Weekly News From Los Alamos County
December 23, 2022
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There will be no newsletter next week due to the holidays. |
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Inside this newsletter, you will find...
The Epidemiology Corner - COVID-19 Update, What is the "Senior Wave", "Tripledemic" Update, Why Wear a Mask, Weekly Survey, COVID-19 data, and more.
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COVID-19 Update:
XBB Variant Rapidly Spreading in US as Reported Cases in County Continue to Decline...
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COVID-19 Update: Omicron XBB Variant Rapidly Spreading in US
Omicron variant XBB is rapidly spreading in the US, and now accounts for 18% of cases nationwide. XBB first emerged in the northeastern US, where it quickly outcompeted other variants and has recently come to predominate. All other Omicron variants circulating in the US are stable or declining in prevalence, including the BQ.1 and BQ.1.1 (BQ.1x) variants. See HERE Health experts believe that XBB and BQ.1x are the most infectious Omicron variants yet observed, and may rival measles in regard to extremely high levels of contagiousness. Although vaccination cannot prevent infection, recent CDC studies have shown the bivalent booster to be effective at preventing severe disease and hospitalization for both XBB and BQ.1x variants. See HERE A recent laboratory study has demonstrated that the bivalent booster stimulates notably higher levels of protective antibodies than the former monovalent boosters alone. See HERE
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Community Level Risk Remains at LOW as Reported Case Transmission Rates Sharply Decline
For the week ending December 21, the Community Level remained at LOW for Los Alamos County, as it did for the three other counties (Taos, Rio Arriba, Santa Fe) which collectively comprise the regional Health Services Area (HSA) over which CDC hospitalization metrics are calculated. Reported cases in the county declined week to week from 10 to 5 cases, which translates to a 50% decline in the county incidence rate from 52 to 26 cases per 100,000. Rates also declined in the three neighboring HSA counties. For the week ending December 21, Los Alamos County had the lowest reported case incidence rate among all counties in New Mexico with populations greater than 5,000 persons. The 4-county HSA hospitalization rate declined at a more moderate pace from 7.5 to 6.2 new admissions per 100,000. As a disease indicator, COVID-19 hospitalization generally lags reported case incidence by several weeks.
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Emergency Department Visits for COVID-Like Illness Decline with Fewer Reported Cases
NMDOH reports the percentage of emergency department (ED) visits in county residents for COVID-like illness declined to 1.9% for the two-week period ending December 21. The decline was accompanied by a 50% decline in average daily reported cases for the single week ending December 21. No COVID-19 deaths or new hospital admissions were reported by NMDOH for the most recent week. Statewide, the percentage of ED visits for COVID-like illness declined to 5% while ED visits for flu-like illness increased to 18%. See HERE
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Levels of COVID-19 Virus in County Wastewater Trend Lower with Continued Reported Case Decline
SARS-Cov-2 virus levels in county wastewater have declined sharply for the past two weeks consistent with sharp declines in reported cases within the county. Viral levels are currently lower now than at any time since wastewater surveillance was initiated by the CDC/Biobot contractor in June 2020. See https://biobot.io/data/
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County Seniors Remain at Highest Risk of Reported COVID-19 Infection
Reported case incidence strongly decreased into the first several weeks of December for all age groups except county seniors aged 65+ years, among whom incidence has been relatively stable over the past several months. CDC recommends that all eligible seniors receive the new bivalent booster, which has been shown to provide 73% additional protection against COVID-19 hospitalization compared with the prior monovalent mRNA vaccination only. See HERE
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New Mexicans Encouraged to Self-Report Positive COVID-19 Home Tests
To assist with more complete case monitoring in New Mexico, NMDOH encourages residents to download the NM Notify app and to report positive COVID-19 home tests on the app, or for a fast and easy way to report your at-home test results online, visit https://makemytestcount.org/.
The NMDOH/CDC COVID-19 incidence data reviewed here are based on PCR-confirmed testing results and do not include data on positive at-home antigen tests. As such, case counts are incomplete and underestimated, but by how much cannot be determined precisely at any given time point.
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A Covid-19 ‘senior wave’ is driving up hospitalizations
Throughout the pandemic, a positive Covid-19 test for a senior has carried an extra heavy weight.
