The dashboard this week reflects a continuing decline in cases and hospitalizations within the city and widely. All of MA is in the CDC's "low risk" category, indicating that cases and hospitalizations due to COVID-19 are down everywhere. All MA counties have dropped into the "substantial" spread category, which focuses just on official cases, not hospitalizations. It's been quite some time since this situation has occurred. The decline in cases continues to be reflected in the wastewater surveillance data. This is a very welcome time for a drop in severe COVID-19, as we enter into the first of our many holiday weeks in the US. 

I'm continuing to track the proportion of cases in the US caused by subvariants, and am noting only minor changes from next week. This is also welcome news! None of the new subvariants have gained dominance at this point. I think the timing of when those variants become dominant will be important. Our best shot for avoiding a surge in infection will occur if we can hold off on a more contagious subvariant gaining dominance until after holiday gatherings. Right now, BQ.1 and BQ.1.1 are competing for dominance, and both account for about 25% of cases in the US. 

I spoke with some health care professionals and public health professionals this week and asked if they had any messages I could share in the dashboard this week. I heard two messages from them:

1) The decline in cases right now is important, but it doesn't mean that COVID-19 is gone. There is still a lot of activity out there, and if you don't feel well, you should definitely still be testing for COVID-19. If you don't feel well and you test negative on a home rapid antigen test, wait 48 hours and test again to be sure.

2) If you're not feeling well and you're fairly certain you don't have COVID-19, it's not a free pass to mix and mingle! The CDC risk category and transmission categories reflect COVID-19 activity, not general / all-cause burden of disease on our healthcare system. Our healthcare system is slammed right now with influenza and RSV. If you don't feel well, ruling out COVID-19 is great but please stay home anyway until you feel better, so you don't inadvertently pass any virus.

Finally, Your Local Epidemiologist posted excellent advice this week on safely gathering, even with high-risk folks (https://open.substack.com/pub/yourlocalepidemiologist/p/thanksgiving-week-friendly-reminder). Being up-to-date on your bivalent booster is an important part of the process, and only about 20% of people in MA have received the booster. It won't help you for this Thursday, but if you get it now, it will protect you for December holidays and gatherings.

Megan W. Harvey, PhD (she/her)
Epidemiologist

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