What we do (and don't) know about the spread of COVID-19 in the D.C. region right now Cases are up slightly, but hospitalizations and deaths remain low. But school outbreaks and wastewater data can also tell part of the story.
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What we do (and don't) know about the spread of COVID-19 in the D.C. region right now

What we do (and don't) know about the spread of COVID-19 in the D.C. region right now

Cases are ticking up slightly around the region, but hospitalizations and deaths from the virus remain low. Tyrone Turner/WAMU hide caption

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Tyrone Turner/WAMU

COVID cases in the D.C. region are ticking up slightly, as several jurisdictions move from "low" to "medium" levels of the virus circulation in the community.

Hospitalizations and deaths from the virus, meanwhile, remain far below levels reported during the omicron surge at the beginning of the year – a testament to vaccination rates, a better understanding of how to treat the virus, and expanded access to antivirals. As is always the case with COVID, it can be difficult to answer what factors exactly are driving an increase in cases, but Dr. Amira Roess, a professor of global health and epidemiology at George Mason University, says it's likely two things: the transmissibility of the omicron subvariant B.A. 2, and waning vaccine efficacy.

"We have a much more transmissible variant circulating" Roess says. "And a lot of people were either vaccinated or even infected in January, and now they are getting exposed because there's so much of this highly transmissible strain circulating. They're getting infected, and they're now passing it on to the next person, and the next person. We are seeing waves every three to five months, coming and going."

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Several Northern Virginia jurisdictions have seen an increase in infections in recents weeks, even prompting some local officials to send out notices reminding residents to stay cautious. In Arlington, cases have increased 32% in the past seven days; in Alexandria City, 41%; in Fairfax, 52%, and in Loudoun, 67%. Per the CDC's dashboard, hospitalizations are also slightly up, and all jurisdictions are in the "medium" level of COVID spread in the community. (The agency uses three different factors to determine this level: new hospitalizations from COVID per 100,000 residents, the percentage of inpatient beds occupied by COVID patients, and new infections per 1000,000 people.)

D.C. still remains in the "low" zone, per the CDC, although the city saw a slight uptick in cases in recent weeks, according to both the CDC's dashboard and the city's own coronavirus website. The percentage of infections that require hospitalization is up from last month, but it's still far below what it was during the worst of the omicron surge. Montgomery County, while considered "low" on the CDC's data dashboard, is now in the medium zone according to the county's own tracker. As of Thursday, the county's case rate per 100,000 residents was 279, up from 160 two weeks ago. Prince George's County, meanwhile, remains in the "low" spread zone, as well.

Relying solely on the numbers, however, might not give residents a full picture of what their risk is before they head outside of the house. Scaled back data, gaps in reporting, and the popularity of at-home testing make our COVID dashboards less reliable than they were, say, even a few months ago.

"It is definitely problematic that you are seeing basically some big gaps in the way the data are being reported," says Roess. "First, people are testing themselves at home now and they're not reporting to any of the health departments. And then the second thing is, as interest and funding for COVID starts to dwindle, we are going to continue to see gaps in reporting and gaps in resources."

This week, DC Health announced that it had failed to report its coronavirus data to the CDC between April 27 and May 8. DC Health did not return DCist/WAMU's request for further explanation of the error, but a spokesperson for Mayor Muriel Bowser told the Washington Post that the city was "looking into" why the data was missing. On Wednesday, DC Health reported that normal data transferring was restored, and that between April 27 and May 8, the city recorded roughly 1,600 new cases and zero deaths (although the cases could be an undercount, given the prevalence of at-home testing.)

When the District stopped publishing daily coronavirus data in March, and instead shifted its focus to reporting more sustained trends of the virus, city officials said the move was intended to help residents determine their own risk level, as both federal and local approaches to COVID moved away from public policy toward an emphasis on individual responsibility. D.C. wasn't alone in this stance: all but four states in the U.S. have scaled back daily coronavirus case reporting, according to Johns Hopkins University.

"What you're seeing is a shifting in the way that we want individuals to think about COVID," senior DC Health official Patrick Ashley told lawmakers two months ago, justifying the city's decision to scale back data reporting. "We want people to change the way that they view their risk and look at it as traditional public health data and look at trends over time."

