Life during COVID: December in Otsego

By Richard Sternberg M.D.

Checking the Otsego County Department of Health dashboard on December 20 showed a distinct uptick in a number of cases of COVID in recent days. Most of these still are probably from Delta, but also are beginning to reflect the Omicron variant. The website did not identify the specific variant of those cases.

Dr. Fauci says the number of cases of the Omicron across the United States doubles every two to three days. That in itself is very disturbing. The good news is that those who have been fully vaccinated and, where indicated, have received booster shots, generally show mild symptoms. The number of patients in intensive care units over the total number of people who tested positive shows a decline from those of a year ago. Additionally, the Paxlovid antiviral medication, when available and when properly indicated, seems to decrease the risk of serious complications by up to 90 percent.

Even in those patients who are deemed to be at low risk for complications — the young and healthy — Paxlovid decreases the risk of hospitalization and death by some 70 percent. One must remember, though, that the number of people who fall in this category is relatively low.

Otsego County finds 500 cases per 100,000 people over the past seven days. This means one half of 1 percent of the county’s population is currently, actively experiencing COVID-19. That is about 300 people. In the last seven days there are listed 381 active cases. Of that, ten are hospitalized. There haven’t been deaths. There have been frequent breakthrough infections.

What does this mean for us in Otsego County?

One: The rate of transmission of COVID-19 has gone up significantly. In the last week, the percentage of tests that are positive is 9 percent. While this represents only people who present themselves for testing, we have to remember that in the past, this rate has been below 1.0 — representing an equivalent transmissibility rate.

Two: The severity-per-case seems to have decreased. This may be because many of those people testing positive have been fully vaccinated with boosters. I would like to see statistics broken out for those who have not been previously vaccinated, which would give me a better idea how dangerous Omicron is in those who are unprotected. We still don’t know how long being fully vaccinated and having one booster gives a person significant immunity from severe disease. We do know that having been vaccinated and boostered does not prevent one from catching the disease and being able to transmit it to others.
Three: We should soon have available Paxlovid for the treatment of early-onset symptoms. The only problem with this is finding an available site to do rapid testing when one has any symptoms of the flu or cold. Someone with more serious symptoms of COVID-19 specifically, such as complete loss of smell, will trigger a greater reaction from the healthcare community. Someone with sniffles could be on their own to find testing.

So now what do we do? The governor has declared a state of emergency and the requirements of this seem reasonable and appropriate. If you’re unvaccinated, I strongly urge you to stay away from groups of people and make sure that when you are near people they are wearing masks properly. Even with proper mask placement, Omicron seems to be highly transmissible.

I, of course, urge everyone to get vaccinated. If you are fully vaccinated your decision is more subtle. So far I’m seeing Christmas party after Christmas party canceled or having people who RSVP’d positively not showing up. People are beginning to avoid restaurants again and meetings are being transferred back to Zoom. On the other hand, the Village of Cooperstown trustee’s meeting for December 20 was in person and I attended.

Currently, more than previous spikes, I feel that we have to make our own informed decisions based on a risk tolerance. I am pretty much convinced that everyone, vaccinated and unvaccinated, will sustain an Omicron infection. It’s that transmissible. There are things to do to mitigate this risk and of course to mitigate the outcome.