Washtenaw County Public Health assesses COVID trends as we enter the pandemic's third year
David Fair: This is 89 one WEMU, and today we're going to take a look at the public health situation and Washtenaw County as we are now moved into our third year of dealing with a global pandemic. I'm David Fair, and certainly things are better, but issues remain, and the pandemic may be far from over. On the other end of the WEMU line this morning is Susan Ringler-Cerniglia. She is communications and health promotion administrator for the Washtenaw County Health Department, and she's been our go to for local information throughout the pandemic. Thank you so much for joining us again, Susan.
Susan Ringler-Cerniglia: Absolutely, David. It's good to hear you back on the radio.
David Fair: Well, Washtenaw County continues to score at a low level for COVID, and we're certainly all cheering that fact. What exactly, though, does that low level mean?
Susan Ringler-Cerniglia: So, as folks might have seen, the CDC recently redid what were transmission levels that we're really looking at case rates and transmission rates. So, these new transmission levels that are low, medium, and high are meant to focus a little bit more on those severe outcomes. So, really look at that impact of hospitalization in a community, and, hopefully, give us a better sense moving forward of when it's most appropriate to take additional precautions. As you said, right now, we're in a lull. So, things like masking are not broadly recommended. But part of the idea is really to be able to look at trends and to understand when it's most appropriate and helpful to layer up additional precautions.
David Fair: And while we are trending in a low category right now, which we certainly all want, it doesn't mean that people aren't testing positive. It doesn't mean that people aren't getting sick. What percentage of those having more serious and sometimes fatal encounters with COVID are unvaccinated at this point?
Susan Ringler-Cerniglia: So, that's been a trend for quite some time now. And really, since we've had vaccination that we can see that the majority, the vast majority of folks, have become seriously ill, are unvaccinated. Now, as you pointed out with COVID overall, that doesn't mean that there aren't cases where people become seriously ill when they are vaccinated. And often, what we see there are folks that are still vulnerable with vaccination, so they may have one or more risk factors--older age, underlying health conditions, and so forth. So we do see some hospitalizations for serious illness among vaccinated folks. But the vast majority, when you really look at the large numbers and the trends, are unvaccinated.
David Fair: So, when the CDC kind of revised its guidelines and recommendations, and you were having the conversations on how to deal with that here in Washtenaw County, what level of concern was there in the health department about removing most indoor masking requirements?
Susan Ringler-Cerniglia: Yeah, there's nothing that's been very straightforward about some of these discussions, and, unfortunately, there's a lot of social tensions, strong feelings, about things like masking. When we're looking at it at the health department level, you know, prior to this last change, I also want to be clear that there really weren't very many restrictions. The only orders that we had in place were the K-12 school orders. So, we had an order for universal masking in the K-12 school setting and one to support isolation and quarantine. And those have since expired at the end of February. Now it's important to note what we have seen in the school setting. And a lot has changed since the beginning of that order and since schools really shifted back to in-person learning, right? And we've seen that those settings are quite low-risk and that what is important is not necessarily the masking by itself, but having layered precautions in place. So, masking can certainly be one of those tools, and it's a beneficial layer. It's not necessarily super powerful, shall we say, on its own, but does matter. So, for example, if a school has or a district has very high vaccination rates, if they're able to do regular at-home testing, if they've improved ventilation, they have multiple layers in place already, masking may be less important. But, on the flip side of that, if some of those other things aren't true, then masking can be more important. So, we felt fairly comfortable with having a little bit of flexibility. The final thing that I'll note about that, and particularly with schools but also in the community, is when we had the Omicron variant that was so much more contagious, the benefit of masking in one sector or one area of exposure when there's so much exposure and spread happening in the community, that was also diminished. In other words, you're not accomplishing as much when something can be so easily transmitted, and there is lots of other places to be exposed.
