Another week of slightly up / slightly down on the official metrics on the dashboard. No drastic changes to report this week. It would be great to report a drop in confirmed cases, but holding steady is better than skyrocketing upwards! Keeping in mind that the confirmed case rate is an underreport, I think the steady trend reflects reality - we probably are in the midst of steady (high) community transmission.
The CDC variant tracker and surveillance data from Hampshire County confirms that the BA.5 variant is dominant. I'm not sure how to explain how quickly the jump occurred in Hampshire county, other than perhaps a reporting anomaly. I suspect the currently reported levels are accurate - more than 80% of infections everywhere in the US are the result of the highly infectious BA.5 variant.
Waste water surveillance data from Hampshire county and the US in general both show a similar pattern of leveling off and perhaps even dipping viral concentration in wastewater. It's possible that this is a momentary respite on the way up (as seen previously, a few times on the way up for the initial omicron surge), but it's also possible that this is signaling a true plateau and perhaps even peak. I'm a bit surprised by the relatively low height of this peak, if it is indeed the peak, but I'm happy to be pleasantly surprised.
That reminds me of something Dr. Osterholm, Director of the Center for Infectious Disease Research and Prevention, often says: the more we learn about this virus, the more we realize we don't understand. As much as we'd like to predict what will happen next, with the next variant, or even with a current variant, there are so many factors that make it very difficult to predict. In this case, I suspect that the level of immunity from prior infection and vaccines has allowed for a large amount of community transmission, with folks in general having a lower viral load throughout their infection, resulting in an overall trend of fewer "sick" people, a low peak of confirmed cases, a relatively small proportion of cases requiring hospitalizations, and an even smaller proportion of cases requiring a stay in the ICU.
A few other updates this week:
- Officials are "hoping" that an omicron-specific booster will be available in early to mid-September. If that timeline is indeed possible, I would expect to not see any other booster recommendations between now and then.
- We are slowly learning more about long COVID - one particular question of interest is if re-infection increases your risk of having long COVID. There are two answers to this that seem to be coming out of the data:
1) Each additional infection seems to be less severe than the one before, and there is a strong but imperfect correlation between disease severity and risk of long COVID - which is to say, a mild reinfection probably has less risk of long COVID that the prior infection.
2) Even if each additional infection is associated with lower risk of long COVID than the infection before, each additional infection has some associated risk of long COVID, and thus, additional infections do raise your overall risk of long COVID. Your best bet for avoiding long COVID is to get vaccinated and boosted and avoid infection as much as possible. (To which everyone says, DUH, no one wants to be infected. You're welcome for this flash of brilliance!).
- Figuring out your personal risk and how you should act in light of that is increasingly difficult. For adults who are vaccinated and boosted and are "generally healthy", there's probably little risk for you, even if you are infected. Anyone who is unvaccinated is definitely at high risk of infection and severe outcome, although the number of prior infections you've had will temper that a bit. The hardest assessment of risk is probably for those who are vaccinated and boosted but who have one or more factors that make them "high risk" (age, cancer, immunocompromised, etc.). While community transmission is so high, universal indoor masking is a good idea. I'd suggest universal indoor masking for all right now, because it will protect individuals and each other.
Speaking of which, in recent discussions about about mask requirements and mask advisories, I was reminded of the power of language around masking. I think this is a great time to remember that there are people around you who would benefit greatly from universal mask wearing. No one is being mandated to wear a mask. Some places might have signage that masks are still required, and some might say things like "please wear a mask!". Those are indications that the space is being kept as safe as possible for all folks, especially those who are high risk. Rather than going back to a world where we need mask mandates, I hope we collectively see these signs (or hear someone say it) and just.... slip one on to protect each other.
Megan W. Harvey, PhD (she/her)