COVID Transmission in Essex County and Peabody, Massachusetts

September 21, 2023. Information about transmission in Essex County and Peabody, Massachusetts.


UPDATE FOR PEABODY & ESSEX COUNTY on September 14, 2023

Community transmission still poses a danger.

In the US, COVID-19 test positivity, wastewater levels, emergency department visits, hospitalizations, and deaths are all rising, based on CDC data through the first week of August.—JAMA

The policy to end the Public Health Emergency does not eliminate the fact that we are still in a pandemic.

The failure to continue universal masking in hospitals and other medical facilities creates significant risk for all, especially the most vulnerable to severe disease: elderly, disabled, immunocompromised, and children. 

The new policies that eliminate our right to universal masking as a precaution in healthcare settings are a threat to public health, a form of "lockout" that prevents vulnerable people from seeking healthcare, and likely a violation of laws that extend accommodations to at-risk individuals. See: Masking is Essential. 


"Our elderly relatives, people with serious illnesses — these are the only places they can go to get care when they are in the worst shape of their lives," said Dr. Theodore Pak, an infectious diseases fellow, who has seen hundreds of COVID-19 patients at the hospitals he practices at in Boston, Massachusetts. 

"We may give somebody a powerful medication that takes away their entire immune system and then in order to get medical care, they have to go to a hospital where they sit next to people that are unmasked that could give them a disease that could kill them," Pak told Salon in a phone interview. "We don't really think about that or weigh that risk anymore."—Hlavinka, Elizabeth, "Mask mandates are returning to some hospitals. Should they be there to stay?," Salon, October 5, 2023 


We all want to put COVID behind us and get on with our lives and put aside all our fears and the constant disruption of our normal life.

Nevertheless, COVID is still here, causing severe disease, death, and long COVID. 

If your hospital or healthcare provider has dropped universal masking, you can fight back by knowing and using your Americans with Disabilities Act (ADA) rights. You can invoke these rights even if you are not disabled, as you can claim to be at high risk for severe outcomes from COVID, which is the truth for all of us in this environment of few COVID protections and high risk of Long COVID...Doctors are required to provide reasonable accommodations under the ADA—People's CDC 


Prolonged exposure in close proximity to someone with COVID-19 puts people at high risk of catching the disease, even if they’ve had both the disease and vaccinations against it, a study shows.

The work, published this month in Nature Communications, reveals that the greater a person’s exposure to SARS-CoV-2, the more vulnerable they are to infection, regardless of their vaccination status. This relationship has long been suspected, but the study is one of the first to document it.

The findings point to the importance of masking, improved ventilation and other measures that reduce exposure to the virus, says Akiko Iwasaki, an immunobiologist at Yale University in New Haven, Connecticut, who was not part of the study.—Anil Oza, Nature.com August 30, 2023


Wastewater

Biobot 7-day wastewater counts for Peabody @  September 27, 2023

SESD Peabody/Salem Pump 619,000 copies of viral RNA/L 

SESD Peabody, 635,000 copies of viral RNA/L 

Source: MASS GOV COVID-19 WASTEWATER REPORT

Samples are currently taken 1 - 7 times a week and analyzed by Biobot Analytics, a wastewater epidemiology company based in Cambridge, MA. The graphs represent the “7-day averages” which are the average viral copies over the past 7 days in each treatment plant. 

High wastewater RNA levels are usually followed within several days by a rise in cases. 


14-Day Positivity Percent

Peabody=13.13 on September 21; 11.82 on September 14, 2023 


14-Day Average Incidence

Peabody=6.8 on September 21; 6.3 on September 14 (incidence=new cases/day average)


Estimation of Infections Based on Wastewater Data (WHN)

We lack good data on community infection and transmission because of the lack of sufficient testing. This estimate uses wastewater levels to model infection cases. The gap between the very low official data on infections and the modeled data is very large, possibly because there is very little testing at this time.

Estimated case counts based on wastewater data are rough estimates. No major decisions should be made upon these estimates, nor should favorable trends be cause for abandoning one’s precautions.

 


Find Resources Near You!

As the government cuts back its programs, find resources near you to continue protecting yourself and others.  See the guide from People's CDC.  

Although elderly people are at very high risk, simple steps can provide protection against transmission and infection. Especially when transmission levels are persistently high, your actions can protect you and everyone around you. And when you work together with your neighbors, family, and everyone you see, you can all be safer together.

