In a pattern that has been repeating itself for more than two years, coronavirus cases in the DC region and across the country are picking up again after a brief hiatus with some of the lowest virus circulation rates of the pandemic.
What is different this time is that many residents are finding it more difficult to monitor the spread of the virus.
Since mask regulations and other restrictions were eased earlier this year, local government leaders have told residents that those trying to avoid the virus should monitor public health data to assess personal risks. But the region’s health departments are reporting far less information to the public than they regularly did up until this winter. Public health officials are also less aware of who will test positive for the virus because so many people can now test themselves at home.
“We’re asking you to make your own decisions about risk, but we’re not giving you the tools to do so,” said Neil J. Sehgal, assistant professor of health policy at the University of Maryland. “…The sad reality is there are no longer any good metrics to look at to assess your risk today versus last week or two weeks ago. What we’ve done is we’re forcing people to trust their intuition.”
Tracking coronavirus cases in DC, Maryland and Virginia
As of Thursday morning, the seven-day moving average over the past week was up 54 percent in the district, 43 percent in Maryland and 27 percent in Virginia.
These rates, driven by omicron’s BA.2 subvariant, are well below the staggering case numbers caused by the earlier omicron variant that hit the region hard in December and January. However, public health experts expect BA.2 will keep cases rising.
Some local universities, including American and George Washington, have reinstated the mask requirement, which they dropped when the first Omicron wave subsided. Philadelphia announced this week that its citywide indoor masking mandate would return, raising questions for DC-area officials if their jurisdictions will do the same. So far nobody has.
American, GW universities are among the latest campuses to reintroduce masks
Montgomery County officials said Wednesday they are not considering plans to reinstate a mandate. Interim health commissioner James Bridgers said he expects cases to peak and plateau in the highly vaccinated county without a significant increase in hospitalizations or deaths, although officials are prepared to quickly change course, especially if the number of cases increases after schools return from spring break.
“We’re concerned,” said Montgomery County executive Marc Elrich (D), “because at some point you can’t just let this thing ramp up out of control.”
Some officials have contracted the virus themselves after avoiding it for the first two years.
DC Mayor Muriel E. Bowser (D) and Council Member Kenyan R. McDuffie (D) contracted the virus earlier this month. both said their symptoms were mild. Fairfax County Board of Trustees Chairman Jeffrey C. McKay (D) called his own symptoms “uncomfortable but manageable.”
When Arlington County chief Matt de Ferranti (D) fell ill, he sent a letter to residents, noting a sharp rise in cases in Arlington and urging people to wear masks and get vaccinated. “We know, and I can tell you first hand, you don’t want to get Covid,” he wrote.
Sehgal said he urges his neighbors and students to watch out for such anecdotal evidence of a spike in cases. “Think of your social circle, the number of people in your network who are infected right now or have been infected in the last week,” he said.
Covid cases surge in Northeast as BA.2 omicron subvariant gains ground
The district, like many jurisdictions, no longer reports the number of new cases it reports each day, and it has also stopped reporting much of the extensive data it formerly released on hospitalizations and other metrics. The site now includes a much smaller set of metrics, including weekly case rate per 100,000 population. That number has risen every week for the past month, from 51 cases in the week of March 6 to 204 cases in the week of April 3, the last reported.
“How does it help me today, two weeks later, to know what happened in the district in March? That’s history,” Sehgal said. “All I can tell you for sure is that we are three times worse off today than we were at the beginning of the month. But that seven-day average case count no longer feels accurate to me,” he added, because at-home testing is widespread and never reported to the government.
Officials say they still have ways to estimate the extent of community transmission. In Montgomery, for example, the health department is asking doctors to report positive test results from patients using at-home kits, and the county is closely monitoring data from places like schools and nursing homes that regularly conduct PCR tests. As of this week, outbreaks in those communities have not increased significantly, said Sean O’Donnell, the county’s emergency preparedness manager.
“Throughout the pandemic, we never had the full picture,” O’Donnell said at a news conference Wednesday. When Covid-19 first emerged, he found tests were not readily available. The virus could spread asymptomatically, suggesting that there were large groups of people who unknowingly carried and spread it. And in late 2021, a cyberattack crippled Maryland’s Covid-19 data reporting system for weeks.
“There were always more cases than our data represents,” O’Donnell said. “The question now is how much has it shifted with the very large proliferation of home testing?”
Because people often use PCR testing to confirm the results of a home test, an increase in PCR test positivity would still signal an increase in community transmission, said Earl Stoddard, the county’s deputy administrative chief.
Stoddard added that there are other metrics and forms of monitoring that indicate case rates, like the number of students who are absent from school or the number of district workers who call in sick.
“People reacting to a test result is much more important than us having the test results in the backend,” he said.
Crystal Watson, a professor of public health at Johns Hopkins University, pointed to some good news: “While we know we are missing many cases, we are not seeing a large increase in hospital admissions.”
Watson noted a number of factors that could cause the current BA.2-driven phase to take a different trajectory than winter’s Omicron wave.
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On the one hand, omicron inspired some to get vaccinated or get a booster shot, meaning people are now better protected. And Omicron infected so many people — some experts estimate it affected more than half the US population — that there’s more natural immunity, too, although immunity can expire after just 90 days. Additionally, Watson says, warm weather means people are engaging in more outdoor activities, which reduces the risk of getting sick.
But parts of the DC region in use tightened coronavirus restrictions, including vaccination requirements for dining out, to fight Omicron for the first time. In the face of BA.2, there has been no such mobilization that could allow the subvariant to spread more effectively in public places.
“We just don’t have these mitigation measures like we had in the winter,” Watson said. She praised Philadelphia’s proactive reinstatement of its mask mandate.
“Personally, I think that’s a good way to go, because then you’re acting proactively and not waiting until it’s so bad that it’s really affecting hospitals,” she said.
Watson said Americans are not settling for an endless cycle of variant to variant that requires masking and social distancing: Increasing immunity over time, especially as more people in the world get vaccinated, will lessen the impact of the coronavirus.
But regardless, she and Sehgal said they could always wear masks during the winter flu season in some settings to avoid getting sick.
Teo Armus contributed to this report.