We recently marked the three year anniversary of the first US cases of COVID-19. The COVID-19 pandemic severely impacted our lives through lockdown, quarantine, remote learning, infection, wearing masks and socially distancing ourselves, serious illness and - for far too many families - death. If we think back to February and March of 2020, I remember a lot of fear and a lot of unknowns. I remember seeing people who had the talent and skill and knowledge to lead us were not doing so. I had lost my mother in 2016. I hadn’t expected to be motherless at such a young age. And I wasn’t prepared to lose my dad too in the face of this new threat. This newsletter and the social media communication I was doing prior to its launch on Facebook and Twitter were born out of an intense need to know all that I could to protect my dad, to protect my children and husband, to protect my siblings and their children, and to protect myself. I had taught microbiology to nursing students who graduated into the front lines of the pandemic and I was in the midst of teaching first year medical students who didn’t realize that the world of medicine that they thought they knew was about to change in drastic ways. I didn’t have the training or skill to save lives through medical interventions like my students could. But I could try to keep as many people out of their hospitals as I could with good information. If I could protect my dad, perhaps I could protect others too.

I’m glad to say that Dad is fine. And so many of you are still here too, three years later. I remember hugging him for the first time since the pandemic started, in June 2021. He was full vaccinated (as were all of us) and he had survived unscathed. Victory! I had been able to coach him through disease prevention until vaccines became available and beyond.

I think the time has come to take a break from writing, at least about COVID-19. It used to be that I had an almost Pavlovian response to need to be at a computer at 4:00 pm EST every day because that’s when Georgia Department of Public Health would upload their data. That was early on in the pandemic. The cadence of data reporting has slowed to once per week and the timing has changed. Last week something weird happened - I forgot to go collect the data on Wednesday and didn’t think to do so until Friday. To me, this was the most in-my-face proof that I had truly burned myself out on COVID-19 and it was time to step away. The need to know and understand was always what drove me in this science communication effort. And I didn’t seem to need to know anymore. If the data didn’t motivate me anymore, then perhaps it was time to focus elsewhere.

Let’s go through the data we have to date on the pandemic for Georgia. Georgia is where I started this newsletter and its situation really isn’t all that different from other parts of the country at this time. First, let’s begin with cases. The graph below shows the weekly case total per week in Georgia since early on in the pandemic, 30Mar2020.

We can see the first summer surge, which seemed so massive at the time, peaking right over 30Jul2020. We can see the first winter surge followed by the advent of vaccines leading to steep declines in spring 2021. Then we see the Delta wave in summer 2021 followed by the biggest peak of all, Omicron, in December 2021. But we have seen two predicted surges since then. The summer surge of 2022 was about the same size as the summer surge of 2020. And the winter surge of 2022 - 2023 was the smallest one yet, even though historically the winter waves have always been so much worse.

Of course, cases aren’t the most reliable indication of the intensity of the pandemic due to the wide range of severity for cases (from mild to severe), it looks like a lot of other things and so many people are taking home tests rather than the official ones that get counted by the states. For that reason, looking at the hospitalization data can be far more indicative of what’s going on. Below, you can see the graph for hospital admissions (orange line, goes with the left y-axis) and ICU admissions (gray line, goes with the right y-axis). These data, and all the others presented in this newsletter, come from the Georgia Department of Public Health.

What we can see is that the number of COVID-19-related hospitalizations reported each week has risen and fallen with each wave. For the first four waves, the peaks were about the same size. But after the Omicron wave in winter 2021-2022, the peaks became much smaller. In the most recent wave, fewer than 1000 Georgians were hospitalized for COVID-19 at the peak. When we look at ICU admissions we notice something interesting. With each successive wave, the peak for ICU admissions related to COVID-19 shrank. What could explain these two findings? My hypothesis is that after Omicron, infection was so widespread that nearly everyone in the country had been exposed to and developed some baseline of immunity to COVID-19 through infection or immunization. And while that immunity might not be bulletproof against every variant, it provided enough cross-protection that cases that came up after Omicron were milder than the ones prior to Omicron. In other words, far more of these were more manageable at home, rather than requiring a hospital bed or an ICU bed.

