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Health

Face masks come back to forefront amid triple threat of Covid-19, flu, RSV

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CNN
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Months after most mask requirements have come to an end and many people have stopped wearing them, some of the nation’s leading health experts are encouraging people to put their face masks back on – but this time, it’s not just because of Covid-19.

As a triple threat of respiratory illnesses – flu, RSV and Covid-19 – sweeps the nation this holiday season, health officials are urging people to take precautions to protect themselves: get vaccinated, wash hands frequently and even mask up in certain circumstances.

“There’s been a lot of attention directed to patients at higher risk of the complications of all of these illnesses – older persons, people who have any underlying illness, anyone who has immune compromise – I think, during this surge of this tridemic, if you will, there’s been a lot of ‘dust off your mask. Put your mask back on,’ ” said Dr. William Schaffner, a professor in the Division of Infectious Diseases at Vanderbilt University Medical Center and medical director of the National Foundation for Infectious Diseases.

At this phase in the Covid-19 pandemic, even with other types of respiratory viruses circulating, masking recommendations based on an individual’s risk have been at the center of public health discussions, “rather than saying everyone in a community has got to put their masks back on,” Schaffner said.

“I don’t want to go to mandates because I think over much of the United States, you will get a lot of pushback, and people will ignore it. Public health recommendations have to be acceptable,” he added.

“The notion that during these kinds of viral surges, that people at risk should be wearing masks and being more cautious seems entirely reasonable – and I add to that, particularly in this part of the country, that we should be accepting, tolerant and indeed supporting people who do that, because they have a reason,” said Schaffner, who is based in Nashville.

“Don’t look at this as a political statement or a social statement. This is a purely health-related statement.”

Some communities across the country are considering bringing back certain masking recommendations as the wave of respiratory illnesses worsens.

The US Centers for Disease Control and Prevention offers specific guidance on when masking is recommended based on its Covid-19 community levels.

The agency says that people may choose to wear masks at any time but that a “high-quality mask or respirator” is recommended for everyone when a county has a “high” Covid-19 community level.

As of Thursday, about 5.66% of US counties have high community levels, including some places in Arizona, Wyoming, Oregon and the Dakotas.

Los Angeles County is at a high Covid-19 community level, but it hasn’t hit all three indicators that would trigger a mask mandate, Public Health Director Barbara Ferrer said Thursday.

The county has 258 new Covid-19 cases per 100,000 people and 14.8 hospitalizations per 100,000 people but continues to stay below the “high” level of staffed Covid patient beds, at 6.9%, she said.

Officials will consider masks again if that level goes over 10%, Ferrer said, but she’s hopeful that metrics might improve before then.

Even without a mandate, she emphasized community efforts like wearing masks inside when possible and getting Covid-19 vaccines or boosters.

“We haven’t reached that super dangerous threshold where CDC has said ‘you really need to start worrying about your hospital system,’ but we’ve reached a threshold, and all of the data shows this, where there is too much transmission, and it’s creating a lot of risk. And the time to mitigate the risk is actually now,” Ferrer said.

Throughout the Covid-19 pandemic, Los Angeles County has been at the forefront of implementing mitigation measures. In this case, officials would be following CDC guidance about masking and community levels.

“What L.A. County is doing is, they’re looking at their uptick in cases, hospitalizations and deaths, and they’re seeing a trending upwards toward that high community transmission level, and they’re preparing to reimplement the guidance that goes along with high community transmission, and that is to reimplement universal masking,” said Lori Tremmel Freeman, chief executive officer of the National Association of County and City Health Officials.

Every community has been looking at the same guidance, considering whether they are approaching high levels and might have to consider universal masking again, Freeman said.

“Now, I say all that based on the pure facts of the guidance, but I do think that has the possibility again of turning into a political divide in community by community where elected officials and others may or may not wish to see universal masking reimplemented. But we will have to see if that legal divide enters the picture again,” she said. “There’s not a lot of appetite for some of these original mitigation efforts to be reimplemented.”

In New York, state officials have encouraged schools and communities to take precautions such as indoor public masking as RSV, Covid-19 and the flu circulate, according to a letter from Health Commissioner Dr. Mary Bassett and Education Commissioner Betty Rosa.

The letter, issued Monday, warned of the multiple respiratory viruses that are straining the state’s health-care facilities.

Over the past three weeks, New York’s flu hospitalizations have more than doubled, and lab-confirmed flu cases have nearly tripled, according to the letter.

“In response, we are urging a community-wide approach, inclusive of schools, to again take precautions this holiday season and winter that can prevent the spread of respiratory viruses and protect young children, older individuals, and those with underlying health conditions,” the commissioners wrote.

The letter said schools and communities should encourage indoor public masking, vaccination and frequent hand-washing, among other measures.

“We encourage schools to utilize their local departments of health as a partner and resource in this work,” the commissioners said. “Together, we will ensure that all students in our state have a healthy and safe holiday season.”