Only about 13% of all reported cases in the US have been among people 65 and older, according to data from the US Centers for Disease Control and Prevention. But about half of all hospitalizations and three-quarters of all deaths have been in this age group.
The Covid-19 hospitalization rate for seniors has generally risen and fallen in line with broader trends, reaching a record high last winter during the Omicron surge and dropping significantly in the summer. But compared with other age groups, hospitalization rates have consistently been higher among the 65 and older population.
This winter, Covid-19 trends are again on the rise across the country. So far, the increase appears to be relatively mild – hospitalizations are ticking up in most states, although the overall rate is still just a fraction of what it was during other surges.
But for older adults, the situation is much more severe. Hospitalizations among seniors are nearing the peak from the Delta surge and rising fast.
And the age gap has never been wider. Since October, the Covid-19 hospitalization rate among seniors has been at least four times higher than average.
Even during the first winter surge in 2020, when Covid-19 took a devastating sweep through nursing homes, there was never more than a three-fold difference.
Dr. Eric Topol, a physician and professor of molecular medicine at Scripps Research, has dubbed the ongoing rise the “senior wave.”
“Right now we have an immunity wall built up against the Omicron family – between shots and prior infections and combinations thereof – that seems to be keeping younger folks in pretty good stead. But the immune systems of people of advanced age are not as strong,” Topol said.
Younger adults who are immunocompromised are also likely experiencing disproportionately severe effects of the latest wave, he said, but there isn’t sufficient data to understand trends in that population as well.
New variants that are more immune evasive and relatively low utilization of treatments like Paxlovid may have played a role in the rising hospitalization rate among seniors, Topol said.
But “the main culprit is booster deficiency” with rates that are “woefully inadequate,” he said. “It all points to waning immunity. If more seniors had their booster, the effect would be minimal.”
Vaccines help, and boosters still work
Just about a third of the 65 and older population has gotten an updated booster shot, according to CDC data – a number that’s concerningly low to public health experts.
More than 40% were worried that they would get seriously sick themselves, but nearly as many said that they don’t have plans to get the updated booster any time soon. In fact, nearly a quarter of seniors say they don’t have any plans to get it at all, or will only get it if it’s required.
A community-minded approach to protect the most vulnerable
Vaccines – including the updated booster – continue to prove to be effective at preventing severe disease. But booster uptake among seniors, while low, is much higher than it is for other age groups. Less than 10% of adults under 50 and less than 5% of children have gotten their updated booster, CDC data shows.
Infectious diseases like Covid-19 don’t spread differently among seniors than they do among younger people, experts say. Instead, family, friends and the broader community are often the ones bringing Covid-19 to seniors – who are more likely to suffer more severe consequences.
And nursing homes are particularly vulnerable again this winter. Weekly cases among residents have already surpassed all prior surges except the initial winter wave and the Omicron wave, and they continue to rise. But just 47% of residents and 22% of staff are “up to date” with vaccines, according to data from the US Centers for Medicare and Medicaid Services.
To read the full article, click HERE!
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This Party Season, You Don’t Have to R.S.V.P., Just Test
As rising Covid rates collide with a return to holiday festivities, hosts are coming up with inventive compromises.
Nearly 60 percent of 252 U.S. companies surveyed in October and November planned to have work parties this year, up from 27 percent in 2021 and 5 percent in 2020, the first year of the pandemic, according to Challenger, Gray & Christmas, a recruiting firm.
In New York and Los Angeles, large cities where rates of Covid and other respiratory illnesses have surged, public health officials have issued ominous warnings in recent days. But they have stopped short of explicitly asking residents to change plans or to stay home, instead suggesting that people wear masks in public indoor settings or even in crowded outdoor spaces.
Many hosts who are proceeding with parties have taken another tack: They’re asking guests to take a rapid Covid test before walking in the front door.
Perhaps surprisingly, many experts endorse rapid testing as a wise strategy for holiday partyers. At-home antigen tests can detect active infections with a high degree of accuracy, even if they are far from foolproof.
Rapid tests are less sensitive than polymerase chain reaction tests, which are performed in a lab and amplify the genetic material in a sample, and so they may miss an early infection when the viral load is low.
But a positive result on a rapid test may actually be more closely “correlated with how infectious you are” than a positive result on a PCR test, said Bill Hanage, co-director of the Center for Communicable Disease Dynamics at Harvard T.H. Chan School of Public Health.
