News and Views

By Ella P. Curry, PhD, MTS, RN
For the BWC-PenDel CoVID-19 Re-entry Team

Prologue

This is a particularly challenging time for many of us.  Attitudes and approaches to the CoVID-19 pandemic are shifting.  Confusion and uncertainty accompany mixed messages and sometimes contradictory recommendations. We long for a reprieve from 2+ years of CoVID-19 as we seek firm grounding toward sustained safety and wellness. We experience pandemic fatigue and the burdens of multiple losses, social isolation, and disrupted church, school, work, and travel experiences. We encounter ever-sharper divisions between us regarding vaccinations, mask wearing, and personal freedom.

 As we reckon with these many things, we must bear in mind that even as we welcome widespread lifting of restrictions and celebrate an array of prevention and treatment options that did not exist 18 months ago, this pandemic is not over. Stay alert to the possibility of another variant, another surge, another booster. Pay attention to those who may be left behind as policy decisions are made and resources are distributed. At the very core of public health initiatives is community care. We are truly in this pandemic together and together we are called: to remember all we have been through and all we have learned; to attend to relationships and places that are broken; to practice loving-kindness with each other; and to participate daily in prevention efforts and necessary acts of preparation.

 So Much Has Happened Since Our Last Update.

•  The Omicron surge that peaked in the U.S. with more than 802,000 new cases on January 15, 2022, has steadily declined as evidenced by this week’s daily average of 31,000 new cases. Hospitalizations are down 77%, dropping from 153,000 on January 20^th to a daily average of 25,000 this past week. The death rate this past week averaged 1,000 people per day.
  • 49 states have lifted CoVID-19 related restrictions on public activities and mask wearing. Hawaii has changed none of their protective or precautionary measures.
  • Everyone in the U.S. is still required by federal law to wear face masks on planes, trains, and other forms of public transportation; the latest extension of this requirement continues through April 18, at which time it will be reviewed again.
  • 970,293 CoVID-19 related deaths have been formally reported in the United States as of March 20, 2022. Healthcare inequities preclude access to testing, treatment, or care for many whose diagnoses and deaths will never be recorded, in the U.S. or around the globe. May we never reach a time when daily or total accounts of CoVID-19 related deaths are merely sets of numbers. Remember the individuals who are represented in these statistics, the individuals who are not represented, and the large number of family members, friends, and others who are impacted by the staggering loss, in our country alone, of nearly one million people over the past 27 months.

• The Centers for Disease Control and Prevention (CDC) introduced new weekly pandemic monitoring guidelines based on a combination of three factors: 1) new CoVID-19 hospital admissions per 100,000 population in the past 7 days; 2) the percent of staffed inpatient hospital beds occupied by people with CoVID-19; and 3) total new CoVID-19 cases per 100,000 population in the past 7 days. Using this information, county-based CoVID-19 Community Levels of risk are established and classified as Low (green), Medium (yellow), or High (red).
  • According to the CDC, less than 3% of the U.S. population now lives in High Risk (red) areas where face masks and physical distancing are still recommended in public spaces. More states and localities are making independent decisions regarding CoVID-19 related restrictions. Most of the counties in the BW and Pen-Del Conferences are in the Low Risk (green) category. This means people may choose to mask at any time. People who are immunocompromised or those with symptoms, a positive test, or exposure to someone with COVID-19 should wear masks.
  • The CDC has repeatedly emphasized that there are people living among us (those over 65 years of age, the immunocompromised, and those who are ineligible for vaccines for reasons of allergy, health concerns, or age) who continue to be at higher risk for serious illness. They face special challenges navigating daily life in a world with active coronavirus transmission and loosened restrictions.
• The National CoVID-19 Preparedness Plan, released by the White House, focuses on four key goals: 1) Protect Against and Treat CoVID-19 (vaccines are the crucial tool); 2) Prepare for New Variants (with world-class variant analysis, national water surveillance, robust emergency response teams for surges); 3) Prevent Economic and Educational Shutdowns; and 4) Continue to Vaccinate the World. Of note, the National Preparedness Plan is encountering serious funding challenges that may derail implementation and/or continuation of key CoVID-19 programs and services.
• As noted in the first goal of the Preparedness Plan, vaccines are our best tool against infection. However, the U.S. daily vaccination rate is down 95%.  Only 60% of the eligible population has received full doses of a vaccine and only 50% of that group has received boosters.  It is a pivotal time, as mask wearing and public restrictions are lifted, to encourage and assist our unvaccinated and under-vaccinated friends and family-members in obtaining vaccines and the protection vaccines provide.
• Both Pfizer and Moderna have applied to the Federal Drug Administration (FDA) for emergency use authorizations to offer a second booster for each of their 2-dose vaccines. If FDA approved, Pfizer’s second booster would be for people over 65 years of age; Moderna’s second booster would be for all adults over the age of 18. The administration of booster doses does not represent vaccine failure.  We knew from the beginning that each available vaccine was less than 100% effective.  We have learned that vaccines and boosters significantly increase protection against infection and reduce the risk of death by 41%.  However, we are also learning that protective immunity levels in our bodies decrease over time.  We will continue to see adjustments in vaccines, boosters, and dosing schedules as we learn more about variants, their impacts on our bodies, and our immune responses over time. 
• The emergence of Omicron sub-variant BA.2 is being closely watched by scientists in the U.S. and around the world. Global reports indicate that BA.2 is three times more contagious than the Omicron variant that caused our surge this past winter, but it does not seem to cause more severe illness. According to government data on Tuesday, March 22, three out of four new CoVID-19 cases in the United States are now caused by the BA.2 Omicron sub-variant.

What We Need To Know Now

• Continue to use the frequently-updated CDC County Tracker Tool for checking Community Levels of Risk for any county in the U.S. The tracker tool is also included on the CDC’s How to Protect Yourself page, which provides important additional information about risk-specific masking, testing, distancing, quarantine, isolation, etc.
• Decisions about preventative precautions such as mask-wearing, physical distancing, good ventilation, and hand washing in churches, businesses, schools, and other gathering places remain crucial to our health and well-being. Foremost among considerations are the many challenges that our immunocompromised, senior, and vaccine-ineligible neighbors and family members are facing as restrictions are lifted all around them. We are called to sustain mindfulness and care for the most vulnerable among us; may our mindfulness inform sound decisions and actions in this time of new guideline impacts on the most vulnerable.
• Individuals need to understand risk levels in their communities to make decisions not only in their county’s context, but also in the context of their particular health needs and the needs of others for whom they may provide services, support, direct care, and/or frequent engagement. The personal choice to wear a mask is always an option for anyone living in Low or Moderate Risk Communities.
• Even as we celebrate the steady decline in new cases and CoVID-19 related deaths, we must do so with an eye toward preparation and readiness to respond quickly in the event of another surge. Our familiar practices of mask wearing, physical distancing, hand washing, and good ventilation not only must be maintained in High Risk communities and in other contexts deemed essential, but also must be retained and readily available when needed again.