Last week I reported a slight increase in the 7-day average of new cases per day in Easthampton, while the 14-day average reported by the state for the city and for Hampshire and Hampden counties continued to decline. This week, however, the 14-day average has "caught up" to the 7-day average (which is more responsive to changes in trends) and the dashboard reflects an increase in the 7-day and 14-day average daily case rate in Easthampton, Hampshire, and Hampden counties. Easthampton is back in the "yellow" medium category of transmission. The case rate in Easthampton over time is depicted in the middle of the dashboard this week.
The BA.2 variant is keeping us on our toes, for sure - there's definitely no large increase in cases like there was in the UK, but we are now seeing this slow increase. As we've discussed, data from the UK indicated the potential for a national increase. Cases are decreasing again in the UK, however, after their BA.2 surge (see visual). It's not clear if there will be a US uptick at some point or pockets of high transmission in some locations, as occurred with the delta variant surge in the US. As unsatisfying as it is, we'll have to continue watching and waiting. Wastewater surveillance data indicates that there may be a continued slow increase in transmission.
The local and national situation is unclear right now, not just because we aren't sure what will happen in the next few weeks, but also because it's not clear how we should classify what's happening right now. For example, you can think about case rate and community transmission in this city / county in at least five ways: 1) the former MA categories of transmission (as presented in this dashboard), 2) the CDC transmission categories, 3) the New York Times transmission levels, 4) transmission risk categories from COVID Act Now, and 5) wastewater surveillance data.
1) MA color categories: We are continuing to categorize the case rate according to the color-coded green/yellow/red metric that the state of MA formerly used, for consistency. It allows us to compare the situation over time, and since we're all used to it, allows us to gauge the situation. Last summer we had a nice long stretch of "green" low transmission - about 16 weeks! That's a nice baseline for us to consider. It would be great to hit that kind of groove again and enjoy an easy, low(er) stress stretch. After a few weeks in the green, however, Easthampton is back to the yellow. You can see this in the middle of the dashboard this week.
2) CDC transmission categories: The CDC metrics categorize most counties in the United States as having "low" community transmission. Those new metrics were discussed in the 2/24/22 Easthampton COVID-19 Dashboard, if you're curious how they're determined. In general, this categorization is helpful for getting a broad understanding of the burden on our health care system. In other words, local health care systems are able to handle the increasing case rates in these green areas of low transmission right now. You can see this in the CDC county-level map.
3) New York Times transmission map: The New York Times maintains a county-level transmission map that doesn't categorize transmission into groups of low / medium / high, but rather allows you to visualize actual case rate in each county across the US with a color density map. It is evident with that data that the Northeast, Colorado, and parts of Texas and Alaska have relatively higher case rates than other areas of the country, although only a few counties in the country are reporting levels above 50 new cases per day per 100k population. You can see this in the New York Times transmission map and the comparison of case rates by region.
4) COVID Act Now risk categories: Covid Act Now maintains a county-level map with transmission risk categorized from low to extremely high, based on daily new cases per 100K (incidence), infection rate (Rt), and test positivity. The trends on this map reflect the transmission levels indicated on the New York Times map, but this version provides additional information about how fast the situation is changing and how equipped the state / county is to handle the increase in cases. It can sort of be considered a merge between the New York Times data and the CDC categories. You can see this in the COVID Act Now risk map.
5) Wastewater surveillance data: Finally, wastewater surveillance data is increasing in importance as a measure for actual community transmission. As we've discussed, the increased availability of rapid at-home tests is great but means that some cases are "missed" in the official count. They're not missed in the sense that a contagious person is out and about, spreading COVID-19 - they test at home, get a positive, and then stay at home until they're no longer infectious. Anyone in this situation is not reflected in the official case rate reported here on this dashboard, or in any of the other data mentioned above (i.e., the CDC, the New York Times, COVID Act Now). Wastewater data doesn't miss cases, however. It gives us a realistic view of viral concentration in the community today and can help us interpret the official reported case rate. You can see this in the graph of viral concentration in wastewater.
That's a lot of information about the current situation! The real question is - what does it all mean, and what are we supposed to do? I think Dr. Osterholm from the Center for Infectious Disease Research and Policy summed it up well when he said last week that we "prepare for the worst and live for the best." We may not see a rise in cases in the coming weeks - that's great. That's (of course) the preferred outcome. But we won't be caught off guard if cases do rise (or if infections rise, regardless of official case rates), and we'll remember what to do - mask with a KF94 or better, and stick to well-ventilated or outdoor locations. You can get a whole lot of additional protection by getting vaccinated. It's certainly not a good time to reduce funding for COVID-19 testing or treatment access. My fingers are crossed that we see adequate funding from federal and state level continue.
A few notes to end the dashboard this week:
- In the past few months, mask mandates around the country have been lifted. Philadelphia, PA has reinstated an indoor mask mandate, starting next week. Notably, public health leaders in the city have referred to the move as a way to be proactive about their local increase in cases, to protect their most vulnerable, and, notably, to attempt to prevent worsening health disparities by race or ethnicity in infection or severe disease. The current case rate in Philadelphia County, by the way, is about 9 cases per 100k population. More information here: https://www.phila.gov/programs/coronavirus-disease-2019-covid-19/guidance/covid-19-response-levels/
- After months of new daily vaccinations, daily vaccinations are increasing again in the US. It's hard to say why - but it's a welcome trend. Every additional dose provides a lot of protection!
- We have not heard any further updates on the Moderna pediatric vaccine. There are many public health leaders growing frustrated at the lack of information and that the data has not yet been made public. We also expected an update from Pfizer on the 3-dose vaccine series this month - no update yet.
Megan W. Harvey, PhD, MS (she/her)