“The way to think about it is that it’s cumulative risk reduction,” he said, adding, “We cannot get the risk to zero, unfortunately, but we can reduce it markedly by vaccines, masks and, if people don’t want to wear masks, having them do a rapid test before getting together.”
To read the full article, click HERE!
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‘Tripledemic’ Rages On: Fever-Filled Weeks Lie Ahead
R.S.V. has probably peaked, but flu is still surging and Covid-19 cases are rising. Scientists are hopeful next winter will be better.
It has become wearyingly routine: Americans are embarking upon yet another holiday travel season in the midst of a viral onslaught.
New, immune evasive versions of the Omicron variant are spreading, and Covid-19 cases, hospitalizations and deaths are once again rising, although the figures remain far below last winter’s peak. But this year the coronavirus has company: Common seasonal viruses, which lay low for the last two winters, have come roaring back.
In particular, influenza and R.S.V., or respiratory syncytial virus, hit early and hard this fall, causing major outbreaks that are now overlapping with a resurgent coronavirus. This viral pileup — what some are calling a “tripledemic” — has already set off an exhausting season of sickness, triggering sky-high demand for pain and fever relievers and pushing children’s hospitals to the brink.
But each of these three viruses is on a slightly different trajectory. Although there is considerable geographic variation, in most parts of the country R.S.V. has probably already peaked, while flu is now surging, experts said. And Covid is still ramping up, with cases likely to continue rising.
It is not too late to get a Covid booster or a flu shot, which appears to be well-matched to the influenza strains circulating this year, scientists said. And experts repeated their now-common exhortations to take basic precautions, such as wearing masks in crowded indoor spaces, using rapid Covid tests before visiting vulnerable people and staying home when feeling unwell.
“I know people are kind of tired of hearing some of that stuff,” Dr. Graven said. “We’re not saying people need to change your life forever. Right now, for the next some number of weeks, we’re in not a great spot.”
Scientists are hopeful that next winter will be better, noting that this brutal season is an unfortunate, and not entirely unexpected, byproduct of several years of pandemic precautions, such as masking and social distancing. These measures shielded many people from routine winter infections and may have spared overburdened health care systems from even bigger surges.
But many children and adults also missed out on the opportunity to build or bolster their immune defenses against flu and R.S.V., leaving the viruses with an unusually vulnerable population this fall.
“There was a bit of a buildup of susceptibility at the population level,” said Virginia Pitzer, an infectious disease epidemiologist at the Yale School of Public Health. “It’s a worse than normal winter, but one that hopefully will not be repeated next year.”
A viral comeback
The first virus to surge this fall was R.S.V., which usually causes mild illness but can be severe, or even fatal, in older adults and young children. By the time children in the United States are two years old, almost all have been exposed to the virus.
The virus typically peaks in December or January. But this year, cases of R.S.V. began rising steeply in September, and by mid-November, pediatric hospitalization rates had hit the highest level since tracking began in 2018. Hospitalization rates for older adults have surged, too.
Flu took off in October, about six weeks ahead of schedule, and has already caused at least 150,000 hospitalizations and 9,300 deaths, according to estimates from the Centers for Disease Control and Prevention. The cumulative hospitalization rate is higher for this time of year than it has been in more than a decade.
“We had a huge pool of people, compared to what we normally do, who could be infected by R.S.V. and could be infected by flu because we’ve basically missed two seasons of it,” said Jeffrey Shaman, an infectious disease epidemiologist at Columbia University. As a result, he said, the viruses were “able to go to work early and infect a lot of people. And that’s why we’re seeing these very large, marked outbreaks early on.”
However, some encouraging signs have recently emerged, especially regarding R.S.V. Nationally, hospitalization rates and R.S.V. detections have fallen since mid-November, according to C.D.C. data.
Covid, again
Covid-19, on the other hand, appears to be on the upswing. At many of WastewaterSCAN’s sites, coronavirus levels began increasing in early November and surged around Thanksgiving, Dr. Boehm said. Levels are still trending upward at most sites, she said; at some, they are even approaching last winter’s peaks.
Officially recorded Covid cases, which remain a significant underestimate, have increased 24 percent over the past two weeks, while hospitalizations are up nine percent. There are more than 400 Covid-related deaths a day, on average, a 41 percent jump from two weeks ago.
