Number of High-Risk US COVID Counties Doubles in Week, and More Than 1/2 Are in NY: CDC

New York health officials raised a fresh flag earlier this month when they said a higher-than-national rate of emergence of two subvariants was to blame for soaring COVID rates in Central New York. They're spreading

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Just 40 of America's more than 3,200 counties are considered high transmission areas by the CDC, the health agency said Tuesday. That's 1.2%.

Great news, right?

Depends on how -- and from where -- you look at it. That 40 county number is more than double the number of high COVID impact counties the CDC listed in its report two weeks ago. And 23 of those 40 counties now considered high transmission spots by the CDC happen to be in New York state, the latest dataset shows.

The entire state, pretty much, is now orange and yellow (high, medium), while only the downstate area, including all five boroughs of New York City, is in the green. That excludes Westchester County, which now has a medium CDC risk assessment.

Almost the whole state was green in a CDC report issued less than three weeks ago. And one week ago, only 14 U.S. counties were considered high transmission areas by the CDC's parameters. New York accounted for 10 at that time.

The numbers are calculated using data through April 21, which means COVID-19 transmission, which has been on the rise in New York and a number of other states in recent weeks, is likely currently higher than the latest CDC map reflects (see below).

cdc transmission update
The CDC uses a community alert system to track COVID impact on a weekly basis.

What is to blame for the latest uptick? The loosening of COVID restrictions like mask and vaccine mandates, among other factors, is a contributing factor, experts say.

More impactful, perhaps, have been the two COVID variants that descended from the original omicron strain -- BA.2.12.1 and BA.2.12. Early findings indicate those strains could be up to 27% higher than BA.2, which was said to be up to 60% more contagious than the original omicron strain that sparked unprecedented case rates and COVID hospitalizations across the U.S. and much of the globe earlier this year.

It's likely no coincidence that the first subvariant, BA.2.12.1 is spreading significantly faster in the New York region than nationally.

According to the CDC, that subvariant became dominant locally a week ago, accounting for an estimated 52.3% of all COVID-19 circulating in the region, which for the agency's purposes also includes New Jersey, Puerto Rico and the Virgin Islands. At that point, its U.S. prevalence was estimated to be about 19%.

As of Tuesday, BA.2.12.1 accounts for an estimated 58.1% of New York region cases -- and could account for as much as 71.5% -- CDC data shows, while its national prevalence has risen to an estimated 29% of the case total.

cdc variant update tues
The CDC updates its variant data weekly.

A month ago, that national number was 3.3%, the CDC says. And BA.2.12.1's share of cases in the New York region was estimated to be around 12% at that time.

Both increases illustrate once again the rapid, albeit expected, pace at which the main omicron variant and its subvariants have usurped New York and the U.S.

Neither is necessarily cause for concern, given lacking scientific evidence to suggest the subvariants cause more severe disease or are more resistant to vaccines, but if the case upticks translate into soaring hospitalizations, both could be.

New York health officials raised a fresh flag earlier this month when they said the higher-than-national rate of emergence of the subvariants in certain counties in the Central and Western regions and said they believed BA.2.12.1 was to blame.

Last week, state data showed Central New York had a COVID reinfection rate nearly three times the state average, though it's not clear why. It could be a function of the subvariants or waning vaccine efficacy or any number of combined factors. This week, Central New York's reinfection rate is less than double the statewide average per 100,000 residents (5.6 vs. 3.3), with the first region's numbers starting to level off as the statewide average climbed for the fifth straight week.

covid reinfection
NYS COVID reinfection data statewide and by region

Breakthrough infection and hospitalization rates have also been on the rise statewide, according to the health department, but it's not clear what's behind that.

Overall, COVID hospitalizations in New York have remained manageable amid this latest viral uptick -- and about half of the people admitted for COVID in the state didn't go to the hospital because of the virus in the first place. It was found during routine testing, which suggests those cases were minor from a COVID perspective.

State data clearly shows total hospitalizations now are a mere fraction of what they were during omicron's peak surge in January. Notably, though, the rolling hospitalization rate per 100,000 residents in Central New York, where those omicron subvariants have been especially prevalent, is about 110% higher than the state's rate (15.92 vs 7.58) and almost 240% higher than New York City's (4.72%).

Now well more than two full years into the pandemic, officials aren't hesitating to urge people to take enhanced precautions whether they're vaccinated or not, even as they insist they are not sounding any public health alarms anew.

As Hochul put it this week, "The vaccine is still the most effective tool we have to prevent serious illness. Make sure you and your friends and family are vaccinated and boosted if eligible. If you are experiencing symptoms make sure you get tested, and if you test positive, talk to your doctor about available treatments. Let's continue to use the tools and move forward safely through this pandemic."

As a new subvariant of COVID spreads, Dr. Ayman El-Mohandes, dean of the City University of New York Graduate School of Public Health and Health Policy and a pediatrician and longtime academic, has the answers to all your top questions. Hear from him on the second booster, masking and a possible viral surge tied to BA.2.
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