The new county COVID risk assessment system

We’ll see how it works.

Harris County has revamped its method for assessing the public’s risk for contracting COVID-19, replacing the threat level system that has been in place since early in the pandemic with a community level system that places a greater emphasis on new cases.

The change was made due to a “decoupling” of the relationship between new cases and new hospitalizations during the most recent wave of COVID-19 fueled by the BA.5 subvariant of omicron, Judge Lina Hildalgo said during a news conference Thursday. Harris County did not see a spike in hospitalizations as COVID-19 cases surged this summer, she said.

The new system will allow the public to make their own decisions about the level of risk they are comfortable with taking, knowing that the chance of being hospitalized with a severe illness is relatively low if they have been vaccinated and boosted, Hidalgo said.

“We’re turning a page on a phase of this virus, and I’m very hopeful that we won’t have to go back to a time when surge hampered the entirety of the community,” Hidalgo said.

Hidalgo said the threat level system had been an important tool for gauging risk throughout the pandemic. It had been updated before, but this week’s changes represent a “wholesale redesign,” she said.

The new system uses a trio of color-coded community levels that indicate the risk for contracting COVID-19. Low is green, medium is yellow and high is orange. Harris County is currently yellow, but Hidalgo anticipated the community level could rise to orange with the risk for transmission increasing with children back in school.

[…]

The Harris County Public Health website offers guidance for each of the three threat levels, including recommendations for wearing a mask, traveling and social gatherings when the county is green, yellow or orange. The site will continue to offer other pertinent information, such as wastewater monitoring data and the percentage of county residents who have been vaccinated and boosted.

I had to find the appropriate webpage for this on my own – click the embedded image to get there. The old threat level webpage now gives a 404 error. This new system seems fine and reasonable. The main concern is about what might come next.

Q: So how are we doing these days? The numbers certainly look better than they did.

A: They are falling, no doubt about it. But we have to keep in mind that we don’t have a lot of details about the real number of cases. Most of us are getting diagnosed at home using home testing kits. The numbers were always underestimating by a factor of four or five. Now it’s probably seven to 10. So you have to have to look trends.

Numbers are going down. But here are numbers I keep reminding people of: We’re still losing 400 or 500 Americans a day to COVID, which makes it the third or fourth leading cause of death on a daily basis in the United States. There’s still a lot of terrible messaging. People say we don’t have as many hospitalizations. Or that everybody has been infected or vaccinated or vaccinated with breakthrough. All of that is true. On a population level, it has had mitigating effects. But that doesn’t help you make an individual health decision.

People conflate that with individual health decisions. If you’re unvaccinated, there’s still a possibility you could lose your life to COVID. Even if you’re vaccinated and not boosted, there’s that possibility. And we’re seeing the boosters aren’t holding up as well as we’d hoped. That’s one of the reasons I’m strongly encouraging people to get this new booster, which has the mRNA for the original lineage and an added one against BA.5. After four or five months, there’s risk again for being hospitalized. The coverage declines from 80 percent to 50 percent protection against hospitalization.

Then this BA.5, even though it’s going down, it’s a long, slow tail. It’ll be around well into the fall. And the toughest thing to get people to understand is what’s going to happen in the winter. Obviously there’s no way to predict. But I think it’s still quite likely that we’re going to see a new variant just like we have the last two winters. Last winter it was omicron, BA.1. The winter before that we saw alpha. And new variants are arising because we’ve done such a poor job vaccinating low and middle-income countries.

We don’t know what a next variant could look like. More like the original lineage? Or something more like BA.5? The advantage of the new combined booster is that it gives you two shots on goal. It’s more likely to cross-protect against what’s coming down the pike. That’s no guarantee. But we’ve never done this before in terms of what the FDA does. We’ve never vaccinated against something that might be lurking out there. It’s a paradigm shift. What’s happening, and I don’t think the FDA will phrase it this way, but we’re creeping toward a universal coronavirus vaccine.

That’s from a Q&A with Dr. Peter Hotez, who knows better than I do. But I do know enough to say that you should get the omicron booster. And I also know enough to say that political stunts that endanger public health are bad. I think that about covers it.

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