Those figures are likely to rise further in the coming weeks, experts predicted, fueled by a combination of holiday travel, indoor gatherings, waning immunity and the spread of BQ.1 and BQ.1.1, two new, highly immune-evasive versions of Omicron. (So far, these subvariants do not appear to be causing more severe disease than earlier forms of Omicron did, scientists said.)
The emergence of new variants remains a wild card. The explosion of cases in China could theoretically increase that risk; the more the virus spreads, the more opportunities it has to mutate and evolve. But new variants can emerge anywhere, and given how widespread the virus already is around the world, China’s current outbreak may not have “an appreciable impact on the rate at which new variants are emerging,” Dr. Lessler said.
It remains too early to say whether flu and R.S.V. will return to their typical rhythms next year. But not every winter will be this bad, scientists predicted. “We are sort of making up for the immunity gap that existed during these last two years,” Dr. Chu said. “Things will probably get better.” (An R.S.V. vaccine might be available by next winter, too, she noted.)
Still, even before the pandemic, the flu burden varied widely from year to year — a bad season can cause more than 50,000 deaths and overwhelm hospitals — and Covid is likely to remain part of the winter mix.
To read the full article, click HERE!
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It’s Time to Wear a Mask Again, Health Experts Say
A high-quality, well-fitting mask is your best protection against infection from the coronavirus, influenza and R.S.V.
Masks are back, and, this time, they’re not just for Covid-19. A “tripledemic” of the coronavirus, influenza and respiratory syncytial virus, known as R.S.V., sweeping through the United States has prompted several cities and counties, including New York City and Los Angeles County, to encourage people to wear a mask in indoor public spaces once again.
Nationwide, Covid-19 case rates have spiked by 58 percent since the end of November. The Centers for Disease Control and Prevention estimates that there have already been 15 million illnesses and 9,300 deaths from flu this season, and those numbers are expected to rise in the coming months. (Over the past decade, annual flu deaths have ranged from 12,000 to 52,000 people, with the peak in January and February.) And while R.S.V. finally appears to be on the decline, infection rates are still high across much of the country.
The C.D.C. officially advises wearing a mask on a county-by-county basis depending on community Covid-19 levels, which take into account virus-related hospital admissions, bed capacity and case rates. However, in an interview with NPR last week, Dr. Rochelle Walensky, the C.D.C. director, said, “You don’t need to wait for C.D.C.’s recommendation, certainly, to wear a mask.”
Rates of Covid-19, flu and R.S.V. “may be more intense or a little bit less intense in some parts of the country, but really, the entire country is being affected,” said Dr. William Schaffner, a professor of preventive medicine at the Vanderbilt University School of Medicine. As a result, he urged anyone who lives in a high-risk household to “put your mask back on” when in public spaces. High-risk households would include those with adults over the age of 65, pregnant women, people with a pre-existing condition such as heart disease, diabetes or lung disease and anyone who is immune-compromised.
Dr. Helen Chu, an associate professor of allergy and infectious diseases at UW Medicine in Seattle, went a step further, recommending everyone mask while infection and hospitalization rates are so high. “I think it’s a good time to mask,” she said. “Given where we are right now with hospitals being at very close to capacity, especially in pediatric hospitals with R.S.V. and with flu, I think that anything that you can do to slow down community transmission is going to be helpful.”
There is strong evidence that masks help to reduce the transmission of several respiratory viruses. A study of Covid-19 policies in Boston-area schools found that removing a mask mandate in 2022 was tied to nearly 12,000 additional cases among students and staff.
Rates of influenza and other respiratory viruses essentially flattened during the 2020 and 2021 winter seasons, which was largely attributed to the protections the country took to prevent the spread of Covid-19. “What Covid has shown us, because we’ve been social distancing and mask wearing, is that influenza, the common cold viruses, R.S.V. are suppressed remarkably” by these small individual behaviors, Dr. Schaffner said.
Masks work by filtering out both the tiny aerosol particles through which the coronavirus is primarily spread and the larger droplets that are thought to be responsible for most influenza and R.S.V. transmission. They also stop you from touching your face in case you picked up virus particles on your hands from a doorknob or subway pole. And while masks are most effective at stopping the spread of these viruses when the infected person is wearing one, masking to protect yourself from disease is still beneficial, particularly if you’re using a high-quality version like N95, KN95 or KF94.
