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Omicron Covid Update

The Calvert Health Department is aware of an email circulating that gives a false impression of current covid infections. This post will not rehash the incorrect information in the email. Instead, we will provide the facts of what is currently happening with covid infections. Details will be provided to back up the information below. For those who prefer not to read a long post, the take homes are:

  • All covid infections this summer have been caused by various members of the Omicron variant. These include XBB variants and the newest strain, EG.5.

  • There has been a gradual, but persistent increase in cases over the summer. This increase is due to a combination of increased social interactions compared to the worst days of covid and a decrease in circulating antibody levels of people who were vaccinated last fall and those who were infected last fall and winter. As circulating antibodies decrease, people of all ages are more susceptible to reinfection, but their immune systems usually will kick in to combat the virus before severe illness occurs.

  • Although we continue to see severe consequences from covid, illnesses resulting in hospitalization or death are occurring at substantially lower rates with the currently circulating Omicron variants compared to Delta and earlier variants. This is due to both: 1) new mutations in the Omicron strains, and 2) residual immune protection from previous infections (good protection) and vaccinations (better protection).

  • Medical studies consistently show that vaccinations result in stronger and longer lasting immune protection than protection following natural infection.

  • Even though severe acute illness is much less likely that during early periods of covid, people who get ill from covid are more likely to have prolonged courses and are at risk of long covid.

  • Long covid can result in a constellation of health problems, including chronic fatigue and lung, heart, and kidney damage. People with covid are also twice as likely to develop diabetes in the year after infection than those who were not infected. Long covid can affect everyone from children through seniors.

Now for the more detailed update: Covid cases have been climbing over the past month. Currently, statewide and local positivity rates (the percentage of people tested at medical offices for a possible covid infection who actually have covid) are at about 11%. A month ago, positivity rates were closer to 6%. We know that as the positivity rate approaches 10%, there is widespread transmission through communities. Because most testing for covid is now occurring via home tests, it is no longer possible to report actual numbers of infections in Calvert or across Maryland. There's been a slight uptick in hospitalizations over the past month. This increase is proportionally low compared to the presumed number cases. There has been a distinct shift in hospitalizations. Almost all hospitalizations this summer have been people over 60 years old and deaths have mostly occurred in those over 75. Across the U.S., covid hospitalizations are up 12% over the past few weeks, but this is still a relatively low number. During the most recent week of reported data, there were 9,056 new hospitalizations involving covid across the U.S. That is 80% fewer than the same week during the summer of 2022, when more than 44,000 covid hospitalizations occurred. Here is a graph looking at weekly hospitalizations in Maryland over the past 2 years. As you can see, there has been a small increase in hospitalizations over the past few weeks, but the numbers are well below what we've seen during the previous summers.

After a 4-month period with no covid-associated deaths, we unfortunately had two deaths last week in Calvert. Both of these people were over 75. Neither had received booster vaccinations. Nationally, deaths reached their lowest weekly rate ever for the week of data ending July 29, with 176 deaths reported by the CDC. There is a new variant increasing in prevalence both locally and internationally. EG.5, which now accounts for the majority of infections, is a direct descendant of the XBB Omicron strains that have dominated in recent months. It has the same makeup as XBB.1.9.2 but carries an extra spike mutation, according to a summary published by the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota. There's no indication that EG.5 is more contagious or severe than other recent variants. The CDC affirmed that current vaccines protect against the new variant. The main reason for vaccination/boosters at this point is to prevent severe disease. Since we are currently seeing relatively low rates of hospitalization, for most people, it is better to wait until sometime between late September and mid-October for your next booster. That timing will provide good levels of circulating antibodies (levels stay high 4-5 months following vaccination) through the winter when virus transmission is typically at its peak and hospital beds are typically in short supply. However, if someone is over 70, particularly if they have underlying high-risk health conditions) or a person at any age who is severely immunocompromised, it is reasonable to receive a booster now. Since people receiving boosters in August will have waning antibodies in December/January, they may need another booster around holiday time. Back to Omicron. The lower hospitalization and mortality rates seen with the Omicron family of variants is likely due to a combination of increased population-wide immunity as almost everyone now has been vaccinated and/or infected and mutations in the virus that make it less pathogenic. Going back to the era of the Delta strain, 1 in 6 people hospitalized due to covid died during the hospitalization. With Omicron, deaths have dropped to 1 in 20 people hospitalized. One in 20 people is not trivial so people should continue to take reasonable precautions, but it is clear that the intensity of infection is lower with Omicron variants such as XBB than with Delta.

Here is a nice chart showing covid mortality nationwide through the various variants. Of note, it distinguishes the early phase of Omicron infections (last winter) from more recent Omicron infections:

Covid will be with us for the foreseeable future. New variants will arise in unpredictable fashion. Some will be less likely to cause severe disease and some will be more likely. The best way to protect ourselves, our families, and our neighbors is to:

  • Make sensible decisions about attending crowded events, especially when they take place indoors.

  • Wear a face covering when you will be in situations where virus transmission is more likely.

  • Take extra care when you're around elderly relatives and neighbors.

  • Keep up on boosters at least annually, just as you do for the flu.

Please continue to take care of yourself and help us keep Calvert a healthier and safer community.

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