Health experts fear CDC Covid-19 maps and measures could be misunderstood

At first glance, the maps on the Centers for Disease Control and Prevention (CDC) Covid-19 Integrated County View website look great. As of April 7, most of the US was in the green, with green representing “low US Covid-19 community levels by county.” It almost seems as if people no longer have to worry about the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). When you’re told there’s little risk of anything, whether it’s getting a disease, being attacked by lemurs in a restaurant, or falling face first into a quiche, you tend not to take precautions.

However, some health experts have raised concerns that such maps and measures could be misleading. For example, Eric Topol, MD, Founder and Director of the Scripps Research Translational Institute, tweeted:

As you can see, Topol called a CDC tweet and accompanying map, “county-level Covid-19 community levels,” “misleading.” He added that this “will give BA.2 more distribution opportunities.” This is presumably because Americans may take it as a false assurance that Covid-19 is no longer a threat, and thus become too lax about Covid-19 precautions. In other words, it could lead to premature relaxation. Premature relaxation of the Covid-19 precautionary measures? Man, when has this ever happened?

Both Jonathan S. Reiner, MD, professor of medicine at the George Washington School of Medicine and Health Sciences, and Jason L. Salemi, PhD, associate professor of epidemiology at the College of Public Health at the University of South Florida, pointed out the differences between the green appearing Covid-19 Community Levels map and the multicolored CDC Covid-19 Community Transmission map:

The US map of the community levels may look like a giant green light, while the community broadcast map looks more like the background of a Where’s Walter picture. Regarding Where’s Waldo, Reiner pointed out that the Community Transmission maps are “not that easy to find on the CDC website.” Contrast this with the fact that the CDC tweeted the community level map without providing the community broadcast maps alongside it. Additionally, the Community Levels website is what comes up first on Google searches.

Focusing on the community level map would be like using a March weather map to determine what to wear today. Life coaches often say, “Don’t live in the past,” so why would you do that with Covid-19? A county’s Covid-19 level is considered “low” if there were fewer than 200 cases per 100,000 people, the number of new Covid-19 admissions per 100,000 people was less than 10 and the percentage of occupied inpatient beds was less than 200 cases Covid-19 patients were less than 10% in the last 7 days. But Covid-19 is not like Bieber fever. You are not diagnosed once you are infected. It can take up to two weeks before you notice any symptoms, if you develop any symptoms at all. It may take even longer to get to the hospital. Therefore, the map of community levels represents a transfer that took place one to four weeks ago. It won’t help you determine when to take precautions like wearing a face mask impede an impending Covid-19 upsurge.

When it comes to Covid-19 precautions, the community transmission maps provide much more relevant information than the community level maps. On these maps, a county is considered “low” if the number of new cases per 100,000 people was less than 10 and the percentage of positive nucleic acid amplification tests (NAAT) in the last 7 days was less than 5%. The level increases to “moderate” when the first reading has risen in the range of 10 to 49.99 or the second reading has risen in the range of 5% to 7.99%. Significant means that either the first reading was in the range of 50 to 99.99 or the second reading was in the range of 8% to 9.99%. If the first reading reached 100 or the second 10%, the transmission levels would be classified as “high”.

Well, even these CDC transmission measurements don’t give you a completely up-to-date and accurate picture. Many people may never get tested, and even if they do, they may take the time to get tested and may not even report the results. Indeed, without Covid-19 testing being free and readily available to all, there can be significant differences in who gets tested and who doesn’t. There may be another difference between the haves and have-nots in this country. So, community broadcast cards alone allow you to be a bit more proactive, but that’s still not enough.

Reiner wondered if the public might misinterpret the community level cards:

Topol, Reiner and Salemi were certainly not the only ones who expressed such concerns. Eric Feigl-Ding, PhD, epidemiologist and leader of the COVID Risk Task Force at the New England Complex Systems Institute, tweeted, “Countless experts are frustrated with the CDC and their risk level maps, which primarily use hospitalization metrics. They’re always late,” as you can see here:

Sure, some politicians and corporations might want things to appear as “normal” as possible as soon as possible. The illusion of total normality could prompt people to spend more and re-elect current politicians to office. Also, the precautionary measures for Covid-19 require some upfront expenditure and investment. All of this could lead to people wanting and enduring “green” and being reluctant to leave the “green”, so to speak. Remember 2020, when some politicians and business leaders kept downplaying the pandemic, claiming that the pandemic is “turning the corner,” and other overly optimistic scenarios I reported on in 2020 forbes? Hmm, what happened since then?

The rush to return to normal, which always means ‘normal’, and the repeated premature easing of Covid-19 precautions remain remarkably short-sighted. SARS-CoV-2 doesn’t really care what politicians and business leaders say. Failure to observe proper Covid-19 precautions such as face mask use, social distancing and Covid-19 vaccination could further spread the pandemic and increase the negative impact of SARS-CoV-2. This is especially true for the spread of the more contagious subvariant BA.2 Omicron. The CDC Covid-19 community levels map alone has you seeing green, like low risk, go go go, and maybe even big bucks. But that could end up being an “off-color” conclusion.

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