The most important update this week is that Hampshire County is now in the CDC’s “medium risk” category. In this case, it’s because there are more than 28.6 new cases per day per 100,000 population – that alone is enough to move to the medium risk category. The other factor to keep an eye on is the number of new COVID-19 hospitalizations per day per 100,000 population and the percent of hospital beds occupied by COVID-19 patients. This week there were 8.1 new hospitalizations per day and 6.4% of hospital beds are occupied by COVID-19 patients in Hampshire County. If those increase past 10 new hospitalizations per day or 10.0% of hospital beds occupied by COVID-19 patients, we’ll move into the “high risk” category.
At the “medium risk” level, the CDC recommends that:
1. those who are high-risk wear a KF94, a KN95, or an N95 mask indoors at all times. Please note that a cloth or surgical mask does not provide enough protection against these highly contagious omicron sub-variants. They used to be a reasonable choice but they just don’t have enough filtration to protect you at this point. KF94 / KN95 / N95 masks are widely available and you can always contact your local department of health to get more (masks – or rapid tests!).
2. those who have household or social contact with someone who is high-risk wear a KF94 / KN95 / N95 mask indoors and test frequently and before contact with the high-risk person.
This is solid advice from the CDC, although epidemiologists would adamantly say this is good advice whenever community transmission is substantial or high, not just when it’s high enough or hospitals are full enough to move into a higher risk category as defined by the CDC.
We focus a lot on serious disease, but of course there are many reasons folks want to avoid infection in general – feeling sick is unpleasant, being out from work or school is disruptive, and each infection is associated with the risk of long COVID. We continue to learn more about long term effects of COVID-19 infection, and there’s one with enough evidence at this point that I want to make sure you know about it.
Research indicates that COVID-19 infection among children under age 18 is associated with an increased risk of diabetes. The data comes from more than a million children, and the study was careful to compare risk after COVID-19 infection to risk after any kind of respiratory infection (like the flu, or RSV) to be sure that there’s something different about risk after COVID-19 infection. It's really important to know up-front that we're talking about small risk differences and an overall small risk. This is not meant to be alarmist news - researchers are not saying that children will get diabetes after having a COVID-19 infection, or anything along those lines. Six months after other respiratory infections, 0.025% of children were diagnosed with diabetes. Six months after a COVID-19 infection, 0.043% of children were diagnosed with diabetes. That is both overall very rare AND nearly a doubling in risk. But any additional pediatric cases of diabetes are important to avoid.
Perhaps this perspective will help with framing: Last week there were 39,200 official pediatric COVID-19 cases in the US. This data indicates that 16.8 of these children will be diagnosed with diabetes in the next six months. If those 39,200 children had a different respiratory infection, like the flu, just 9.8 of these children would be diagnosed with diabetes in the next six months. The AAP reports about 15 million pediatric cases since the start of the pandemic - and remember, we know that official cases are an underreport of the true number of cases. Many people, including children, test positive at home on a rapid test and are never included in the official case count. At those kinds of numbers of infection, you can see that this increased risk of diabetes has a very real impact on children.
The take-away message is that it's a very good idea to everyone, including children, to avoid infection if possible and for everyone, including children, to be up to date on the COVID-19 vaccines. And get the new booster! Vaccination rates are incredibly low among children, however. Less than 20% of children under 5 in our area are vaccinated. Rates vary among children ages 5-18, but are lower than vaccination rates in older age groups.
Other news this week:
- We have data that confirms what we suspected to be true: the risk of severe disease and death as a result of COVID-19 is higher for cancer patients than for the general population. People being treated for cancer should take precautions to lower their risk of contracting COVID-19, including staying current on vaccinations, avoiding crowded indoor spaces and wearing masks in public.
- The general global trend in cases and death is continuing down, but a number of countries are reporting an increase in cases. It's unlikely at this point that the new subvariants that we're watching are a significant cause of these increases because they have not become dominant in any location. We are still very much in a watch and wait situation. That means the increases are of already circulating subvariants, and it's not entirely clear why we're seeing increases in some locations - likely a combination of waning immunity and spending more time indoors as weather gets cooler.
- Your local epidemiologist released an excellent report last week about COVID-19 and the COVID-19 vaccine among pregnant, postpartum, and breastfeeding women. The report is easy to read and the data is encouraging: in short, there are no additional concerns for pregnant women or babies in getting the vaccine and ample evidence of benefit. You can read it here:
yourlocalepidemiologist.substack.com/p/mrna-in-breastmilk-thats-okay-and
Megan W. Harvey, PhD (she/her)
Epidemiologist