We Seem to Have Given Up on COVID Prevalence

With the ending of the COVID public health emergency and the resulting change in reported CDC COVID-related data, it’s clear we’re flying blind here. At this point, the only meaningful data we have are wastewater data, and, as I’ve noted before, those data don’t tell us much about actual prevalence* (other than, perhaps, “it’s really bad right now”). This is the new plan:

CDC officials say the coronavirus remains a priority, but its surveillance will be folded into a wider strategy for monitoring respiratory viruses. The agency will no longer track community levels of covid-19 or transmission rates after May 11. Instead, the CDC will rely on a variety of other measures, including hospital admissions, emergency room visits, and wastewater surveillance to track covid-19 trends.

None of this will help people be able to answer questions like “Is it safe for me to gather indoors unmasked with certain numbers of people”**, which is what those of us who are trying to protect others in our lives and avoid long-term illness***. What we should be doing is having sentinel hospitals screening every patient, asymptomatic and symptomatic, for COVID (and RSV and influenza too) and reporting percent positive rates for both those categories. The data CDC currently are collecting simply aren’t useful, except perhaps as advanced warning–and during the pandemic, our elected leaders never heeded advance warnings, so why would they start now? Worse, by the time you see an increase in hospital and emergency room admissions, it is already too late.

Given former White House COVID czar Jha’s long-overdue admission that a small percentage of vaccinated and boosted people will have some form of long COVID, you’re not the weirdo if you’re still trying to avoid being infected (and according to the CDC’s serological data, for kids, we’re essentially trying to avoid re-infection, as nearly all kids have been infected at least once–by the way, did you consent to that experiment?).

What’s frustrating is, if we had prevalence estimates, some of us could safely live ‘normally’ when the prevalence is low. For example, in May 2021, when the prevalence in D.C. really did plunge (and I was vaccinated), I dined indoors. But now all I have is the occasional DCPS back-to-school testathon, which is better than most places. We haven’t been “given the tools”, so some of us will have to be wearing masks for a while longer, I guess.

*It gets worse when you realize much of what we see in wastewater might be driven by a small number of fecal supershedders, which arguably isn’t that useful at all.

**Of course, if someone is immunocompromised, since most people aren’t masking indoors, the answer for them is going to be “no” for the foreseeable future.

***Anyone who has caretaking responsibilities can’t afford to get sick for a lengthy period of time (weeks or months) even if they avoid some of the nightmarish outcomes of long COVID.

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