In a pattern that has been repeated for more than two years, coronavirus cases are rising again in the D.C. region and nationwide, after a brief respite with some of the lowest rates of virus circulation of the pandemic.
Since loosening mask mandates and other restrictions earlier this year, local government leaders have told residents that those trying to avoid the virus should monitor public health data to assess personal risks. But area health departments are reporting far less information to the public than they regularly did up until this winter. Even the health departments don’t know as much now about who is testing positive for the virus, because so many people can now test themselves at home.
“We’re asking you to make your own decisions with regard to risk, but we’re not giving you the tools to do that,” said Neil J. Sehgal, an assistant professor of health policy at the University of Maryland. “… The sad reality is there’s no longer a good set of metrics that you can look at to gauge your risk today as opposed to last week or two weeks ago. What we’ve done is we force people to rely on their intuition.”
As of Thursday morning, the seven-day average had risen in the past week by 54 percent in the District, by 43 percent in Maryland and by 27 percent in Virginia.
Those rates, driven by the BA.2 subvariant of omicron, are far below the staggering caseloads caused by the earlier omicron variant that hit the region hard in December and January. But public health experts say they expect BA.2 to keep propelling a rise in cases.
Some local universities, including American and George Washington, have reinstituted mask requirements that they dropped when the first omicron wave subsided. Philadelphia this week announced that its citywide indoor masking mandate would return, prompting questions for D.C.-area officials about whether their jurisdictions will do the same. So far, none have.
Montgomery County officials said Wednesday they were not considering plans to reinstate a mandate. Interim health officer James Bridgers said he expects cases to peak and plateau in the highly vaccinated county without causing significant increases in hospitalizations or deaths, though officials are prepared to change course swiftly, especially if case rates surge after schools return from spring break.
“We do worry,” Montgomery County Executive Marc Elrich (D) said, “because at some point, you can’t just let this thing run up uncontrolled.”
Some public officials are themselves sick with the virus, after having avoided it for the first two years.
D.C. Mayor Muriel E. Bowser (D) and council member Kenyan R. McDuffie (D) tested positive for the virus earlier this month; both said their symptoms were mild. Fairfax County Board of Supervisors Chairman Jeffrey C. McKay (D) called his own symptoms “uncomfortable but manageable.”
When Arlington County Board Member Matt de Ferranti (D) got sick, he sent a letter to residents, noting a sharp uptick in cases in Arlington and urging people to wear masks and get vaccinated. “We do know, and I can tell you firsthand, that you don’t want to get Covid,” he wrote.
Sehgal said he urges his neighbors and students to pay attention to such anecdotal evidence of a spike in cases. “Think about your social circle, about the number of people in your network who are infected right now or who have been in the last week,” he said.
The District, like many jurisdictions, no longer announces the number of new cases reported each day, and it also has stopped reporting much of the copious data it used to publish on hospitalizations and other metrics. Its website now features a much smaller set of metrics, including the weekly case rate per 100,000 residents. That number has risen each week for the past month, from 51 cases the week of March 6 to 204 cases the week of April 3 — the most recent week D.C. has reported numbers for.
“How does it help me today, two weeks later, knowing what happened in March in the District? That’s history,” Sehgal said. “All I can tell you with certainty is we’re three times worse today than we were at the beginning of the month. But that seven-day average case count doesn’t feel accurate to me anymore,” he added, because of the prevalence of at-home tests that are never reported to the government.
Officials say they still have ways to gauge their levels of community transmission. In Montgomery, for instance, the health department asks doctors to report positive test results from patients who use at-home kits, and the county closely monitors data from places such as schools and nursing homes that regularly conduct PCR tests. As of this week, outbreaks at those congregate settings have not significantly increased, said Sean O’Donnell, the county’s emergency preparedness manager.
“Throughout the pandemic, we’ve never had the full picture,” O’Donnell said at a news briefing Wednesday. When covid-19 first arrived, he noted, testing wasn’t readily available. The virus could spread asymptomatically, suggesting there were large groups of people carrying and spreading it unwittingly. And in late 2021, a cyberattack crippled Maryland’s covid-19 data reporting system for weeks.
“There have always been more cases than what our data represents,” O’Donnell said. “The question now is, how much has it drifted with the very large distribution of at-home tests?”
Because people often use PCR testing to confirm the results of an at-home test, a bump in PCR test positivity would still signal a bump in community transmission, said Earl Stoddard, the county’s assistant chief administrative officer.
Stoddard added that there are other metrics and forms of surveillance that hint at case rates, such as the number of students absent at school or the number of county workers calling out sick.
“People reacting to a test result is way more important than us having the test results at the back end,” he said.
Johns Hopkins University public health professor Crystal Watson pointed to good news: “Even though we know we’re missing a lot of cases, we’re not seeing a huge surge in hospitalizations.”
Watson noted a number of factors that may make the current BA.2-driven phase take a different course than the winter’s omicron wave.
On the one hand, omicron inspired some to get vaccinated or get a booster, meaning people are now more protected. And omicron infected so many people — some experts estimate more than half the U.S. population caught it — that there is more natural immunity as well, though immunity can expire after just 90 days. On top of that, Watson noted, warm weather means people are doing more activities outside, reducing the risk of getting sick.
But parts of the D.C. region deployed heightened coronavirus restrictions, including vaccine requirements to eat in restaurants, to combat omicron the first time. There has been no such mobilization in the face of BA.2, which could allow the subvariant to spread through public places more effectively.
“We just don’t have those mitigation measures in place like we did in the winter,” Watson said. She praised Philadelphia’s proactive revival of its mask mandate.
“Personally I think that’s a good way to go, because then you’re being preventative, not waiting till it’s so bad that it’s really affecting hospitals,” she said.
Watson said Americans are not in for an endless cycle of variant after variant that requires masking and social distancing: Increasing immunity over time, especially as more of the world gets vaccinated, will lessen the impact of the coronavirus.
But regardless, she and Sehgal both said, they might always wear masks in some settings during winter flu season to avoid getting sick.
Teo Armus contributed to this report.
Correction: An earlier version of this article incorrectly stated Matt de Ferranti’s title. It is Arlington County Board Member, not Supervisor. This version has been updated.