While there are minute fluctuations in the numbers of the dashboard, I think the overall picture is of another week of steady and low community transmission in Easthampton. There are some communities in Massachusetts experiencing slowly increasing cases, but there's nothing dramatic to report at this time. In fact, 21 states + Washington D.C. are currently reporting an increase in cases. For the most part, these are slight to moderate increases from a low daily average of new cases. Most of the US is continuing to report less than 30 new cases per day per 100,000 population, as seen on the map provided by the New York Times.
The CDC is reporting that about 70% of new infections in the US are caused by the BA.2 variant. That percentage does vary by location. Wastewater surveillance data for Hampshire County indicates that the proportion of cases due to BA.2 is about 83% - slightly higher than the national average. What exactly this means in regards to predicting if there will be a larger increase in cases is unclear. I wish I could predict that better, but I haven't seen any evidence from infectious disease experts that the pattern of cases associated with BA.2 is consistent. This is quite different from the original omicron variant! We knew to brace ourselves for a large increase when that variant became dominant. To me, this is good news. We're not where we were last November! (Not even close).
I'm keeping a close eye on the (lack of) funding getting passed at the federal level for continued pandemic relief, including funding for things like testing, vaccines (booster doses!), and treatments. We need this funding to continue! It is far too soon to consider scaling back public health efforts to prevent, monitor, and treat COVID-19. I hope this issue is resolved favorably, and soon. If there is an increase in cases and then an increase in hospitalizations, not having life-saving treatments available would be (another) incredible tragedy.
Speaking of vaccines, I'm hearing a lot of questions about booster doses! The CDC released updated recommendations for an additional booster dose for folks over age 50. It can be hard to keep track of those recommendations from the CDC - the total number of doses you are recommended to receive, and of what vaccine type, varies by age and health status. I've created a flow chart to help you identify the specific recommendations for you, although, as always, if you have questions or concerns, you should speak with your health care provider. It's in the center of the dashboard, but also as a separate image because I know it's hard to pinch and zoom when it's tiny and in the middle.
In general, the recommendations include getting "fully vaccinated" with 2 doses of an mRNA vaccine (Pfizer or Moderna) or 1 dose of J&J, and then receiving 1 or 2 additional doses of an mRNA vaccine. I'm being very specific when I talk about vaccine type! Essentially, the CDC is recommending that we do not consider J&J to count as a booster dose. Regardless of your original vaccine series, if you were boosted with J&J, you'll want to consider an additional booster of either Moderna or Pfizer. The best evidence we have right now is that the highest level of protection comes from all mRNA doses OR a mixture of J&J and mRNA doses (but not J&J only).
Right now the CDC definition of immunocompromised includes those who are receiving active cancer treatments for tumors or cancers of the blood, received an organ transplant and are taking medicine to suppress the immune system, received a stem cell transplant within the last 2 years or are taking medicine to suppress the immune system, have moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome), have advanced or untreated HIV infection, or who are receiving active treatment with high-dose corticosteroids or other drugs that may suppress the immune system. Importantly, you do not need any documentation of your status to receive any additional booster doses. You self-attest to your immunocompromised status, which means you and your health care provider have the final call on if you should count yourself as immunocompromised or not.
There are no additional safety concerns that have been identified with any number of additional booster doses.
Finally, some folks are asking about if they should be "strategic" about the timing of the booster dose. This is a tough question to answer, because there probably is a "best" time to get a booster dose - if you have the ability to see the future. (And if you do have the ability to see the future, sure, use it to time your booster dose but then be in touch because we all have a whole bunch of questions for you.) It's unsatisfying, but the reality is that there are so many variables related to immune protection and any potential future variants, including that the situation can change incredibly quickly. The advice I have seen from infectious disease experts is to continue getting booster doses when you are eligible for them. I did not include time between doses in the flow chart (that made it quite messy!). Timing information and additional vaccine information can be found on the CDC website, including at the following 2 links: 1) https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html
, and 2) https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/immuno.html
Finally, I have not seen an update on the timeline for the pediatric vaccine in the past two weeks or so. Hopefully soon, but that could mean weeks to a month or more. Specifically, we're waiting for the data submission (and hopefully a public release of data!) and the FDA to schedule a meeting to review and make a recommendation.
Megan W. Harvey, PhD, MS (she/her)