We can also look at deaths attributed to COVID-19 in Georgia. The graph below shows 5 major waves followed by two very small ones that are harder to define above the baseline.

Again, I think that a certain amount of cross-protection is conferred by vaccination and past infection, even if its not a perfect match for the variant circulating at the time. However, I would be reluctant to assume that this cross-protection lasts forever. The latest decision from the Food and Drug Administration is to administer the COVID-19 vaccine once per year, likely along side the flu shot. It will be designed and manufactured in much the same way as the flu shot in that they will have to predict months in advance (usually in the spring) the strains that will be circulating during the following winter. They can base this off of what is most common in the southern hemisphere (where it is fall and transitioning to winter). Sometimes their estimate is spot on, sometimes it is not. But even when it is not a perfect match, the flu shot often provides a lot of cross-protection and can reduce the severity of illness. That’s why I make sure my whole family gets it every year. We’ll be getting the COVID-19 vaccine, likely at the same appointment. In fact, the CDC has now added the COVID-19 series to the regular vaccines recommended for children (ages 6 months and up) and adults.

I plan to keep collecting data through 11Mar, because I want to have three complete years of case data. But this will be the final newsletter for the COVID Digest. I’m going to take at least a couple months off from this and then may consider relaunching the newsletter focused more broadly on science communication on a range of topics that are in the news. For paying subscribers, I’m pausing all billing during this hiatus. If and when I relaunch I’ll reach out to paying subscribers first so that they can make an informed decision in regards to continuing to support my work.

There is a sadness that comes with pausing writing right now. While I’ve never met many of my readers, some of you have shared such personal stories with me regarding your losses, worries, etc. Some asked for help better understanding the vaccines as they were pregnant and then sent me baby pictures after their beautiful children were delivered. I have made valuable friends through this work - in politics, in the news media, in civic organizations, and in public health and government.

But there is also joy in recognizing that the reason I can pause writing right now is because the pandemic is in a much better place than it was three years ago. Like many other scientists around the country, I stepped up to the microphone to explain what was happening to try to educate those around me so that they could make informed choices about preventing disease. I’m grateful to have been born in the time and place that I was so that I could have the opportunities and education to serve my dad, my family and all of you in this way. I’m proud of this work. I’m pleased to say that a lot of people know more about how disease spreads and how to access and understand data. Hopefully this will prepare people to have more confidence if and when we are faced with a similar crisis.

I wouldn’t say that the pandemic is over. And my heart goes out to those who are immunocompromised and having to navigate a treacherous disease landscape. As the public health emergency lifts, I think we will see disparities in health that are already all too familiar in this country. We must do more to make sure that those who have been medically underserved continue to have access to health education, routine and preventative care, robust availability of nutritious food, mental health, vaccines and other tools that are important in preserving both quantity and quality of life. I want to applaud and support those who work tirelessly in public health and public health policy who have been working these issues for years and who will continue to do so in the years to come.

With the utmost gratitude for your readership, trust and support, I am signing off now for the COVID Digest.

Amber Schmidtke, Ph.D.

My Ph.D. is in Medical Microbiology and Immunology and I am Chair of the Division of Natural Sciences and Mathematics at the University of Saint Mary. I've worked at places like Creighton University, the Centers for Disease Control & Prevention and Mercer University School of Medicine. All thoughts are my professional opinion, do not represent the views or opinions of my employer and should not be considered medical advice.

Read more

There’s lots to talk about with Georgia and COVID-19 though. We know that cases are probably not a reliable metric anymore given how many people are ignoring symptoms and skipping a test altogether, but also many are testing at home and not reporting their results. Therefore, hospitalizations and test positivity might be better indicators of how the landscape is changing. Let’s begin our walkthrough of COVID-19 data by looking at the COVID-19 patient census graph from the Georgia Geospatial Information Office. This graph shows statewide data and identifies the number of patients who are currently admitted in a hospital for COVID-19.

We can see two important things from this graph: the current patient census is now greater than the peak observed in summer 2022 and it appears to be increasing rapidly.

