COVID-19 data last week continues to stay low. We do see a continuation of some of that slight "up-and-down" variability that I've referred to in prior weeks, but I don't see significant changes.
Given this current trend and the amount of time we seem to be spending here, I thought it was worth zooming out to see how this plateau with slight up-and-down variability registers in the context of our three (yes, three!) years of experience with COVID-19. I see three things worth noting:
First, the case rate in Easthampton and Hampshire County are steadily low and have been since a peak that occurred about a year ago. The official case rate, particularly in the last year, represents only the results of PCR and rapid tests that occur in health care settings and certainly misses cases identified through a home rapid test. So we should acknowledge that the true case rate is something higher than the number we see reported. But, we should also acknowledge that it's not a meaningless rate just because we know it's not 100% accurate - it reflects how many people feel icky enough that they decide to schedule a visit to figure out if they have COVID-19, the flu, RSV, strep, or "just" the common cold. This might mean there's a really low rate of COVID-19 in the community, and/or it also might mean that people who are getting it are not getting very sick (if they feel sick at all).
Second, there's a bit of variation in the past year in the concentration of virus in wastewater and in hospitalizations in Hampshire County. This indicates greater variability of infections in the community than is represented by the case rate. These are not contradictory pieces of data! We have a lot of immunity from a combination of vaccines and prior infections. That means that even when we see more infections (and therefore, more virus in wastewater), we don't end up with surges of people who are feeling really sick (hence the steady case rate), but we do see variability in severe disease (hospitalizations and deaths) because some individuals remain vulnerable, even with high levels of immunity.
The question, of course, is who is in that vulnerable group at this point? We've thought about this group in a variety of ways over the past three years and certainly there are risk differences by health status, but we have arrived at a point where one group is clearly more vulnerable than others - older adults. I checked hospitalization and death data in Massachusetts to confirm this information. The pattern is clear. Risk of severe illness and death increases a little after age 60, jumps a lot after age 70, and then really jumps high after age 80. The average age among those who die from COVID-19 is 80.
I hope this provides some helpful insight into where we are right now with COVID-19 and how to think about your personal level of risk. For those who do consider themselves at risk (and for their friends and family) or who want to avoid infection for any reason (hey, being sick isn't all that much fun, even if it's not "serious"!), the things we know to reduce the risk of infection always work, like being vaccinated and boosted (especially with the updated bivalent booster) and wearing a high-quality well-fitting mask in public locations with poor ventilation (either via an old / dysfunctional HVAC system or sealed / unopened doors and windows).
Stay Well,
Megan W. Harvey, PhD (she/her)
Epidemiologist