It's not hard: Vaccinate; boost; ventilate; mask; hand hygiene; avoid unmasked gatherings; test.

See this excellent guide to protection for ensuring safer gatherings from People's CDC.

“We should all be masking indoors, staying home when sick, and testing for COVID-19. In addition, getting boosted is the best way to protect yourself from severe illness and hospitalization.”—Dr. Bisola Ojikutu, Commissioner of Public Health and Executive Director of the Boston Public Health Commission. January 6, 2023

Respirators like N95 offer better protection.

Respirators (for example, N95) are made to protect you by fitting closely on the face to filter out particles, including the virus that causes COVID-19. They can also block droplets and particles you breathe, cough, or sneeze out so you do not spread them to others. Respirators (for example, N95) provide higher protection than masks.—CDC

Comparison of how well various types of mask prevent COVID infection
Comparison of how well various types of masks prevent COVID infection—CDC

If you have COVID symptoms, have been exposed, or had COVID and want to be sure you're clear, get tested. And report the results of your test at https://makemytestcount.org

The pandemic has become a plague on the elderly, with nearly 9 out of 10 deaths in people 65 or older.—Ariana Eunjung Cha and Dan Keating, The Washington Post, November 28, 2022 

Links to data sources included here enable the reader to learn the situation in their locality. The sources used are the levels of COVID found in wastewater. These are the only available leading indicators preceding cases, hospitalizations, and deaths. Use these warnings to protect yourself.

For information about strategies for protecting yourself and your community, see The New "How to Avoid COVID"

Vaccination, past infection, or timely access to testing and treatment can help protect you from getting very sick if you get COVID-19. However, some people are more likely than others to get very sick if they get COVID-19. This includes older people, who are immunocompromised, have certain disabilities, or have underlying health conditions. Understanding your COVID-19 risk and the risks that might affect others can help you make decisions to protect yourself and others.—CDC, October 19, 2022


Masking and protective strategies

The interventions that prevent aerosol inhalation are those that reduce the concentration of small particles in a shared space and the time someone spends in that space inhaling those small particles. Particle concentration can be reduced by having fewer people in the space, sharing space for shorter periods, using ventilation that removes particles quickly near the source, and using source controls (masks and respirators) with good filters and fit.—Lisa M Brosseau, ScD; Angela Ulrich, Ph.D., MPH; Kevin Escandón, MD; Cory Anderson, MPH; and Michael T. OsterholmPh.D.hD, MPH, COMMENTARY: What can masks do? Part 1: The science behind COVID-19 protection, October 14, 2021 


Disabled, sick, immunocompromised and vulnerable people seeking care at a hospital, have the right not to be exposed to a virus that has killed 1.1 million Americans in 3.5 years. They have the right to seek care without having to fear that their care team will quite literally kill them with a preventable illness. Practitioners, on the other hand, have no right to compare the irritation of having to wear a mask at work with the moral injury of infecting vulnerable people who then go on to die at high rates.—Jessica Wildfire


 

Lockdowns and face masks ‘unequivocally’ cut spread of Covid, report finds

Royal Society review looks at non-pharmaceutical interventions when applied in packages of several measures...

Measures taken during the Covid pandemic such as social distancing and wearing face masks “unequivocally” reduced the spread of infections, a report has found.

Experts looked at the effectiveness of non-pharmaceutical interventions (NPIs) – not drugs or vaccines – when applied in packages that combine a number of measures that complement one another... These included masks and face coverings, social distancing and lockdowns, test, trace and isolate, travel restrictions and controls across international borders, environmental controls, and communications.

When assessed individually, there was positive – if limited – evidence of transmission reduction from many of the NPIs used in the pandemic, the review found. However, evidence of a positive effect was clear when countries used combinations of NPIs.

Additionally, evidence showed NPIs were most effective when the intensity of transmission was low, supporting their use early in a pandemic and at first sign of resurgence.

The Guardian Article basis at: The Royal Society report


Comprehensive public health strategy

The People's CDC is an excellent guide to policy and action.

  • Preserve healthcare access for all. This means maintaining the State of Emergency

  • Renew Congressional funding for the pandemic response

  • Make public health policies including masking based on the CDC’s Community Transmission Map, and retire the misleading Community Levels Map

  • Support and promote a layered approach to the pandemic including:

    • Free, fast accessible PCR testing for all

    • Free access to N-95 grade masks for all

    • Free access to updated treatments for all

    • Booster access for all

    • Funding for accelerated, next-generation vaccines

    • Paid sick leave for all

    • Clear and science-based quarantine and isolation policies

    • Funding for air ventilation and filtration upgrades in all public buildings

    • Funding for Long COVID treatments, and research led by Long COVID patients

More than COVID 250,000 deaths in 2022 – the third year of the pandemic – is an emergency. We have the tools to prevent more unnecessary severe and chronic illness and death. In 2023, let’s use them.