Read more

A year in review

In 2022 Georgia recorded the following:

Read more

Read more

Read more

COVID-19

We’ll start with COVID-19 since that’s the virus people might be most familiar with. It is also the least remarkable of the three viruses of interest this week. As a reminder, we do have a vaccine for COVID-19. In fact, if you haven’t received a dose of vaccine within the past 2 months, there is a new bivalent booster for you. Bivalent means it is targeting two variants of the virus: the original variant and omicron from last winter.

Read more

COVID-19

I want to start with some interesting findings in the national picture. I want to point your attention to the four corners area of Utah, Colorado, New Mexico and Arizona. It’s the dark blue area in the southwest of the US in the map below. The map shows the percent of the population that is fully vaccinated for COVID-19 meaning one dose of the Johnson and Johnson vaccine or two doses of either the Moderna or Pfizer-BioNTech vaccine.

So on this map from the HHS Community Profile Report (10Nov2022), it’s a good thing to have a dark-colored county. It means that the vaccination rate is high for that community. This four corners area tends to have a large Native American population and this community was one of the success stories of the COVID-19 vaccination effort.

Read more

I’m certainly not here to shame my husband. I can’t fault anyone for getting sick. There was a time during his illness that he wondered how and where he caught this bug. And that gave us an opportunity to talk about risk. But I think this story is not all that unusual or uncommon given the way that our society has “moved on” from COVID-19. I think there is still a desire to go back to the way things were prior to the pandemic, as though we’ve learned nothing about how disease spreads. But why would we do that? I’m not saying that people need to wear masks all the time, like we did through parts of the pandemic. But we have learned a lot about high risk situations. When confronting a high risk situation, perhaps it’s best to bring some disease prevention strategies with you?

What does a high risk situation look like? To me, the risk goes up any time I’m in an indoor gathering with people I don’t know and whose risk avoidance attitude is unknown. Do I know these people well enough to know that they wouldn’t intentionally bring an infection to this gathering? Do I know them well enough to know that they stay up to date on their vaccines? Do I trust that they are the sort to regularly wash their hands? The larger the indoor gathering, the more risk it entails. If I’m going into a healthcare facility (clinic or hospital), I’m wearing the mask the entire time. Healthcare is a resource people seek out WHEN THEY ARE SICK. This is a good thing, that’s what healthcare is there for. But it does mean that the risk of exposure to illness goes up in that setting.

What kinds of things can we do to avoid infection from a variety of threats? First, I do think it’s important to stay up to date on recommended vaccines. This includes the flu shot and COVID-19 boosters. If you’ve not received a COVID-19 booster within the past two months, it’s time to get the updated bivalent booster. Take care of yourself by getting adequate rest, staying hydrated, and eating a diverse diet. In high risk settings, wear a high quality mask, wash your hands regularly (or take advantage of hand sanitizer if soap and water aren’t available/practical), and avoid touching your eyes, nose or mouth.

In about 2 weeks I’m planning to travel by airplane. I will be wearing a mask for the entire time I am in airports or on an airplane. That’s because I am traveling for a reason and I don’t want to miss the events that are happening at my destination. When I return from my trip, I have classes to teach and a division to run. I can’t afford to be out due to an infection that I had the power to prevent.

Miraculously, our boys and I have avoided catching my husband’s infection. As a family, I think we’ve taken some risks as COVID-19 disease levels have been low. But I’m vigilant about monitoring data for signs that COVID-19 disease might be picking up in our local area, including wastewater surveillance. We are starting to see some indications that disease spikes have begun overseas, and I think we are starting to see some warning signs in the US as well.

Read more

This week, the FDA and CDC authorized and recommended the use of the bivalent COVID-19 booster for children ages 5-11. This means that anyone over the age of 5 can get a bivalent booster provided that they are more than 2 months past their most recent booster. It’s pretty important to go get this done if you haven’t done so already. That’s because there’s a collection of new variants causing surges in Europe and we’ve learned from experience that what happens in Europe eventually finds its way to the United States. As the weather gets colder and we approach flu season and the holidays, it is very likely that we will also see a surge in COVID-19. Let’s begin by looking at what is happening globally.

