detention Center 7 per. Mov. Avg. (Without Detention Centers)
Positive samples collected during this time may not yet be reported.
1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
The largest increase in COVID-19 hospitalization rate per 100,000 population is in the NW region
Source: Infectious Disease Epidemiology Bureau, Epidemiology and Response Division 6.29.2020, New Mexico Department of Health. Population estimates, UNM Geospatial and Population Studies Program.
472.2
16.3 33.48.2
33.375.6
0
100
200
300
400
500
600
Northwest Northeast Metro Southeast Southwest NewMexico
June 22, 2020
491.6
17.7 35.110.6
38.479.8
0
100
200
300
400
500
600
Northwest Northeast Metro Southeast Southwest NewMexico
June 29, 2020
1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
COVID-19 hospitalizations are declining, and ventilator use remains ~30%
As of June 25, 2020
1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
1 11
2
111
2
11
2
1
4
2
4
5
1
6
3
77
4
5
1
5
99
7
66
9
10
8
5
10
11
14
10
5
8
10
12
13
88
12
10
88
6
7
6
3
4
6
8
10
8
3
6
7
6
8
10
555
7
4
3
4
6
1
6
4
5
4
55
3
2
5
2
5
1
7
1
4
1
3
2
1
0
100
200
300
400
500
600
0
2
4
6
8
10
12
14
163/
23
3/30 4/
6
4/13
4/20
4/27 5/
4
5/11
5/18
5/25 6/
1
6/8
6/15
6/22
Cum
ulat
ive
Num
ber o
f Dea
ths
Dai
ly N
umbe
r of D
eath
s
Cumulative Deaths
Reporting through 6/26/2020
489
COVID-19 deaths are declining
1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
COVID-19 case fatality rates have decreased in the NW, Metro, and Southeast regions since last week
Rates have been age-adjusted to U.S. COVID-19 cases.Source: Bureau of Vital Records and Health Statistics and Infectious Disease Epidemiology Bureau, Epidemiology and Response Division, reporting through 6.29.2020, New Mexico Department of Health.
7.1%
1.6%
5.1%
1.5%
2.6%
5.6%
5.0%
0%
2%
4%
6%
8%
Northwest Northeast Metro Southeast Southwest New Mexico U.S.
Case
Fat
ality
Rat
e (a
ge-a
djus
ted)
1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
6.9%
4.7%
0%
1%
2%
3%
4%
5%
6%
7%
8%
M F
Perc
enta
ge
COVID-19 Age-Adjusted* Case Fatality Rate by Gender, New Mexico
Reporting through 6/26/2020; *Adjusted to U.S. COVID-19 cases.
23.2
15.6
0
5
10
15
20
25
M F
Rate
per
100
,000
pop
ulat
ion
COVID-19 Age-Adjusted Mortality Rate by Gender, New Mexico
Reporting through 6/26/2020
The COVID-19 mortality and case fatality rates are higher in males than females
1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
• Early evidence in China, South Korea, and United Stateso China: Increased hospital admissions and mortality rate in males (Chen et al. 2020, Guan et al. 2020)
oSouth Korea: ~60% of females tested positive, but had lower case fatality rate (Dudley et al. 2020, Ministry of Health and Welfare of South Korea 2020)
oUnited States: prioritization of testing for symptomatic disease revealed similar diagnosis rates between males and females, but 1.5 times higher mortality in males (NYC COVID-19 data)
• 37/38 countries that provide sex aggregated data report a male bias in mortality (Jin et al. 2020, Peckham et al. 2020)o Male CFR is 1.7 times higher than females (male
CFR 7.3, female CFR 4.4)o Increased risk with advancing age and/or co-
morbidity for both sexes, but higher in males at all ages above 30 years
o Increased mortality risk in males, but gender-associated risks influence differences in infection rates
A male bias in COVID-19 mortality and case-fatality rates has emerged worldwide
Scully et al. 2020
1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
Biological sex differences in response to COVID-19 are consistent with other viral pathogens
• These differences encompass “susceptibility to infection, early pathogenesis, innate viral control, adaptive immune response or the balance of inflammation and tissue repair in the resolution of infection.” (Scully et al. 2020)
• Influence of sex steroids, sex chromosomes, genomic and epigenetics
• Differentially affects the aging of the immune system. The resulting immune response to SARS-CoV-2 infection remains unclear
• Alterations in sex steroid concentrations• Age-related mosaic loss of chromosome Y in leukocytes may cause changes in transcriptional regulation
of immunoregulatory gene (Dumanski et al. 2020)
• Consistent with observations during the MERS and SARS epidemics
1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
Known sex differences that may impact immune responses to SARS-CoV-2 and COVID-19 progression
Scully et al. 2020
Integrate sex as a biological variable in all stages of the research and development pipeline (for example- improve therapeutics, vaccine design and efficacy)
Include sex in the intersection of other demographic variables such as age and race/ethnicity to understand the biological and sociocultural factors that result in differing COVID-19 outcomes
1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
New Mexico Status Updates
• Case count: Statewide, daily case counts are increasing.
• Hospitalizations: For the past three weeks, hospitalizations have declined.
• Deaths: Deaths have been steadily declining since mid-May.
• Social distancing: Cell phone data suggests the mobility of New Mexico is on the rise and, in some counties, is reaching pre-pandemic levels.
• Contact tracing: The median time to quarantine for contacts identified last week was 2 days.
1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
Supplementary Slides
1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
Modeling Assumptions
Variable Measured Value Value as of 6.29.20
R_Effective Actual Measured Daily Value by key county
R_eff=1.21
Positive Test Multiplier Calculated by LANL 4.1
Hospitalization and Mortality Actual rolling value / estimated number of total infected
Medical 0.2% ICU 0.2%Vent Rate 63.5% of ICUCrude Case Fatality Rate 4.1%
Length of Stay Actual rolling value / estimated number of total infected
Medical 5 daysICU 14 days ICU on Vent 14 days
1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
The areas with the largest burden of disease in AZ also border the NW region in NM
AZ cases per 100,000 population(as of 6/29/2020)
Source: https://www.azdhs.gov/preparedness/epidemiology-disease-control/infectious-disease-epidemiology/covid-19/dashboards/index.php Source: https://navajo-nation-coronavirus-response-ndoh-nec.hub.arcgis.com/
Navajo Nation Service AreaCumulative incidence rate per 10,000
(as of 6/27/2020)
1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
Case counts in Apache County may be decreasing, while Navajo County is increasing (as of June 29, 2020)
Arizona Apache County(n=2,309)
Navajo County(n=3,570)
Source: https://www.azdhs.gov/preparedness/epidemiology-disease-control/infectious-disease-epidemiology/covid-19/dashboards/index.php
Note: Illness in the last 4-7 days may not be reported yet
1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
El Paso County has the 6th highest number of cases in Texas: 5,745 (as of 6/28/2020)
Texas cases by county
Source: https://txdshs.maps.arcgis.com/apps/opsdashboard/index.html#/ed483ecd702b4298ab01e8b9cafc8b83
COVID-19 in El Paso, TX
Total cases 5,745
Active cases 1,932
Recoveries 3,685
Fatalities 128
Source: http://epstrong.org/results.php
1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
Number of cases in El Paso, TX is increasing
>100 cases confirmed near the border with NM (as of June 21, 2020)Source: http://epstrong.org/results.php
El Paso County cases by zip code
Day by day cases (as of June 26, 2020)
