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Surge in Covid-19 deaths leaves Erie County's spot on pandemic curve unclear

Erie County seems to have experienced a surge in deaths related to Covid-19.

But what that means about the county's spot on the pandemic's curve is not clear.

The uptick seen earlier this week in the number of deaths in the county may have been a byproduct of reporting delays due to the holiday weekend, County Executive Mark Poloncarz said Wednesday. In addition, there was a "disconnect" between when information reported by nursing homes was sent to New York State and when that data was received by Erie County, Poloncarz said.

The latest modeling projects that Erie County still won't see its peak until some time in May, and while the projected peak for hospitalizations has been lowered, there is still concern the county may not have enough intensive-care beds to meet projected demand, the county executive said.

Erie County has "sort of plateaued" with regard to the total number of people with Covid-19 who are hospitalized and in intensive care in the county, Poloncarz said. On two recent days, the number of hospital discharges exceeded new admissions for Covid-19.

"I'm not certain if the hospitalization and ICU numbers are indicative of just (fewer) people getting sick and having to be put in the hospital as much as it is individuals who have just died," he said.

Since Monday, Erie County has received reports of the Covid-19-related deaths of 35 nursing home residents, Poloncarz said Wednesday. Four of the 35 who died were living in a nursing home in the county but were not considered Erie County residents, he said.

As of early Wednesday evening, the county's death toll had reached 104, with three new deaths reported Wednesday. Twenty-eight deaths of county residents were reported Tuesday, after 12 came Monday. Those were the single-deadliest days reported in the county so far during the pandemic.

That flatlining hospitalization rate is especially significant, said Dr. Peter Winkelstein, executive director of the Institute for Healthcare Informatics at the University at Buffalo, who has developed models to help hospitals and health officials predict the local spread of Covid-19. Overall case numbers are a poor indicator of the virus’ trajectory, Winkelstein said, because of limited public testing.

Hospital testing, on the other hand, is thorough and frequent – so trends within local hospitals provide “our best window” into the spread of the virus across Western New York, Winkelstein said. Right now, the leveling-off of new hospitalizations suggests that social distancing has begun to slow the outbreak here.

Deaths have continued to increase, however, because critical patients die in the weeks after they’re first infected. In other words, the current death rates mirror spiking hospitalization rates from a week or two ago.

“This is a clear indication that social distancing is working,” Winkelstein said. “We don’t know what the future is going to be, if it’s going to stay flat or go up or down. And it’s not time to back off social distancing yet, because we don’t know if we’ve hit the peak … But it’s encouraging that the number of Covid-19 patients in hospitals has begun to level off recently.”

Winkelstein declined to publicly project when that peak precisely might hit. While he has shared those predictions with local hospitals and health officials, he said, there is too much flux and uncertainty in the models to forecast a date for the public. Passing the peak also will not mean a return to “normal” life, he and other public health experts have warned.

“This virus is not going away,” Winkelstein said. “Even if the peak were today, which would be wonderful … that just means we’ve weathered first big wave of it, and can start to talk about how we plan to live in a world where the virus is still circulating and where people are still getting sick.”

Information revealed earlier this week about the nursing home deaths in Erie County, while it was sent to New York State, was not sent to the county and contributed to the significant increase in reported Covid-19-related deaths, Poloncarz said. Some nursing homes reported deaths Monday that occurred late Saturday or Sunday, and that may have been due to reduced staffing for the Easter holiday weekend, he said.

"It threw off our numbers," he said.

The nursing homes, which report the deaths to New York State, are not required to report deaths to the county, Poloncarz said. However, the nursing homes are required to report confirmed Covid-19 cases to the county, he said.

Erie County has tied directly into the state's information system and officials believe that will allow the county to receive information more quickly, he said.

Statewide, there had been 2,477 Covid-19-related deaths of nursing home residents and 6,198 confirmed cases of Covid-19 as of Tuesday, according to the state Department of Health. In assisted living facilities as of the same time, there had been 583 deaths of residents and 1,375 confirmed cases, the department said.

In Erie County over the six days from April 8 through Monday, there were two days when more people who had been diagnosed with Covid-19 were discharged from hospitals in the county than there were cases admitted, according to Poloncarz.

"If we see a continued upward trend in new hospitalizations over discharges, that’s telling us we have not reached our peak yet," he said. "When we start to see a continued trend of the discharges being greater than the hospitalizations, then we now were in a good position."

"We're not there yet," he said.

There were 123 new confirmed cases of Covid-19 in Erie County as of Wednesday evening. The new batch of cases brings the total number in Erie County to 1,853.

Niagara County on Wednesday announced four additional deaths and 13 more cases. Niagara County has reported nine total deaths and 229 confirmed cases.

Erie County on Tuesday received a shipment of personal protective equipment from the state, including 29,000 N95 masks, 192,000 surgical masks and 84,000 gloves, which will be distributed to area health care providers, Poloncarz said.

News staff reporter Caitlin Dewey contributed to this report.

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