Public Health Madison & Dane County

We are once again in a period of transition with the pandemic, where we are coming off a major surge (the Omicron wave). Where are we and what can we expect in the future?

Cases, hospitalizations, and deaths have all been decreasing.

Overall, we’ve seen cases decrease dramatically since January 2022, when Omicron was highest in Dane County. The 14-day average of cases per day in Dane County as of March 10th was 66.4 cases. This is a 95.3% decrease from our peak 14-day average almost two months ago, on 1/17 (which was 1410.6 cases). As of 3/14, cases have stabilized at a manageable level, and hospitalizations continue to decrease.

It’s possible that some of this decrease is because of the widespread availability of home tests, which aren’t counted in our case numbers. But there’s reason to believe that’s not a big factor. For one, percent positivity is also falling and is well below 5%, which means that we are capturing a lot of the new cases through community testing. Also, we’ve seen a corresponding drop in hospitalizations and deaths, which indicates that this is a true decrease in cases.

The CDC’s new community levels put Dane County in the “low risk” category.

In late February, the Centers for Disease Control and Prevention (CDC) changed the way they classify counties for monitoring COVID community risk levels. Previously, they only looked at COVID cases and percent positivity to determine a county’s transmission levels. Now, they also look at hospital capacity and new hospital admissions, and adjusted the case thresholds. The original indicators and case thresholds were developed in fall 2020 prior to availability of vaccines. The new metrics place less of an emphasis on case levels for community risk because most people now have some immunity either from vaccination or infection or both, which reduces the risk of severe outcomes in the future. This change is also helpful in assessing community risk because it now places greater emphasis on medically significant disease and healthcare strain. These new measures are much better at predicting regions that will experience severe outcomes, and give more meaningful differences between risk categories.

As of March 10th, all of Wisconsin was classified as either low or medium community level. Dane County is in the low level, which is great news. You can track this on our data dashboard on the People tab, or on the CDC website.

We are continuing to monitor local and worldwide trends. 

We know that COVID probably isn’t going to go away anytime soon, and public health will have to continue monitoring the situation for a long time. We do this through our local COVID data, as well as keeping an eye on state, national, and worldwide trends. We also keep up to date on the World Health Organization’s worldwide variants of concern and the variants that are being sequenced in Wisconsin and the US. The prevalence of the BA.2 Omicron subvariant (which spreads more easily than the BA.1 lineage) has been increasing; CDC estimates BA.2 is now 23.1% of new cases in the US, up from 13.7% last week, and 7.1% the week before that. However, considering how large the initial Omicron wave was, we don’t expect there to be another huge wave; a very large number of people were infected with Omicron BA.1, and reinfection with BA.2 (after someone was infected with BA.1) seems to be rare, based on recent research in Denmark and Qatar. Our high vaccination rate also helps protect us against severe outcomes from BA.2. However, we will be monitoring the situation in Europe closely as BA.2 spreads so that we are prepared for whatever may happen here.

Wastewater monitoring is also being conducted in Wisconsin, including in Madison. Samples are taken from local sewers and the levels of COVID in the wastewater is measured. The data are intended to serve as an early warning of COVID in communities, especially as more people use at-home COVID tests that aren’t well captured by local health departments. Madison’s wastewater, however, has had many ups and downs, and for unknown reasons it hasn’t been a great predictor of future COVID surges. But we can look at Wisconsin as a whole and try to predict future trends. Right now, some areas in Wisconsin and nationally are seeing an increase in COVID wastewater levels, but it isn’t yet clear if that trend will actually lead to more cases in the next few weeks or if it will fizzle out. If we do see a small increase this spring, it would not be unprecedented. During this time last year, we saw a steady decrease in cases from January to March, followed by a small increase in cases between mid-March and mid-April, then followed by a sustained decrease to low levels throughout the summer.

We don’t know what letter of the Greek alphabet might or might not be in our future. But we can use the data available to us to make decisions around COVID. Right now, as a whole, things are looking up for Dane County. And we still have the tools available to help us reduce risk, including vaccines, masking, distancing, and taking special care around people who are most vulnerable. We’re cautiously hopeful about where we are, while also staying prepared for whatever might happen in the future. And while we’re at it, now is a great time to get up to date on your COVID vaccine and booster!