For nearly two years, D.C. published daily coronavirus case counts on its coronavirus website. During more acute phases of the pandemic, the city's reopening was even (theoretically) tied to these metrics. Now, the city publishes metrics as rates over time (which appear on a lag) and frequently sends raw case numbers to the CDC.

But when the numbers are missing for two weeks, or updated sporadically, some residents might be left in the dark.

"DC Health dropped these protections to allow people to make risk based decisions, and then they took away the tools that helped risk-sensitive people make those decisions," Neil J. Sehgal, a public health professor at the University of Maryland tells DCist/WAMU. "In a lot of ways that feels like DC Health isn't keeping up their end of the bargain."

The degree to which case counts and COVID dashboard influence one's COVID decision-making vary, according to Sehgal. A fully vaccinated and boosted young person, for example, may not be checking D.C.'s weekly COVID data on the CDC dashboard, like someone who is immunocompromised could be.

"Not everybody is sensitive to changes, especially changes that might be happening over a two-week period, because their perceived risk is lower," Sehgal says. "But if you're a small business owner concerned about keeping your employees healthy, if you're a public facing worker, if you're a parent of an unvaccinated D.C. public school student or you need to send your kids to daycare because you're working in person again ... certainly you are more likely to be monitoring."

In a sense, both Sehgal and Roess say that relying on anecdotal reporting, or COVID-related updates from hyperlocal settings – like schools, churches, or workplaces – can be an indicator of how to assess your risk in the absence of raw data from public health departments. Maybe a place of worship has asked members to wear masks again, or an office has sent around emails notifying employees of several recent infections.

"If you're asking yourself 'what is going on in my neighborhood?' What you might need to do is pay attention to some of the local organizations, are they reporting that they've had a number of their members testing positive?" Roess says. "Those are some small things that can give you a sense of what's going on in your community, as we're waiting for the health department to update their numbers."

School settings seem to be driving a good number of the recent cases, at least in Northern Virginia. In the last week of April, Fairfax County reported 74 classroom outbreaks, and 139 in the first week of May. On May 9, Fairfax County Public Schools reported the highest number of cases in the school system so far this academic year – even surpassing the record set during the omicron surge. In D.C., during the week of April 24, schools reported 416 infections among students and staff – the highest total since January.

Wastewater is also a way to measure the level of COVID in a community. Several states have started analyzing sewage water for virus particles – a helpful tool that can identify new variants and spot potential surges. Across Virginia, 37 different sites are measuring wastewater. A sewershed in Northern Virginia, which contains sewage from Loudoun, Fairfax, and Prince William counties, shows a slight increase in the presence of COVID this spring.

Neither D.C. nor Maryland have reported wastewater data yet. D.C. officials told Axios DC in March that the city would begin publishing information on sewage analysis in April, but a DC Health spokesperson told DCist/WAMU on Thursday that they're still working on launching the program.

"The wastewater project is continuing to move forward, and we are working on getting the program up and running as soon as possible but do not have a specific launch date available yet," the spokesperson wrote in an email.

The slight uptick in cases in the D.C. region mirrors the upward trend in infections seen in the northeastern United States since early March. While cases are up in states including New York and Connecticut, officials say that the increase in deaths and hospitalizations that follows spikes and infections has not materialized to the scale they'd expect. They attribute the change to high booster rates and better treatment for COVID.

In D.C, 35% of fully vaccinated residents have received a booster. In Arlington, Alexandria, and Fairfax, more than half of the fully vaccinated population is boosted. Montgomery County has boosted 55% of its fully vaccinated population, and roughly 44% of fully vaccinated Prince George's County residents are boosted.

Individuals over the age of 50, immunocompromised people over the age of 12, and anyone that received both an original and booster dose of the Johnson & Johnson vaccine is currently eligible for a second booster. According to D.C.'s data, about 10% of boosted residents have received a second booster. The city also has also expanded the availability of Paxlovid, a Pfizer pill that can treat COVID. While the medication can only be given with a prescription from a doctor, anyone who is considered high-risk can get their prescription filled at a number of D.C. pharmacies.

This story is from DCist.com, the local news site of WAMU.

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