As everyone knows, covid numbers are way down. In the context of the recent devastating surge, this is wonderful. If you look at it through pre-pandemic eyes though, the numbers are still significant and bear watching. The trend, though, is very good. Sort of. How do we know?
We can look of course at numbers on local covid “dashboards” which give us case counts, hospitalization rates, etc. These numbers are very helpful at figuring out what is happening “now” on the ground. What about forecasting the future?
Wastewater surveillance is quickly becoming one of our most powerful forecasting tools. People with covid can shed virus in their stool and if enough people in a community have covid, it can be detected in sewage. Wastewater is a very early indicator of trends in a community, especially if people aren’t doing a lot of testing. It could give us a warning that a community is in the early part of an outbreak and allow us to re-instate mitigation measure. The CDC is currently basing mitigation efforts at least in part on lagging indicators such as hospitalization, but they are developing a wastewater surveillance program, as is the state of Michigan.
We can also forecast by watching the rest of the world. This is how we follow flu trends and plan for yearly flu seasons. But covid is still pretty new and isn’t following clear patterns. Still, we have seen that when outbreaks begin in one continent, they tend to spread globally over the course of weeks. That makes data we’re seeing out of Asia and Europe a bit worrisome.
In Europe, Germany, the Netherlands, and the UK are seeing an uptick in cases. This is also true in parts of Asia. (China is unfortunately not a reliable source of data.) If a new surge is coming, might it come here? And why, so soon after the last one?
The cases in Europe are still due to omicron, but a strain called “BA.2”. A huge number of Americans are recovering from infection with BA.1 acquired this winter. They are probably immune to BA.2 for now, and people who have been vaccinated and boosted are well-protected against severe disease. But there are still tens of millions of vulnerable Americans, so while we aren’t yet seeing a surge develop here, we need to be cautious.
We need to be better about using the tools we have to give us an early warning. And we need to be willing to respond when we see a storm coming. Among the vulnerable are our children. Kids 12-17 don’t have a great vaccination rate. Neither do 5-11 year olds and the two shots many had are probably not sufficient to provide long-term immunity. Kids younger than five don’t have any protection.
So we need to know quickly if boosters can help 5-11 year olds; we need to get more vaccines into arms; and we need to continue to be cautious. With people dropping masking we are seeing an increase in flu cases and in gastroenteritis (“stomach flu”). This is an indication that our covid prevention measures aren’t sufficient to fight off a new surge.
No one really knows the optimal time to re-instate more diligent masking and distancing, but the CDC has set some guidelines (which I don’t entirely agree with), and wastewater data can help as well.
My feeling is that as soon as we start seeing hints of a surge we need to mask in public and in schools. I still mask in public and don’t anticipate changing that soon. I do think we should keep kids masked in schools, at least until vaccination rates go up. (There is a very good argument to requiring covid vaccination in schools as a condition to dropping mandatory masking.)
So go live, enjoy life in a way you haven’t been able to in a few months, but keep an eye on the news and keep a mask in your pocket.
-pal