BY RICHARD SKOLNIK
The number of cases has increased over the two weeks ending June 14 by 157%. We are at a
7-day average of 25+ cases per day, equal to 129 per 100,000 people.
This rate of new cases is the highest in New Mexico and as high as any time except the peak of the Omicron surge. For reference, the county with the 10th highest rate of new cases in the country has 139 cases per 100,000 per day.
The number of reported cases is almost certainly a major undercount of the true number of cases. In addition, the County’s wastewater testing program has not functioned during the recent surge, denying us an important indicator of the magnitude of viral spread locally.
The better news is that only one county resident is hospitalized with COVID and no county residents have died recently of COVID.
Should we care about cases?
In an environment where few are hospitalized or die from COVID, should we “care” about cases? The evidence to date says that “infections matter.” First, each case leads to lost workdays, lost schooldays, healthcare costs, possible hospitalization, or possible death. Second, it is estimated that 10-30% of infected adults will suffer from a range of post-infection effects, including premature mortality and, among others, possible pulmonary, renal, and neurological problems. COVID may also trigger diabetes. “Long COVID” is also occurring in children. Third, we need to remember that COVID in its first two years killed 15 times more adults and 6 times more children per year than the flu.
So, what are we to do?
The first step to being “as safe as possible” is to recognize as most do, that “you are mostly on your own.” This has no precedent in modern communicable disease control efforts and is stated as “personal choice.” Those old enough should imagine what this approach would have brought us on polio.
We can also see that avoiding infection in Los Alamos has become very difficult. We have high viral transmission in the community; waning immunity; limited collective mitigation efforts; limited personal mitigation efforts; and almost no data for decision making or public action against the spread of infection.
Nonetheless, the evidence says that by being up to date on vaccination and boosting, one can lower the risk of severe illness, hospitalization, and death. The evidence also says that masking indoors when at risk of exposure, with a high-quality mask, can reduce your risk of infection. Home testing is imperfect but can still be helpful to avoid being infected by others or infecting others. Some of the latest evidence (in the Journal of the American Medical Association) suggests that symptomatic individuals with an initial negative home antigen test should test again 1 to 2 days later. Good ventilation is also important to reducing viral spread and air filtration with a HEPA-based filter can also be helpful.
The last things we can do in the short term are: keep up with information on COVID locally so we can make informed decisions about dealing with COVID; encourage local organizations to host events in a manner that takes account of viral spread in the community; encourage the County to place greater urgency on the COVID-related matters for which it can take responsibility.
Richard Skolnik is the former Director for Health for South Asia at the World Bank. He was the Executive Director of a Harvard AIDS treatment program for three countries in Africa and taught global health at The George Washington University and Yale, at which he holds a Lecturer’s appointment. Richard is also the author of the widely-used Global Health 101, Fourth Edition and Global Population Health: A Primer and the instructor for the Yale/Coursera course Essentials of Global Health.