Read more

If you are concerned about being exposed to COVID-19, then the risk is still quite high. The map below comes from the CDC. It uses a combination of recent case rate and recent test positivity to estimate the risk of exposure to COVID-19. At present, ~84% of US counties are in the high or substantial risk of exposure category. But, things have improved from an even higher percentage several weeks ago.

Read more

The second way to look at the national picture is to look at CDC’s Community Levels map, which estimates the difficulty one would have in finding a hospital bed (for any reason) if they needed one. It uses a combination of COVID-19 admission rates, percent of patients hospitalized for COVID-19 and recent case rate. In this color scale, green is good or low risk of difficulty. In the graph to the right, we can see that the proportion of counties that are green is growing steadily since early August.

One thing to note is that the community levels graph is improving much faster than the community transmission graph. They are measuring different things. But one could interpret this to mean that while a lot of people are still getting sick, fewer of them are needing a hospital bed. This could be due to a combination of vaccine-provided immunity and naturally acquired immunity (i.e. people who have recovered from infection).

We are also seeing a sustained lull when it comes to death rate per 100,000 across all regions of the country. Compared to where we have been, death rates are relatively low. Though, I think one could argue that any deaths from a preventable disease are unacceptable. Whereas we did see a bit of a case bump over the summer, we did not see a corresponding death bump.

All the same, over the most recent 7 days for which the CDC is providing data (9/16 - 9/22), the US has recorded 2496 deaths. As a point of reference, the death toll from September 11, 2001 was 2977. So we’re not that far off from a 9/11 scale of death each week. To date, 1,050,631 Americans have died from COVID-19.

Given that the US is continuing to lose so many people to COVID-19, it was surprising (and yet not surprising) to hear President Biden tell Americans that “The pandemic is over. We still have a problem with COVID. We’re still doing a lot of work on it. But the pandemic is over.” It was surprising because his claim isn’t supported by data and because he doesn’t have the power to declare that a pandemic is over, and certainly not when COVID-19 continues to cause problems throughout the world, including in many countries who have yet to receive a single vaccine dose. It was unsurprising because President Biden’s posturing regarding the pandemic has always been based on what was politically expedient. In short, if you want people to stop talking about the pandemic and recognizing that the government has fallen short on its responsibility, you tell people the pandemic is over. Is this really all that different from the previous president who also minimized the importance of the pandemic for similar reasons?

Of course, an easily predictable consequence of a statement like this is that when you tell people that the pandemic is over and you’re the President of the United States, they have a tendency to believe you whether you’re correct or not. That includes other politicians who would rather not fund emergency spending for COVID-19 mitigation efforts. The Biden Administration cannot simultaneously tell people the pandemic is over and still ask for $22B+ in funding for the COVID-19 response and expect to get a good result.

It also won’t help efforts to get Americans to take the updated bivalent COVID-19 vaccine booster.

The updated bivalent COVID-19 booster was authorized for use earlier this month. So far, people are getting them, but likely not enough. The graph below comes from the CDC and it shows the number of doses administered each day with a 7-day moving average shown in the red line.

So far, 4.4M Americans have received an updated booster dose. That’s roughly 1.3% of the US population. It is 2.2% of the population who received the primary vaccine series. But it is 4% of those who received a previous booster dose. So those who have been diligent about staying up to date on their COVID-19 shots are more likely to do so. We may see some improvement in these numbers with time. Many might wait until closer to flu season to get both their flu shot and their COVID-19 booster at the same time. It remains to be seen what impact President Biden’s comments will have on the booster roll out effort.

As for me and my family, we went a couple weeks ago to get our flu and COVID-19 bivalent boosters done. We have an 11 year old who is too young yet to get the updated booster. But he will get it as soon as he is authorized. For those who might ask - I did get mine in the same arm. My husband and older son did one in each arm.

The Biden Administration’s “You Do You” approach to COVID-19 response is also demonstrated in the latest CDC updates to healthcare facility guidance. This week they released a host of changes. Among the more controversial changes is that hospitals can end universal masking, particularly when community transmission levels (red-orange-yellow-blue map above) are low. Note that, at present, that represents 9% of US counties (translation: keep your mask on for now).