“The basic truth is that masks work,” said Syra Madad, senior director of the systemwide special pathogens program at New York City Health + Hospitals. “Whether you’re talking about Covid-19 or other respiratory viruses like R.S.V. and flu, wearing a mask will help protect you against all these respiratory viral illnesses.”
When weighing when and where to mask, Dr. Madad recommended paying attention to the “Three Cs”: close contact, crowded spaces and confined places with poor ventilation. The experts urged wearing masks while traveling on planes and public transportation, and they strongly suggested doing it while out shopping for groceries and gifts. For smaller holiday parties with people you know, it’s fine to forgo masks if guests test beforehand and stay home if they’re feeling rundown.
Realistically, not everyone in the United States — or a certain city — will wear a mask. In fact, you might find yourself the only person in a store or on a plane who’s wearing one. Don’t let that discourage you. For one thing, remember that no one is thinking about you as much as you think they are. In social psychology, this is called the spotlight illusion, said Gretchen Chapman, a professor of social and decision sciences at Carnegie Mellon University. “I may feel that everyone’s staring at me because I’m wearing a mask, but chances are that’s like the 11th thing on their list to worry about,” she said.
What’s more, Dr. Chapman said, “There are lots of situations in life where we do something that makes us feel awkward, but if we think it’s important enough, we do it anyway.”
To read the full article, click HERE!
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A Guide to Winter Illnesses
As Covid, the flu and R.S.V. collide this winter, here’s what to know.
Covid-19
Got questions about the bivalent booster or the latest Omicron iterations? We’ve got answers.
The Flu
R.S.V.
What are the symptoms of R.S.V.? Who is most at risk? Are there tests for it? Here’s what to know.
Many Americans are still in the dark about R.S.V. and what to do about it. Apoorva Mandavilli, who covers infectious diseases for The Times, provides some insight.
To read the full article, click HERE!
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Have you gotten your flu shot?
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Los Alamos Testing Information |
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Free COVID-19 at-home antigen tests available again
All U.S. households can order a total of four at-home COVID-19 tests that will be mailed directly to them for free. Tests can be ordered HERE.
Additionally, New Mexico residents can still receive mail order free at-home tests through the Rockefeller Foundation’s Project Act program while supplies last at: https://accesscovidtests.org/.
DOH would like to remind residents with private insurance, as well as Medicare and Medicaid that they can request reimbursement for up to eight tests per month.
Residents can self-report a positive COVID test at Make My Test Count. The reporting of tests on this site is confidential and no personal information is required to use the site.
For more information on how to stay safe and healthy from COVID-19, visit cv.nmhealth.org.
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Los Alamos County COVID Testing Resources
Visit the County COVID Page for information regarding testing, click below:
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Los Alamos Vaccine & Booster Information |
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How do I know if I'm eligible for a vaccine or booster?
Follow these links to review the CDC eligibility guidelines:
Where can I get my COVID-19 Vaccine or Omicron booster?
In addition to the clinics that use the NMDOH scheduling site, Los Alamos has other options available. Click below on the vaccine/booster resources website for more information.
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Los Alamos County COVID Vaccine/Booster Resources
Visit the County COVID Page for information regarding vaccinations/boosters, click below:
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CDC COVID Data Tracker - December 23, 2022
To get today's break down of positive case data, demographics information, vaccine status and more for Los Alamos County or other counties across the United States, click HERE
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NMDOH Epidemiology Reports - Daily and Weekly Data
As part of the COVID-19 pandemic response, NMDOH collects and analyzes statewide data for COVID-19 positive cases, hospitalizations, and deaths. The reports reflect these critical data and are updated weekly - click HERE
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We are listening to you!
Your feedback is helping to shape future newsletters, inform decisions regarding services, and make Los Alamos County healthier and safer. Make sure to participate each week to be heard!
Check out the responses to our last survey:
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Remember, we appreciate your questions! We always try to respond in a timely manner, and if appropriate, we will include those Q&As in future newsletters.
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Have a question? Email us. |
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Los Alamos Treatment Information |
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Los Alamos County COVID Treatment Resources
Visit the County COVID Page for information regarding treatments, click below:
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What else would you like to see in this newsletter?
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