By LeAnn R. Ralph
COLFAX — Although the number of new cases of COVID-19 in Wisconsin was down to 4,781 on February 3, which is much less than the 18,000 cases in one day a few weeks ago, the rate of transmission is still critically high.
All 72 counties in the state are still listed as having a critically high transmission rate, said Deb Standridge, deputy secretary of the Wisconsin Department of Health Services, during a media briefing February 3.
The seven-day average as of February 3 was 4,679, and the state has confirmed 11,293 deaths from COVID-19, she said.
The hospitals are still overwhelmed as well with 92 percent of the Intensive Care Unit beds filled and 95 percent of the intermediate care beds, Standridge said.
As of February 2, there were 1,442 people in Wisconsin hospitalized because of COVID-19, and 296 people were in ICU beds with COVID, she said.
To date, 64.3 percent of Wisconsin residents have had at least one dose of the SARS-CoV-2 vaccine, and 59.5 percent have completed their vaccination series. In addition, 1.8 million booster doses of vaccine have been given, Standridge said.
National Guard
Nearly 120 National Guard members have completed the training to work as Certified Nursing Assistants (CNAs) in skilled nursing facilities and have been deployed to help with staffing at 17 facilities in the state, Standridge said.
The plan is to have National Guard CNAs help with staffing so that people who are recovering from COVID-19 can be transferred from a hospital to a nursing home to complete their recovery, which will free up hospital beds.
The National Guard CNAs are working at facilities in all the regions of the state, including Antigo, Cornell, Green Bay, Kenosha, La Crosse, New London, Milwaukee, Mineral Point, Racine, Sturgeon Bay, Wisconsin Dells and Woodville, Standridge said.
The feedback has been positive, and more National Guard members will start CNA training soon, she said.
Omicron
The Omicron variant of the SARS-CoV-2 virus has been responsible for the latest surge in cases of COVID-19, and a new variant of Omicron has recently been detected in the state.
A reporter from the Wisconsin State Journal asked about the sub-variant and how it may impact the surge of cases.
As of the day before the media briefing, the sub-variant had been identified in five cases, said Dr. Ryan Westergaard, chief medical officer for the DHS Bureau of Communicable Diseases.
The sub-variant has a few more mutations than the first version of Omicron, and the evidence suggests that it is even more transmissible than the first Omicron, which is much more transmissible than the Delta variant, he said.
While health officials had been hoping to see a decline in the cases of COVID-19, it has been theorized that the new variant will cause the number of cases to decline more slowly, Dr. Westergaard said.
Both variants of Omicron will continue to spread until there are no more susceptible people, and those who are susceptible include those who are not vaccinated and those who are far enough out from their vaccination to have waning antibodies, he said.
Another reporter asked about the location of the cases caused by the new Omicron variant.
Surveillance of genetic variants does not identify where individual cases are located, Dr. Westergaard said.
A certain percentage of the tests that are conducted are screened for the genetic variants, so it is likely that there are many more cases of the variant than the surveillance would indicate, he said.
The individual cases of a variant “is not the point,” and it is more important to understand how the virus behaves in the population, Dr. Westergaard said.
Endemic
While the world is in a pandemic now with the SARS-CoV-2 virus, health officials are hoping to enter a state of the virus being endemic — that is, a steady state of transmission without the surges.
SARS-CoV-2 is likely to become endemic in the next year, Dr. Westergaard said.
Unfortunately, no one is able to predict whether there will be new variants of the virus that could change the transmission rates from a steady state to a surge in cases, he said.
The best defense against additional variants of the virus is to maximize vaccinations globally, Dr. Westergaard said.
“That’s what viruses do is evolve,” he said, adding that he is optimistic that over the next several weeks, the number of cases will decline as the Omicron surge subsides.
Masking
A reporter from WTAQ Radio in Green Bay asked about the transmission rate that would be necessary to begin backing off from wearing masks and social distancing.
Guidelines from the Centers for Disease Control and Prevention consider the community level of transmission, Dr. Westergaard said.
If the level of transmission is low, then people do not have to be as concerned about wearing masks, although in many settings, masks are not required now, he said.
Wearing a mask will increasingly become a personal decision, but when the virus is transmitting at high levels, it is in the best interests of everyone in the community to wear masks, he said.
When the transmission rate is low, like it was in early to mid summer in 2021, then it is less urgent to wear a mask, Dr. Westergaard said.
More than 4,000 cases per day is a high transmission rate, and Dr. Westergaard said he would like to see daily cases in the state at around 400 or 500 before people ease up on the mitigation strategies.