There are at least two really glaring problems with this. First, we are depending on a metric that is based on recent case data, when we know that testing volume is not high enough to identify most disease. COVID-19 testing centers have closed. It is a recommendation to follow a data point that the CDC knows is imperfect and the Biden Administration has worked to ensure will be inaccurate. You can’t find disease if you aren’t looking for it. The second problem is what is happening to the immunocompromised. Society has gradually forced them out of population centers by creating unsafe spaces that are teeming with disease. As masks have come off, people knowingly travel while sick, and people ignore testing because they would rather not know (and isolate) the world is a scary and dangerous place for the immunocompromised. Society’s messages have been for these folks to wear a mask if they want to or just stay home. Ugly though these things may be, we have some modern conveniences that may have made this work for those whose risk was too high to go into some of these places including grocery ordering, outdoor dining and concerts, etc. But the immunocompromised are some of the most medically vulnerable folks we have. They don’t have another option when it comes to accessing healthcare. They need hospitals and clinics to treat their conditions while not exposing them to an infection that could kill them. I had honestly expected that universal masking was just going to become the norm in hospitals and nursing homes.

The past two years of masking had big impacts on influenza, drastically dropping the number of annual infections and deaths. However, now that masks are present in lesser numbers we should expect many respiratory infections to come roaring back, including influenza. The CDC tracks influenza data at their FluView website.

District of Columbia is already seeing very high levels of influenza like illness. Texas, Hawaii and Georgia are in the moderate category. Early in the pandemic, many of us in public health were worried about a so-called Twindemic, where we saw the combined impacts of COVID-19 and influenza. That didn’t materialize in the first year, partly because of masking but also due to heightened awareness of COVID-19 symptoms that shared similarity with influenza and people staying home when they were sick. We also still had virtual learning in some schools. Not saying virtual learning is good or bad, but it did contribute to decreasing disease. None of those things are in place this year. So there is some concern that this year will be the year we see the Twindemic.

I do think that getting the flu shot and the COVID-19 booster are going to help us to decrease the number of infections and deaths this winter. But if few people are taking them, we have to consider a vaccine plus strategy where we layer additional strategies on top of vaccines. I think this pandemic has shown us that we do have very effective tools to limit disease transmission. But we lack the community willpower to use them in a way that protects the most vulnerable. In this sense, we are on our own. And when that’s the case it is the people who are well-resourced who suffer the least impact. They are the ones who have health insurance, paid time off, and don’t live paycheck to paycheck. The government’s current indifference to the medically and economically vulnerable will further exacerbate the disparities in health that we see for people of color, rural populations, and the poor.

Unless otherwise stated, all data presented are publicly available from the Georgia Department of Public Health and the Georgia Geospatial Information Office. Graphs and images that were not produced by me are linked to the original source if you click on them. Thank you for your support of the COVID Digest.

Subscribe now

Give a gift subscription

Share Georgia COVID-19 Updates

My Ph.D. is in Medical Microbiology and Immunology and I am Chair of the Division of Natural Sciences and Mathematics at the University of Saint Mary. I've worked at places like Creighton University, the Centers for Disease Control & Prevention and Mercer University School of Medicine. All thoughts are my professional opinion, do not represent the views or opinions of my employer and should not be considered medical advice.

Cases, hospitalizations and deaths are all declining in Georgia.

Read more

I work in a high exposure setting. I work with college students who recently came together from all over the country and live together in dormitories. There are no pandemic precautions in place other than the KN-95 mask that I put on my own face and the Corsi-Rosenthal box that I use to filter the air in my classrooms. People are coughing and sneezing. Is it allergies? Ragweed is high right now. Is it COVID-19? I don’t know. So I am going to get the updated booster as soon as I can schedule an appointment because of my risk of exposure. In addition, my last booster was given last November, so I expect that my immunity has waned. I have dodged COVID-19 through the omicron wave and BA.2. I think this is a combination of luck and using a “vaccine and” strategy of disease prevention. The third reason I’m planning to get the new booster soon is because of something a colleague said to me…we don’t know what the future variants will look like. But we do know that the booster works well against what is circulating now.

