Thread by @jonlevyBU

1. With the BA.2 wave here in MA, it is worth asking what the @CDCgov "community levels" tells us to do, when it will tell us to do something different, and what this means. I'll look at Suffolk County, which includes Boston. 🧵

2. Right now Suffolk County is "medium", because cases are > 200 per 100K. At that level, CDC says to talk to your health care provider if you are "at high risk for severe illness" to ask about wearing a mask. So, do nothing. It would be "high" using the old scheme.

3. What triggers "high" in the new scheme? Hospital admissions >10 per 100K. It's 5 now. So once admissions double, we enter the red zone.

Will that happen? Probably. When? Hard to say. But hospitalizations up 30% in the past week on CDC website. 3 more weeks of 30% gets there.

4. Wastewater levels in Suffolk County have nearly doubled in the past 2 weeks, so we may not have that long. Or it could be longer. Regardless, waiting a few weeks will bake in a lot of cases and hospitalizations, especially if things start to accelerate.

5. It's also important to note that cases are under-ascertained, much more so than in previous waves. So we could be baking in a lot of cases by waiting a few weeks, and if those cases hit the unvaccinated and unboosted, a lot of hospitalizations and deaths.

6. Calendar matters here. In MA we have April vacation next week, plus Boston Marathon. That could seed an acceleration of cases, though having kids out of school could cut the other direction.

7. I'm not going to prognosticate. But doing nothing for a few more weeks has a good chance of locking in bad outcomes. And decision makers who don't want to act until we are in the new "red zone" should understand that they may only have a couple of weeks before that happens.

8. We know that things are increasing fast right now - hospitalizations in MA went from 200 on 4/6 to 255 on 4/10 to 343 on 4/14. And we will be flying blind for a few days, with no reporting over the long weekend, then data may be harder to interpret over April vacation.

9. By the time the data settle down, things could be a lot worse. So politicians are going to need to make decisions with imperfect data, recognizing that doing nothing is itself a decision.

10. I know it's not politically popular to acknowledge that the pandemic is still here. But if you are running a city or school district in MA and aren't thinking seriously about policy shifts for the return from April vacation, you have your head in the sand. #mapoli

11. I always feel like I am pooping in the punch bowl when tweeting out this kind of info. Everyone wants “normal”. But a lot of people are at risk especially in lower-income communities, and we can’t just ignore reality.

bostonglobe.com/2022/04/14/met…