People must consider the transmission rate in the community where they live to make an informed decision, he said.
Trusted messengers
A reporter from Fox 6 out of Milwaukee noted that there are a certain number of people who are not vaccinated who “will not budge” and wondered if incentive programs, such as the gift cards given out in Milwaukee, could be implemented by the state to get people vaccinated, or if there is anything else that can be done to encourage vaccination.
“We hope that there is. We have not stopped trying,” Dr. Westergaard said.
DHS is providing the best information through media campaigns and through healthcare providers, he said.
Primary care providers are the most influential source of information for people who are hesitant about being vaccinated, Dr. Westergaard said.
DHS has tried to equip and encourage healthcare professionals to have those conversations with their patients. The clearest lesson from the pandemic is that vaccines save lives, he said.
The biggest goal is to make sure that people understand vaccines save lives. Another goal is to make sure the vaccines are easily accessible, Dr. Westergaard said.
Trusted messengers with the correct information is the best way to reach those who are not vaccinated, Standridge said.
Deaths
One reporter noted that the daily cases of COVID-19 are declining, but the number of deaths are not declining.
People who are infected with COVID-19 die after a prolonged illness, so there is a lag between the hospitalizations and the deaths, Dr. Westergaard said.
When the case numbers go up, the number of deaths increases some time later, he said.
Dr. Westergaard said he hoped to see a decline in the number of hospitalizations in the coming weeks with a corresponding decline in the number of deaths.
While the Omicron variant does not seem to cause more severe illness, the sheer numbers of people who are infected affect the numbers of hospitalizations and deaths, he said.
Safer-at-home
A reporter from Fox 11 in Green Bay said a recent report from Johns Hopkins University indicated that shut-downs did little to prevent deaths from COVID-19 and wondered if DHS has studied the impact of the Safer-at-Home order in Wisconsin, especially since the numbers of cases are higher now than when the pandemic first started.
Dr. Westergaard said he had no specific numbers from the Safer-at- Home order in Wisconsin.
The numbers in terms of cases and deaths have changed because the virus has changed dramatically, he said.
The Delta variant was much more transmissible than the original SARS-CoV-2 virus, and the Omicron variant is much more transmissible than Delta, Dr. Westergaard noted.
The way the virus behaves is the key driver of case rates, he said.
More concern?
A reporter from WEAU TV in Eau Claire asked how concerned health officials are about the new Omicron variant.
The new variant produces the same clinical illness as the other variants. For people who are vaccinated or who have recently been infected, the new variant can cause unpleasant illness but not life-threatening illness, Dr. Westergaard said.
For the unvaccinated, Omicron and the new variant can cause severe disease and death, he said, adding that people are urged to remain cautious and to get vaccinated.
The Omicron variant makes people less sick than the Delta variant, but Omicron spreads much more quickly, so there are still large numbers of sick people, Dr. Westergaard said.
Since the Omicron variant spreads so much easier, the chances of any one individual catching it are quite high, he said.
One of the reasons Omicron is able to spread more quickly is because it is able to better evade the immune protection people have. Antibodies wane over time, and Omicron more easily overcomes the immune system. When fully vaccinated people get a booster dose, their antibodies go back to 90 percent protection, Dr. Westergaard said.
Treatments
A reporter from WAOW TV in Wausau asked about investing more in treatments for COVID-19 to deal with flare-ups in the future.
Treatments, such as antiviral medication and monoclonal antibodies, will continue to grow in availability, Dr. Westergaard said.
With increased production, and the development of new antivirals, we will get to the point of where we are with antivirals for influenza, he said.
Healthcare professionals will be able to prioritize by risk factor about who should get the treatments. The treatments will become more available, so there will be a continued need to test for COVID-19 and then to treat people to keep them out of the hospital, Dr. Westergaard said.
Contact tracing
A reporter for WISN TV out of Milwaukee noted that the local health department had indicated staff were no longer doing contact tracing and asked about the change in protocol.
For the first year and a half of the pandemic, the goal was to find every case, investigate it, do the contact tracing and notify those who had been exposed, Dr. Westergaard said.
The goal was to know where it was spreading and trying to stop it, he said.
With the Omicron variant, there are too many cases to keep up, and DHS and local health departments have other things to offer people other than investigation, he said, noting that people can do their own contact tracing when they have become infected.
Health departments have other tools, such as testing and offering vaccinations, and it is now time for a broader approach, Dr. Westergaard said.
Contact tracing will still be done where it can do the most good, such as older people who are more susceptible to severe illness or where outbreaks occur, such as at a workplace or a long-term care facility, he said.
