The regional risk assessment (also known as the “bottom line”) is a tool used to understand and communicate the level of risk in our communities through looking at:
- Hazard – Effects on the population
- Mitigation measures
- Ability to respond – capability of the health care system
This product is shared during presentations to regional partners as well as publicly on the Kansas City Region COVID-19 Data Hub.
Over the course of the pandemic, our understanding of the virus and risk factors has evolved. Regional partners have concurred with the following modifications to the regional risk assessment, which will be implemented on Dec. 13, 2021:
- Hazard – Effects on the population
- Remove deaths. Deaths are our most lagged indicator of the COVID-19 situation. This data element will continue to be available on the hub. However, as an assessor of regional COVID-19 risk, this indicator lacks timeliness to a degree that makes it less useful than other metrics.
- Add CDC community transmission. The Centers for Disease Control and Prevention use a four-tier system to rank levels of community transmission, which is a combination of new cases per 100,000 persons in the past seven days and percentage of positive tests during the past seven days. Many of the health departments within our region are using this as their risk measure. To ensure we are aligning with both our public health partners and the CDC, we have added this metric to the bottom line. Ratings are collected by county and weighted for their percentage of the regional population to calculate the overall score.
- Add cases thresholds. Case rate thresholds have been added to define the upper and lower bounds of each risk category, based on the CDC thresholds (less than 10 new cases per 100,000 persons in the past seven days, 10-49.99, 50-99.99 and greater than 100). Previously, we had been using two weeks of increase/decrease as our benchmark for risk rating changes. Because this previous version was relative, it did not lend itself to standard reporting for a specific case number at different times over the pandemic period.
- Add hospital thresholds. Hospital rate thresholds have been added to define the upper and lower bounds of each risk category, based on historical pandemic experience (for the Metro Region: less than 10 new hospitalizations, 11 – 45, 46 – 75, and greater than 75, and for the HCC NS Region: less than 3, 3-5, 5-10, and greater than 10). Previously, we had been using two weeks of increase/decrease as our benchmark for risk rating changes. Because this previous version was relative, it did not lend itself to standard reporting for a specific hospitalizations number at different times over the pandemic period.
- Mitigation measures
- Remove hospital staff access to PPE. This is much less of an issue than it once was, and we believe it falls under our hospitals’ ability to respond rather than a community mitigation measure.
- Add testing thresholds. Testing rate thresholds have been added to define the upper and lower bounds of each risk category, based on the recommendation of 150 tests per 100,000 in the population (100, very high; 125, moderate; 140, low; and 150, very low).
- Add masking protocol. Very rough estimates of the percentage of the population covered by a masking protocol have been added as a mitigation measures risk factor.
- Add assessment category definitions for vaccinations. We added a percentage of the population representing fully vaccinated individuals required for each risk category (80%, very low; 70%, low; 60%, moderate; and 50%, or less very high).
- Add dynamic rating for mitigation measures. If the hazard is low, thresholds for testing and mitigation measures move down one level. If they’re very low, they move down two levels.
- Ability to respond – capability of the health care system
- Adapt hospitals’ staffing metric to look at reporting over a week rather than a single day. The field in the data collection tool used to gather this information defaults to “N” and is an optional field (staff_shortage_overall_today: Enter Y if you anticipate a critical staffing shortage within a week. Enter N if you do not anticipate a staffing shortage within a week. If you do not report this value, the default is N). We have requested area hospitals report at least once per week into this optional field.
- Replace hospital resource capability with hospital resource utilization: Hospital resource utilization will give us a better understanding of any resource limitations in the region.
We believe these adjustments will provide an improved assessment of risk. As always, feedback is welcomed at covidhub@marc.org.