As part of Grand Forks' COVID-19 response, data leader Michael Dulitz looks under the hood
Grand Forks Public Health COVID-19 data analytics leader Michael Dulitz spends his days looking at what the numbers can tell us about coronavirus in Grand Forks, how we got here and where we might be going.
Grand Forks Public Health COVID-19 data analytics leader Michael Dulitz spends his days absorbed in local coronavirus data, case numbers and trends. And when the day is over, it's those numbers that keep him up at night.
In a Friday, Nov. 6, interview with the Herald, Dulitz ticked off a list of his greatest concerns. In recent weeks, Grand Forks County has experienced an exponential growth in cases. Particularly worrisome is the recent uptick in cases in people 60 and older, who are at higher risk for COVID-related complications.
Other regions that have seen an uptick in older age groups have seen hospitalizations and mortality rates rise soon after, Dulitz said.
"That is incredibly concerning for us because we're seeing case growth in a way that we haven't seen before, to the point that we're looking at it as a matter of doubling time versus anything else," he said.
As cases have risen, Grand Forks and the surrounding communities have begun to adopt policies to try to mitigate the spread of the virus. On Oct. 26, the Grand Forks City Council unanimously passed a resolution requiring mask use in public, and last week, Grand Forks Mayor Brandon Bochenski ordered bars and restaurants to close at 11 p.m.
It's too early to see the impact the local mask mandate will have on COVID-19 numbers. Dulitz says increased mask usage will likely start to be reflected in the case numbers two to three weeks from the day that the resolution took effect. Because there has been nothing similar to a mask mandate in Grand Forks in the past, it's difficult to make guesses about what the impacts might be, Dulitz said.
But there has been an early closure order for bars and restaurants before in Grand Forks. That makes it a little easier to guess what impact the new order might have on the community, though Dulitz said this situation isn't 100% comparable to the last time Bochenski issued such an order.
The previous mayoral order that closed bars early was in August, when case numbers rose dramatically as UND students returned to Grand Forks. During that time, Dulitz said cases spiked particularly among the younger age groups. Case numbers went down after Bochenski ordered bars and restaurants to close. Dulitz believes that's probably for multiple reasons, but he believes the early closure order was one of them.
It's tough to say whether the early closure order will have the same effect this time, he said. In August and September, high case numbers were concentrated within younger age groups, and could be likened more to an outbreak. Now that there appears to be uncontrolled community spread among all demographics in the community, Dulitz said it's unclear whether the virus will be so easily contained.
One area in which Grand Forks does well is testing, he said. Dulitz commended Grand Forks community members for their apparent willingness to be tested, and said he remains confident about Grand Forks Public Health's ability to identify people who have the virus.
That could help slow the spread of the virus in Grand Forks. Dulitz used the example of Ward County, which includes Minot, where the rate of testing is significantly lower. That county is experiencing a high positivity rate among older generations, and as predicted when that happens, the local hospital system is experiencing critical strains.
According to Dulitz's calculations of a simple mortality rate, or the number of deaths divided by the number of cases, North Dakota's mortality rate is 1.2%, compared to 0.46% in Grand Forks. Unlike positivity rates, mortality rates are not as closely impacted by the amount of testing a community does or doesn't do, but mortality rates also can be a lagging indicator of COVID-19 in a community. He noted that Grand Forks Public Health first observed the uptick in positive cases among people in older age groups in mid-September.
Altru Hospital reported last week that it is expanding the number of beds in its COVID-19 ward, and transitioning to the second tier of its surge plan. If the hospital becomes overwhelmed, the effects will be felt throughout the community, Dulitz said.
"I'm worried for individuals who have COVID and individuals who are seeking care for other reasons, just because of the burden that COVID has on hospital system," he said. "It is pretty substantial and that could end up affecting other areas of the hospital or making it more difficult to provide the high quality care that we're used to."
As local decisionmakers continue to adopt policies to help bend the curve, Dulitz suggests that looking at North Dakota's neighbors might be a good place to start.
Minnesota is recording record case numbers, but increases relative to that state's population are still a fraction of what's being seen in North Dakota. South Dakota's case numbers are following a similar trajectory as North Dakota, though their testing rate is significantly lower. Dulitz guessed South Dakota probably has substantial undetected community spread.
Manitoba is seeing increases in case numbers, but its numbers of new reported cases and community spread are substantially smaller than in North Dakota.
"I don't have a specific model that I would mention to use," he said. "But, you know, looking at our neighboring states we can kind of see what positions a state or province well versus what necessarily did not."