We Hit “High” Again: What Does That Mean

On Thursday, August 11, the Centers for Disease Control (CDC) updated its Community Levels . The weekly refresh reflected that Dane County has tipped from the “medium” category back into the “high” COVID activity category. So, what are these Community Levels? And why are we seeing this ping pong between levels? Let’s take a closer look:

What are Community Levels?
In February, the CDC updated the way it monitors COVID-19 and its impact on communities. With the widespread availability of vaccines, testing and treatments, COVID looks different than it did two years ago. Therefore, the way we approach COVID moving forward is going to look different, too. Instead of focusing primarily on case counts to gauge where we stand, we also consider additional predictors of severe outcomes due to COVID, including overall COVID hospitalizations and percent of beds utilized by COVID patients.

The CDC looks at the following three metrics to figure out COVID-19 community levels:

New COVID-19 hospital admissions per 100,000 population in the past 7 days (regional)
The 7-day average percent of staffed inpatient beds occupied by COVID-19 patients (regional)
Total new COVID-19 cases per 100,000 population in the past 7 days (county)
Notice that the hospitalization metrics are based on regional Health Service Areas, not just Dane County. Our region encompasses seven counties in south central Wisconsin. Using this information, the COVID-19 community level is classified as low, medium, or high . Once a week, on Thursday evenings, communities all across the country can get a fresh look at where they stand within these metrics, including Dane County.

The CDC recommends people adjust behaviors based on which category a community falls in.

Why are these levels bouncing between “high” and “medium”?
Case activity in Dane County has been holding relatively steadily at a high level since late April. The metric that is causing the levels to ping pong between “high” and “medium” involves hospitalizations. Here are some scenarios:

Scenario 1: Higher cases + elevated hospitalizations = High
Regional new COVID-19 hospital admissions per 100,000 population (7-day total) of 10 or greater (As of 8/11, we are at 10.9)
Percent of regional staffed inpatient hospital beds occupied by COVID-19 patients (7-day average) of 10% or greater (As of 8/11, we are at 5.3%)
New COVID-19 cases per 100,000 population (7-day total) of 200 or greater (As of 8/11, we are at 247.9)
Scenario 2: Lower cases + very elevated hospitalizations = High
If our cases fell back down to less than 200 new cases per 100,000 people, we would still reach high if we saw a very elevated hospitalization rate:

Regional new COVID-19 hospital admissions per 100,000 population (7-day total) of 20 or greater
Percent of regional staffed inpatient hospital beds occupied by COVID-19 patients (7-day average) of 15% or greater
7 day total of new covid 19 hospital admissions per 100000 population shows the threshold for high community level and the line bouncing around either side of it in recent weeks
Based on our metrics, we are currently experiencing Scenario 1. Because the number of new hospitalizations is hovering around 10, we’re seeing our status shift back and forth between “medium” and “high” when the CDC updates their levels each week.

How do I stay up to date on our current level?
You can find updates on the latest community level on our website, our Facebook and Twitter pages, and on the CDC’s website to see a broader look at levels across the state and the country.

So what does all of this mean for me?
The CDC’s Community Levels system is one of many tools at our disposal to help make decisions about our risk and our behaviors.

Staying up to date on your vaccines is the best thing you can do, no matter the community level. Other CDC recommendations include the following:

Wear a well-fitting mask indoors in public, regardless of vaccination status
If you are immunocompromised or high risk for severe disease:
Wear a mask or respirator that provides you with greater protection
Consider avoiding non-essential indoor activities in public where you could be exposed
Talk to your healthcare provider about whether you need to take other precautions
Have a plan for rapid testing if needed
Talk to your healthcare provider about whether you are a candidate for treatments like oral antivirals, PrEP, and monoclonal antibodies
If you have household or social contact with someone at high risk for severe disease:

consider self-testing to detect infection before contact
consider wearing a mask when indoors with them
From quarantine recommendations to advice for business owners, we have all of the latest guidance on our What to do if you’re sick or possibly exposed pages.

You can find spots to get vaccinated—including many pop-up vaccination sites—on our website. There, you can also find a full list of testing options in Dane County.

This content is free for use with credit to the City of Madison – Public Health Madison & Dane County and a link back to the original post.