You’re eligible to receive the updated booster if it has been more than 2 months since your last dose. The Pfizer-BioNTech booster is available to anyone aged 12 and older. You can find a dose near you using vaccines.gov. You can also contact your local health department.

Read more

I’ve spent a lot of time in anger and frustration at the Biden Administration’s response to COVID-19 that has resulted in more deaths than the previous administration. The list of decisions that haven’t made sense is long. But pandemics of the past eventually did end, with ever shrinking subsequent waves until a disease faded into the background (endemic - we aren’t there yet). I have to think that the latest decisions to abandon all pretense of trying to prevent disease and protect the vulnerable must have included a meeting where they looked at the vaccination rates, the mountain of infections that happened with Omicron and they threw their hands up and thought their chances were pretty good that there was so much infection, so much death, that *surely* this pandemic was going to decline. It’s a gamble, to be sure. But so far it is playing out in their favor. I think it would be lovely for this to be true, though I’m holding judgment until we get through the winter, which has historically always been worse than summer waves. And I certainly want this pandemic to end. But I don’t think letting the virus chew through our communities as a strategy for ending the pandemic is one that we should celebrate or ever replicate again.

There’s been a lot of damage to public health infrastructure over the past several years and morale is low among the workforce. This week the CDC Director announced a new accountability initiative, which overlooks her own missteps but throws the agency rank and file under the bus. That’s not to say that there aren’t things that could improve, but the politicization of the agency’s response has happened at the direction of political appointees, specifically the CDC Director. The employees and contractors at CDC didn’t politicize the response or curtail isolation guidance at the behest of big companies. This is sure to do further harm to morale of the public health workforce. I don’t think accountability happens without also acknowledging the degree to which political interference has harmed public trust in public health. I think an important and authentic first step in that direction would be for Dr. Walensky to step down and for reform at the agency to include strategies that reduce political interference, similar to what is done for the FBI.

Read more

Last week, Georgia saw a 3% increase in the weekly case total compared to the previous week. A 3% rise isn’t a huge deal. But what’s interesting is that cases went down for every age group except for kids 1-17. In fact, there were big, big increases for the K-12 age groups. In fact, cases for the 5-9 and 10-17 age groups roughly doubled in the past two weeks, which is right around when school started.

Using the same 8 week timeline for each age group, we can also look at weekly hospitalization totals for COVID-19. We do see a rise in hospital admissions for 5-17 year olds. Thankfully these numbers aren’t as large as for older age groups. But all the same, I don’t think we want to see hospital admissions jump 153% over 14 days as they have for 10-17 year olds.

What we really don’t want is a repeat of the Delta wave last year that was the deadliest wave to date for Georgia’s K-12 aged children.

Of note, according to HHS data, the proportion of children 5-11 who are fully vaccinated in Georgia is only 17.5% and only 8.9% of those 17.5% have received a booster dose (fully up to date). For teens 12-17, 44% of the population in Georgia is fully vaccinated and of those, 19.7% are boosted (fully up to date). Granted, Georgia has come a long way in a year. Around this time last year, the proportion of 12-17 year olds who were fully vaccinated was only 22%. So the fully vaccinated population this year is twice as high.

My bigger worry is what happens as these K-12 aged kids get sick (which we can already see is happening in greater numbers) and then take that illness home. They can pass it on to their family and caregivers. Additionally, with so many people believing the pandemic is over, parents might be less likely to test their symptomatic children and, worse yet, they might send their sick kid back to school while believing their symptoms are due to allergies or a common cold. It is possible that amplification of disease in K-12 schools could result in a renewed wave of illness among adults. I think what remains to be seen is whether there is sufficient immunity among the adult population to ward off a potential resurgence of illness.

We can begin to see a similar trend on a national level. The graph below comes from the HHS Community Profile Report. It shows test positivity for each age group. Test positivity should ideally be at or below 5% as an indication that existing testing capacity is sufficient to not miss many cases. Test capacity has been pretty stable over the last few months. So if test positivity is going up, it means we are missing more cases because there are more cases circulating - not because test capacity went down. Two of the gold colored lines (solid and long dash) are for the K-12 aged population. You can see that test positivity is rising sharply for these age groups nationwide.

