Spring is springing and cases are very low. Dunn County is now down into the Moderate level of community *transmission*, which was CDC's *old* and conservative threshold for when masks were no longer recommended indoors. We've been at a low Community *Level* (Green) for several weeks now. Remember, the change is prompted by the fact that our current variant, Omicron, is less severe (and that we finally have some better therapeutics), so we are a bit less concerned about overall cases / transmission and instead focus more on severe illness/hospitalizations and preserving medical capacity.

Vaccines are still working really well at preventing severe disease.

Unvaccinated folks are still > 10x more likely to die or get hospitalized, so about 90% of those now getting hospitalized are unvaccinated folks. WI DHS data from December (Delta wave) shows that the mortality rate among those infected was 0.23% in vaccinated folks and 1.07% in unvaccinated. Omicron is less severe, with mortality rates of about 1/4 to 1/3 that of Delta, so approximate mortality rates of those infected with Omicron are likely 0.07% for vaccinated and 0.36% for unvaccinated.

BA.2 is making her move, slowly, here in the US. The proportion of cases due to this sister variant of Omicron is gradually edging up and in some regions of the country is over 30%. In some areas of the world, once it topped 50%, they saw another surge. In other areas, however, they didn't. We don't know yet what will happen here.
This is why all eyes are currently on wastewater surveillance monitoring. Yes, your sewage (if you're on a public system) is being tested for COVID. In general, there has been a pattern where numbers in sewage tend to go up about a week or two before numbers of actual cases go up, so it can act like an early predictor of case rates. In some parts of the country, sewage numbers are starting to go up, a little, maybe. Not here yet. We shall see.
In the UK and other European countries that are currently seeing a surge due to BA.2, they not only dropped masking requirements at the same time but ALSO dropped any requirement to stay home and isolate when you test positive. Yes, you heard right - in those countries, people actively infected with COVID are still going to work and school and about town. That would of course serve to increase transmission. Officially, that is not the case here, which could make things play out differently here, although we all know that unofficially there are likely many folks doing the same thing, whether because they don't know they're infected or they don't care.

So, we may see another surge in cases in due to BA.2 in the next weeks to months. Or we may not. We are unlikely to see any significant increases in severe illness in vaccinated folks in any event. And we will keep an eye on our hospital capacity to make sure they don't get overrun due to unvaccinated folks. If hospitalizations start to get too high, it will make sense to re-institute mitigation measures to decrease transmission and protect medical capacity. In the meantime, if you feel comfortable, now is a good time to get together with friends and go out for a nice dinner.

Dr. Alexandra Hall
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