Confirmed cases are down last week, but wastewater data indicates that infections are continuing to increase. My guess is that the decrease in cases reflects fewer tests being performed. However, the rate of new hospitalizations per day in Hampshire and Hampden county dropped last week, moving both back into the CDC's low risk category. Hospitalizations wouldn't be impacted by things like reduced testing over the holidays, so I'm not sure what to make of that exactly. It's interesting that while the rate of new hospitalizations per day decreased, the county case rate, percent positivity, and percent of hospital beds occupied by COVID-19 patients increased. 

I don't put too much stock in these specific numbers in general, as we know they are subject to underreporting, but this is especially true around holidays when we know testing decreases dramatically. I do think it's worth noting that we didn't see an "explosion" in hospitalizations - that's good! That puts the numbers in context a bit for me - they're not so inaccurate that we're missing what's happening entirely in the community. 

We didn't see an "explosion" in hospitalizations, but I think it's worth noting that the number of people who are hospitalized in MA is quite high. I looked back at trends in hospitalization since the beginning of the pandemic to get a sense of how this time period compares. There have been three "surges" in hospitalizations larger than the one we're experiencing now. This is the 4th highest level of hospitalizations in the pandemic in Massachusetts! Before prior surges in hospitalizations, there were "lulls" in severe illness, but we've had months now of a high plateau in COVID-19 cases. In fact, the plateau is about at the level of hospitalizations experienced during the delta variant surge. 

I have to admit that I am caught off guard by this! The data has been there all along, so I shouldn't be surprised, but like many of us, it all starts to feel "normal" and expected sometimes. Zooming out to the 10,000 foot view is helpful to put this context. I've noted many times that the consequence of infections and case rate are very different now than earlier in the pandemic. At this point, we have a high level of vaccine and infection-based immunity, and so the percent of people who are infected who become quite ill has dropped substantially. For most people, the risk of a severe outcome after getting COVID-19 is quite small. It is surprising, therefore, that there would be so many people getting ill enough from a COVID-19 infection to require hospitalization. 

COVID-19 is not preventable but hospitalization and death are far more preventable than the data we're looking at suggest. The risk of hospitalization and death is dramatically lower among those who are up-to-date on their vaccine (meaning, they've received the updated bivalent booster). Specifically, if we consider folks who are up-to-date as our baseline / comparison group, those who are vaccinated (and even have booster doses) but who do not have the bivalent booster have almost 3x higher risk of hospitalization. Those who remain unvaccinated have nearly 16.5x higher risk of hospitalization. The absolute best way to stay out of the hospital with COVID-19 to get the bivalent booster, and at the risk of being a broken record, it's not too late to get the bivalent updated booster or the yearly flu vaccine. 

We'll know more next week (although we'll also have new questions, I am sure). In the meantime, I'll reiterate my advice from the past few weeks about matching your risk mitigation strategies to the most vulnerable person in your group (or house) and that if you don't feel great, for whatever reason at all, please stay home if you can!

Take good care,