Editor’s note: The following Tri-Town Health Department update was written by Amy Hardt, MPH BSN RN, Lead Public Health Nurse at the Southern Berkshire Public Health Collaborative, and sent out Wednesday morning, Dec. 29. It has been edited for clarity.
LEE — The seven-day data on our current dashboard is now 10 days old (December 12–18), because the state numbers come out every Thursday evening and cover the previous week, running Sunday–Saturday. Add in a long holiday weekend, and the numbers seem even less timely. Meanwhile, we are constantly hearing on the news that throughout the Northeast, in Massachusetts overall, and in the states surrounding us, case rates have been skyrocketing.
Let’s take a moment to explore where those numbers come from, and why they can be confusing or seem irrelevant at times. For example, the New York Times COVID case averages in Berkshire County have been jumping around. Yesterday it showed a -1% change over the most recent 14-day period. This morning, it shows a 6% increase. On our dashboard for December 12–18, overall county cases were up by 5%, but the number of PCR tests was down by 5%, so new cases were likely even higher. This still doesn’t really point to a “surge,” as we’ve been hearing about everywhere else. Meanwhile, in the same period, new cases in South County towns went up by 50% (before accounting for a 10% increase in testing over the previous week). So, cases are down in the county overall but a lot higher in South County? What could explain this?
1.) Maxing out of local PCR testing resources. The state’s officially reported numbers only reflect molecular tests that are administered, and there is a real limit to these. At a certain point, they can’t go any higher, even if the volume of new cases is clearly still growing. Also, on a day-to-day basis, reported new case numbers can surge and shrink, which does not necessarily reflect real change in the number of infectious people in the community, but may simply be due to staffing or other logistical factors. That’s why we look at trends.
2.) Increasing use of at-home rapid antigen tests. These are not reported to the state, although using the MassNotify app is encouraged to help others know they may have been exposed (it’s anonymous). There’s also been an increased use of site-administered rapid antigen tests, which must be shared to the state but are not included in the official reported numbers.
3.) In South County, towns went from 94 to 72 to 109 over the past three reported weeks; these swings meant a 40-50% change up or down each time. In smaller communities, there is more volatility in case change percentages and case rate per population calculations, which sometimes makes communities such as Clarksburg or Hinsdale appear as if they’re the epicenter of the pandemic in the state. In South County, we also have periodic influxes of visitors, which brings more cases if they share a local temporary address, but does not affect our population numbers in the denominator, thereby increasing our local case rate while they’re here.
When they test positive, people ask me: is it Omicron? I don’t have that information, but if the time between a known exposure to symptom onset or positive result was less than three days, it very likely is, especially if it was a fairly minor exposure and folks are already vaccinated/boosted. Omicron is speedy, sneaky, and can still manage to get in, even when we’re finally feeling safe. In Massachusetts, only a small percentage of test samples are genetically sequenced to determine their variant. Results then flow into the state epidemiological database about three weeks later, but individuals are not notified of the outcome. So, whenever you see reported variant percentages of new cases, these are based on surveillance estimates. And, as we learned today via the CDC, those estimates can span quite a wide range and are easily misinterpreted in the press with huge headlines.
On that note, New Year’s Eve is just around the corner. Is it safe to celebrate with friends and family? That depends on with whom, how many, and where. The best plan is to set up layers of protection with the most vulnerable person in your group in mind. Is everybody vaccinated and boosted, and able to test within 12 hours of gathering? Party like it’s 1999. Will there be a mix of vaccinated/non-vaccinated, or boosted/vaccinated, with only some or maybe no one able to test the day of, and do you have very young ones or very old ones planning to attend? Be extra cautious and layer up: keep the guest list small, crack the windows, encourage masks except for eating, set the food up on the deck … there are lots of ways to keep our loved ones safe and still spend time together. If you can be with your people safely enough to not lose sleep over it, do that.
