By Dr. Stephanie Paulmeno, DNP, RN, NHA, CPH, CCM, CDP, Greenwich Health Dept.
Omicron BA.2 is spreading rapidly in Greenwich, Connecticut, and beyond, and is impacting all age, socio-economic and cultural groups.
Between April 7 and April 8 the number of Greenwich cases increased by 103.
Over the three preceding days that number had increased by 223 (CT- DPH/Data Wrapper, April 9, 2022).
While public health professionals were not prescient about the take-over of Omicron Sub-variant BA.2, it was no surprise to see the spread of COVID occurring after home testing was made widely available.
While increased testing was and is a great and much needed public health measure, home testing rapidly led to a reported drop in our calculated positivity rates because positive home test results are not reported to the state.
The Connecticut Dept of Public Health calculates the critically important positivity ratings based on how many people test positive in comparison to the total number of people who are tested. We now know neither.
The State Health Dept does not receive reports of people testing positive on home tests, and as of April 4, 2022 even negative rapid PCR and rapid antigen tests are no longer reported to the state (Lamont Press Release, April 8, 2022); thus the total number of tests performed is no longer part of the calculation. The rapid drop in calculated positivity rates following the delivery of home test kits to the public precipitated the elimination of mask mandates and social distancing guidance in all settings; schools, business, and social settings.
Greenwich is now, once again, back in the RED ZONE along with 24 other Connecticut municipalities (Governor Lamont’s Daily Updates, April 7, 2022, CDC). Red Zone designation means uncontrolled community spread (CDC).
In a convened staff meeting on Friday, Health Director Caroline Baisley discussed this latest surge & the public health & safety guidance the Health Department staff needs to continue to provide during contact tracing & the monitoring of the rapidly increasing numbers of COVID-19 patients, & as calls come into the office. She noted that Omicron sub-variant BA.2 now accounts for 75% of all new COVID cases in the US. It is more highly contagious than the prior COVID variants and sub-variants, but fortunately less lethal.
Selectman Fred Camillo alerted us a week ago to rising COVID cases & hospitalizations (Community Connections from Fred, April 1, 2022). Symptoms of the Omicron sub-variants are milder than Delta & prior variants, however many more people will become infected. Omicron A.1, A.1.1, & BA.1 and BA.2 are much more highly transmissible/contagious than prior mutations. Early studies out of South Africa and other countries showed BA.2 doubling its numbers every 2-4 days. As so many more people become infected and ill, some will become sick enough to require hospitalization, and some will die. Research (AMA, 2022) indicates that 10-30% of those who become even mildly or asymptomatically ill also run the risk of developing persistent/long-haul COVID symptoms. Those with underlying health conditions, the elderly & infirm, & those not fully vaccinated are at considerably higher risk for more serious consequences, including hospitalizations & death (CDC, CDC Morbidity & Mortality Weekly Report, Mayo Clinic, Johns Hopkins, WebMD, CT DPH, British Medical Journal).
On Friday, our positivity rate reached 5.27%. It will undoubtedly continue to rise as it has been progressively climbing for days. The public health challenge is that this figure now only reflects those who tested positive with a lab (not home) test. Our actual calculated COVID positivity rate would be different if it also included positive home testing results. During contact tracing and monitoring calls, entire families are often ill, but only one or two people did lab testing, the rest are confirmed on home testing.
Assuring public health and public safety are in the purview of Departments of Public Health. Accurate positivity rates are important from a public health perspective because they tell us how widespread COVID infection is in a community, and that should determine health and safety guidance provided. A number over 5% tells us to take precautions (WHO, Johns Hopkins, CDC, Mayo Clinic, 2022). A 5% or higher rating is not the time to reduce public health constraints or your personal safety measures. Today those choices are in your hands alone, and you need to make your best call for yourself and your family. It does not matter what someone says you can do, ask yourself it doing it makes sense to you given what is going on in your community.
If you or your family remain unvaccinated, now is the time to look again at your personal risk factors (age, health, weight, race, vaccine status), your community risk factors (Greenwich is again a Red Zone), & at the personal choices you make in attending social activities, mask use, social distancing, & the measures you implement to protect yourself & your loved ones. The holidays are again upon us. Consider getting vaccinated or boosted, select your guest list wisely, wear masks in enclosed social groupings, socially separate, & test if you are exposed or show COVID symptoms.
Check the Greenwich Department of Health website (https://www.greenwichct.gov/575/Health-Department ) for information on COVID, testing/test kits, vaccines/vaccination sites, & COVID guidance.
The expiration dates on the I-Health COVID-19 home kits have been extended for prolonged use. You should test on day 2 following the appearance of symptoms and if negative repeat the test on day 4, but before day 5. If you result is positive, you can be pretty sure you have COVID.
If you test negative, twice but are still symptomatic, get a PCR test because there are false negatives. (https://ihealthlabs.com/pages/news?fbclid=lwAR3UaMCQRaCDELPdK-
x2hE17ypMboHb_7x50cUgnJP2s3rAJNgOw49RJVWA).