NEW VARIANTS ARE ALMOST LIKE A NEW DISEASE, ABLE TO SLIP THROUGH IMMUNE DEFENSES, AND ARE SPREADING RAPIDLY. TAKE CARE! New boosters can help you, make sure you are fully vaccinated and boosted. Use N95 masks when indoors and when in any crowded situation. Fresh air ventilation can reduce risk. Hand hygiene is still important. Protect yourself and others from the flu as well as COVID.


"Universal masking and individual masking are distinct interventions. Universal masking lowers the amount of virus exhaled into shared air, reducing the total number of cases of Covid-19 and making indoor spaces safer for populations that are vulnerable to its complications. Individual masking lowers the amount of virus that a masked person inhales from shared air, but only in environments with a relatively high amount of circulating virus and when others are unmasked. Furthermore, individual masking has little effect on population-level transmission."—Universal Masking Policies in Schools and Mitigating the Inequitable Costs of Covid-19, Raifman, Julia Sc.D., and Tiffany Green, Ph.D, N Engl J Med 2022; 387:1993-1994
DOI: 10.1056/NEJMe2213556

The authors recommend universal masking early in the rise of a new variant.


 

Julia Raifman, assistant professor of Public Health at Boston University, encouraged policy leaders to consider reinstating measures that can help reduce the spread of COVID-19 and other respiratory illnesses, such as implementing mask policies and expanding testing.— Zeina Mohammed, Boston Globe, December 2, 2022

“We need leadership to create a virtuous cycle of caring about one another and protecting people who are disproportionately harmed by COVID and the other respiratory viruses,” she said. “That takes policy leadership, we see that nothing an individual can do is nearly as powerful as what a policymaker can do for reducing transmission.”—Julia Raifman

 

COVID is with us and ready at any time to cause sickness and death. 

The pandemic is still raging: COVID is the 4th leading cause of death in the U.S., and millions of people in the U.S. have long COVID, a variety of symptoms that can limit normal activity. COVID is airborne, transmitted through invisible aerosols (tiny droplets), and 40% of COVID infections are without symptoms. Thus universal masking and pre-procedure testing are essential layers of protection in healthcare settings, especially for immunocompromised, disabled, high-risk children, elderly, and chronically ill people. 

Those of us who are especially vulnerable to severe disease and death from COVID infection depend on our social and medical systems to help keep us safe, o accept severe restrictions to protect ourselves. Failing to maintain basic safeguards makes everyone vulnerable. Our healthcare system should continue surveillance including free at-home testing for individuals and measures of community transmission such as wastewater testing, continue free access to vaccination, and support universal respirator masking in all parts of a hospital or clinic.  
    
Infection control professionals

“...propose an updated standard for universal precautions in healthcare settings: permanently including universal masking in routine patient-care interactions. Such a practice prioritizes safety for patients, healthcare providers (HCPs), and visitors.”


New Sources of Information and Action

World Health Network

 

The World Health Network (WHN), is a global community devoted to protecting health and minimizing harm to individuals and society in response to the COVID-19 pandemic. We advocate for effective responses to end the pandemic as a global health threat. Our members have guided successful elimination efforts, advised governments, advocated for airborne precautions, and led community-based efforts to promote individual and public health. We are independent from any political body or government. We are guided by compassion, science, transparency, social responsibility, and value for life.

 

Anyone can join and participate in frequent online conversations. Participants are ordinary citizens and subject matter experts. 

As a WHN member, you will connect and collaborate with scientists and community members to strengthen, leverage, and complement your actions. Our resources include practical tools and support, as well as access to virtual collaborative spaces. You’ll team up on projects, attend and host meetings, take part in campaigns to address current challenges, and connect with a network of like-minded experts and passionate advocates of public health.


 

Dr. Joe's Covid and Science Newsletter

Joe Eastman is a retired scientist who does models to predict the direction of COVID, publishing a free newsletter at substack.

Working with WHN, Eastman uses wastewater data to model infections.

He delves into the intricacies of viral mutations.

He seeks to correlate long-term illness, like long COVID, with missing workers.