So we will want to pay attention to what happens over the next several weeks, both to the pediatric population and those who might be their parents (25-44 year olds).

That’s it for now, I’ll be back on Wednesday I hope! It’s a busy time getting ready for the new academic year.

Unless otherwise stated, all data presented are publicly available from the Georgia Department of Public Health and the Georgia Geospatial Information Office. Graphs and images that were not produced by me are linked to the original source if you click on them. Thank you for your support of the COVID Digest.

Subscribe now

Give a gift subscription

Share Georgia COVID-19 Updates

My Ph.D. is in Medical Microbiology and Immunology and I am Chair of the Division of Natural Sciences and Mathematics at the University of Saint Mary. I've worked at places like Creighton University, the Centers for Disease Control & Prevention and Mercer University School of Medicine. All thoughts are my professional opinion, do not represent the views or opinions of my employer and should not be considered medical advice.

• COVID-19: national, regional and state trends for Georgia

Read more

COVID-19

National

Let’s begin with the likelihood that you’ll be exposed to COVID-19 based on your county. For this, we need to consult the Community Transmission Level map from CDC. Not a lot has changed since last week. There is just disease everywhere.

Click on the map to explore your county. Nationwide, 98% of US counties are in a high or substantial risk of exposure category. Previous guidance indicated that these counties should be wearing masks.

Next, let’s take a look at how COVID-19 is impacting hospitals across the US. For this, we look at the Community Levels map from CDC. It uses a combination of recent COVID-19 case rate, COVID-19 admission rates and the percent of hospitalized patients who are there for COVID-19 to estimate the degree of difficulty one might experience if they needed to access a hospital bed. Of note, hospitals can be busy for a wide variety of illnesses and conditions, but this map gives us an estimate of COVID-19’s burden.

Again, we see a pretty large number of counties (42% of the US counties) that are in a high community level.

So what can we expect this fall? Around this time last year is when the Delta wave really got going in the South. Schools across the country are about to start the new academic year, if they haven’t done so already. We enter this season with a lot of immunity on board - either through vaccination or infection. But we don’t know what to expect about that immunity against infection both its durability in general and particularly against the variants that are circulating these days. We also enter this season with few if any disease prevention measures in place. So as I’m asked what to expect in the fall, I am telling friends that they should 100% expect to be exposed to the virus. If that worries them, then they have choices they can make regarding reducing their risk. I strongly advise people to be up to date on their vaccines, avoid indoor crowds and confined indoor spaces, and to test if/when they have symptoms.

I am hopeful that the new vaccines that are expected to be released in October will help to blunt the winter wave that I think most of us expect to see. The new vaccines will use a more recent variant for conferring protection, but even the more up to date variant isn’t the current one. Hopefully there is sufficient cross-protection even if it isn’t a perfect match. But the pandemic can’t really be over if we continue to see successive winters where the disease impact is even greater than the winter before.

Read more

Today we’re talking about COVID-19 and Monkeypox.

COVID-19

COVID is not over, it’s just over for those in power to do anything about it. And they definitely want us to stop talking about COVID-19. This week’s update from CDC includes the hospital accessibility map (Community Level map) that identifies the degree of difficulty one would have accessing a hospital bed if they needed one. Eighty eight percent of the US population lives in a county in a high or medium range of difficulty. CDC wants us to “consider” taking steps to protect ourselves and others, like wearing a mask.

This is the map that CDC started producing to distract us from how bad things would look on the Community Transmission Level map, which estimates the risk of EXPOSURE to COVID-19. The latest map is shown below. About 98% of US counties are in the high or substantial risk of being exposed to COVID-19. That matters when you have events that you do not want to miss, like a wedding, the first day of school, or simply being able to attend work so that you can put food on the table. This isn’t just a cold, it is something that keeps people from doing the things they want to do.

“Living with COVID” means 88% of the US population living in an area where they have difficulty accessing a hospital bed. The reality is that if our country doesn’t try to control COVID then it will control us.

Read more