There are slight variations in the case rate this week at the community and county level, but essentially I think we're looking at stability. I am encouraged, again, that ICU hospitalizations are not increasing and, additionally, this week I am encouraged that it looks like wastewater surveillance data is showing a decrease in viral concentration. I think this is a sign that we are moving in the right direction. Hampshire County has moved back into the low risk category according to the CDC. It's interesting to note that while this looks like an indication of change from last week, it actually reflects just small variations in official case rate. We don't yet see a difference in hospitalizations. There does seem to be a decrease in hospitalizations at the state level, however. Hopefully that is coming to Hampshire County. Again, all in all I think this is a signal of stability from last week. But stability versus continued increase is very welcome!
Whatever increase we are currently experiencing is not yet due to any new variants. We are continuing to watch new variants in the US. Last week I reported an increase in variants BQ.1 and BF.7. Both of those variants continue to increase in the US, but this week we saw a large increase in another variant, BQ.1.1. BQ.1.1 has surpassed BF.7 and is poised to become dominant over B.Q.1. We will continue to keep our eye on all of the new variants, but it does look like BQ.1.1 is going to become dominant. We don't have data on these new variants in Hampshire county wastewater yet. I hope we will have this information soon! As we discussed last week, whatever variant becomes dominant next, by definition, will be more contagious than BA.5 and has the potential to cause a surge and contribute to that "triple threat" situation worrying epidemiologists.
Finally, this is the first week that I have seen an indication that the United States is going to provide data specifically tracking how many people are getting the updated bivalent booster. I hope we will see more detailed information on this in the coming weeks. Right now we have state level information about the booster. In general, too few people have received the booster dose. Massachusetts is on the higher end of the spectrum, but still shockingly low at just 14.1% of people of age 5 receiving the updated booster. Around the time the booster dose was approved, data was released predicting what might happen over the winter at various levels of booster uptake. The conclusion was, unsurprisingly, that high booster uptake would prevent some disruption due to illness but would have large implications for severe disease and death, perhaps preventing more than 100,000 deaths. The current level of booster uptake is below even the lowest estimate in that prediction. In other words, we need to get this booster rate up if we are going to avoid the potential for devastating loss this winter.
Stay well - and get boosted!
Megan W. Harvey, PhD (she/her)
Epidemiologist