Russian missiles, bombs, artillery rounds, and mis/disinformation are reigning down on Ukraine. News reports on this humanitarian crisis have pushed worldwide attention away from the COVID-19 diseases which have plagued the U.S. for over two years. While the virus remains with us, it finally looks like we have turned the corner in this pandemic. Cases, hospitalizations, and deaths are continuing to recede. The criteria for assessing the community spread of this virus is showing that we are indeed in a better place. Hamilton County and all of the seven counties in OH, IN, and KY that border it, are now in the LOW level CDC classification of disease. With this level of spread people no longer need to wear masks indoors and the maintenance of good indoor ventilation is recommended. The COVID-19 test positivity rate in the City of Cincinnati is around 1%, the best it’s been since June 2021. Consequently, the city has dropped its mask mandate for employees and more people are being allowed to return to in-person work. Masks are no longer required for employees, regardless of their vaccination status. The testing requirement for the unvaccinated is also being eliminated. Very importantly, the new community-level guidance of the CDC DOES NOT apply to healthcare facilities. We still remain masked in hospitals as on public transportation. Healthcare settings such as hospitals and nursing homes continue to rely upon the community transmission rates and the CDC recommendations that pertain
The Cincinnati Public School (CPS) system has also announced the elimination of its mask mandate effective March 8, 2022. Masks remain optional for students, staff, and visitors. A section of the new policy says that students who elect to continue wearing masks “are protected from any form of harassment, intimidation or bullying”. Just as with every public place, people who are sick are still recommended to remain at home. A person who tests positive needs to be in quarantine for five days and then for the sake of CPS policy, wear a mask when in schools and/or administration buildings for TEN (10) days.
On the virus front, there is news on the “Stealth Omicron” variant (BA.2). It is stealth no more as several tests easily identify this variant. This subvariant continues to increase and crowd out its Omicron parent (BA.1). It has become the dominant variant worldwide. This BA.2 variant appears to be more transmissible as it jumped from being 1% of US isolates in February to 11% in early March. The good news continues to be that the vaccines remain effective at preventing hospitalizations and death from this variant. People who have had the booster are well protected against even getting COVID-19 infection from BA.1 or BA.2. Another reason why this “stealth” variant is likely not going to cause a significant surge is that antibodies resulting from the original Omicron infection have proven to be very effective against the BA.2. Lastly, the two oral medications, Paxlovid and molnupiravir, as well as Remdesivir are effective against both variants if given soon (5d) after symptom onset.
It appears that the world has “dodged a variant bullet” with BA.1 and BA.2. Predictably, a rare new variant, named “Deltacron,” has been identified. Currently, it is not considered a virus of interest. The way to prevent mutation is to prevent replication by vaccination. Only 65% of Americans have been fully vaccinated and only 44% of the fully vaccinated have received boosters. Even though it may be non-productive to try to encourage an eligible person who is not vaccinated to do so, it is still recommended. Convincing a person who has been previously vaccinated to get a booster is probably more likely to be successful. The data continues to show that vaccinated and especially those who have been boosted are well protected from hospitalization and death, even from the Omicron and its known subvariants.
We are overjoyed that masking is no longer necessary in Cincinnati. It is wonderful to see people safely out and about without masks. We must remain vigilant and recognize that this level of safety may not last forever. Masks will need to go back on if the community level increases. Time will tell if we heed future recommendations.
Clyde E. Henderson, MD
Cincinnati Medical Association