David Fair: This is 89 one WEMU. We're talking with Washtenaw County Health Department spokesperson Susan Ringler-Cerniglia. As you well know, in Europe, there's a big uptick in the number of COVID cases attributed to what scientists are calling a stealth version of the Omicron variant. China is seeing another huge spike in cases as well, and everybody kind of agrees it's only a matter of time before it begins to spread throughout the U.S., too. How are you preparing at the Health Department for what appears to be an inevitability?
Susan Ringler-Cerniglia: Yeah, I'd say sort of personally and professionally, I'm a little nervous about what comes next. But, you know, that's kind of been the norm for us when we see these lulls, and we know that the virus hasn't gone away. And that, right now, combined with this feeling of, "Oh, it's over" and the idea of getting back to normal, you know, it's very, very likely we'll see some more increases. As you mentioned, we're seeing those in other countries. And, typically, it takes a few weeks for that impact to happen over here or happen locally. But the million dollar question, of course, is what will that look like? And how much? How will we respond? Like, will we be able to flip back and accept some additional precautions to help buffer that impact, for example, if we go up to higher medium? Will people kind of willingly adapt some of those measures? And, of course, those are unknown. Generally, what we'd say right now, it's a great time to make sure you have home tests available, know how to get them, have masks available, and check in with your health care provider about the availability of treatment and what you would need to do if you should become ill.
David Fair: So, once again, as you've just touched upon, it never hurts to go over best practices. And you mentioned that home testing kits are available. There are a lot of institutions that don't accept those as evidence that you are negative. So is that just to if you test positive at home, then go gets a more formal test?
Susan Ringler-Cerniglia: We don't necessarily, you know, particularly if you have symptoms and you test positive with a home test kit, you don't necessarily need to confirm that. We understand that that's a positive test, and it can be that trigger to go ahead and seek treatment--if you need treatment--and let others know that that you're ill, that kind of thing if you've been exposed to them. The reasons that you might want a confirmatory test are really more about proving that infection. So, for example, if you were planning to travel, and you needed to have confirmatory testing before you travel, having documentation of that official infection could be important. So, in other words, it doesn't matter so much for diagnosis, but it might matter for proving that later on.
David Fair: As I make my very limited travels to the grocery store and out and about to the gas station, I do see a lot of folks still wearing cloth masks. Is it still best advice that if masks are required or desired, that we avoid those cloth masks?
Susan Ringler-Cerniglia: Well, again, Omicron has sort of changed some of that. You know, one of the things that's unfortunately often fuels mistrust but is a reality in something like this, that information changes, we learn more, right? So, again, Omicron sort of diminished the effectiveness of cloth masks. But, we recommend if you are going to wear a mask that it be something well-fitted, a surgical mask, KN95, something like that. You can layer a surgical mask in a cloth mask and get a decent level of protection. So, we're not really advising the sole cloth mask anymore. And that's really because of the impact of Omicron.
David Fair: And, as we move forward, there's been so much talk of getting out of pandemic and into an endemic state, we have no idea when that's going to happen, do we?
Susan Ringler-Cerniglia: No, we really don't, and that's been the been the trick, right? We can tell you kind of what's going on now, what the impact we're seeing, but this has been a tricky and unpredictable virus, and it's very hard to tell what will happen next. A key marker of getting to that endemic stage, though, is really to be able to reduce the impact--the negative and most serious impacts--of this pandemic. And to do that, we need to have as much immunity and protection as possible on board. For lack of a better expression, it's when we are able to live better with this virus, right? We don't see high hospitalization rates, we don't see the deaths happening. And this one is especially tricky because we don't see lasting immunity from natural illness, and we don't necessarily see it right now from boosters. So, we do see those reinfections. At least, we have those tools to protect folks from the most serious impacts.
David Fair: Well, thank you very much for the time today. And in our next conversation, we'll talk about when and how we're going to go about getting those fourth booster shots.
Susan Ringler-Cerniglia: Absolutely. Thank you.
David Fair: That is Susan Ringler-Cerniglia, communications and Health Promotion Administrator for the Washtenaw County Health Department. I'm David Fair, and this is 89 one WEMU FM and WEMU HD One Ypsilanti.
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