The CDC’s Covid-19 community level metrics for US counties are based on three things: new Covid-19 hospitalizations, hospital capacity and new Covid-19 cases. But the agency is looking into revisiting these community levels, possibly to include data on other respiratory viruses such as flu and RSV, Director Dr. Rochelle Walensky said Monday.

“It’s something that we are actively looking into at CDC. In the meantime, what I do want to say is, one need not to wait for CDC action in order to put a mask on,” she said.

“We do know that 5% of the population is living in places with a high Covid-19 community level. We do encourage people to mask,” she said, adding that people should stay home when sick, practice good hygiene like washing hands frequently and improve air ventilation in indoor spaces.

Covid-19 hospitalizations are starting to tick up after Thanksgiving: More than 34,000 people were admitted to the hospital with Covid-19 in the past week, up 20% from the week prior, according to the CDC. Ensemble forecasts from the CDC predict continued increase over the next month or so.

About 1,800 Covid-19 deaths were reported to the CDC in the last week of November, and ensemble forecasts that predict Covid deaths will remain steady for the next month or so.

Dr. Anthony Fauci, who is stepping down this month as director of the National Institute of Allergy and Infectious Diseases, said he is not afraid to recommend a return to masking in some circumstances as the nation faces a triple threat of Covid-19, flu and RSV.

“I’m not talking about mandating anything,” Fauci said Wednesday on “NBC Nightly News.” “I’m talking about just common sense of saying, ‘You know, I really don’t want to take the risk of myself getting infected and, even moreso, spreading it to someone who’s a vulnerable member of my family.’ “

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Health

Here’s what to know about wearing COVID-19 masks

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The Centers for Disease Control and Prevention (CDC) recently encouraged people to wear masks as the holiday season approaches to aid in preventing flu, COVID-19 and RSV.

Here’s what you need to know about how long and how many times you can wear those masks.

How long should I wear a mask after testing positive for COVID-19?

According to the CDC, regardless of your vaccination status, if you have no symptoms after staying home for five days, you should wear a mask around others for five more days.

The same guidelines apply, if you have been exposed to COVID-19 and are unvaccinated. They also apply, if you have only received your primary series of vaccinations for Pfizer and Moderna more than six months ago or the Johnson & Johnson vaccine more than two months ago.

If you can’t stay home for five days or have already received your COVID-19 booster, the CDC recommends masking up for 10 days.

How many times and how long can you wear a KN95 mask? Does the same thing apply to cloth masks?

You should use a different KN95 disposable mask every day so you do not wear the same mask more than once in a 72-hour period.

Feel free to reuse a KN95 mask more than once as long as it is not soiled or visibly damaged. When these masks are not in use, they should go in a paper bag to keep bacteria from growing on it.

You can reuse cloth and fabric masks can, but you should wash them after each use.

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Health

Face masks may return amid holiday ‘tripledemic’ of covid, flu and RSV

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With three highly contagious respiratory viruses sickening adults and children around the country and holiday gatherings just weeks away, public health officials are beginning to talk about face masks again.

While mask mandates are unlikely in most parts of the country, health experts are renewing recommendations to wear a high-quality medical mask on public transportation, in airports and on planes, while shopping and in other crowded public spaces.

What’s notable is that the mask recommendations this time aren’t just about avoiding the coronavirus. Masks are advised to protect against what is being called the “tripledemic” — a confluence of influenza, coronavirus and respiratory syncytial virus (RSV) that already is straining hospitals and forcing parents to miss work in record numbers.

As the country heads into its third pandemic winter, covid-19 cases are on the rise, and the 2022-23 flu season is shaping up to be the worst in a decade — there have already been 4,500 deaths from flu, including 14 children, according to the Centers for Disease Control and Prevention.

With such a heavy burden of illness straining the health-care system, it may be hard to believe that something as simple as a face mask could make a meaningful difference. But health experts say a quality medical mask — such as an N95, KN95, or KF94 — remains a highly effective line of defense, especially when combined with vaccination, hand washing, better ventilation and avoiding crowds.

“Masks will help reduce your risk of all respiratory viruses not just covid,” said Jay K. Varma, an internal medicine physician, epidemiologist and professor of population health sciences at Weill Cornell Medical College. “They have to be the right quality masks worn consistently and correctly. Even a very small percentage increase in mask-wearing when multiplied by a large population can have a big impact.”

We talked to several public health experts about why a face mask may be your best holiday accessory this winter. Here’s what they had to say.

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Health

CDC encourages people to wear masks to prevent spread of Covid, flu, RSV

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The Centers for Disease Control Prevention on Monday encouraged people to wear masks to help reduce the spread of respiratory illnesses this season as Covid, flu and RSV circulate at the same time.

CDC Director Dr. Rochelle Walensky, in a call with reporters, said wearing a mask is one of several everyday precautions that people can take to reduce their chances of catching or spreading a respiratory virus during the busy holiday season.

“We also encourage you to wear a high-quality, well-fitting mask to prevent the spread of respiratory illnesses,” said Walensky, adding that people living in areas with high levels of Covid transmission should especially consider masking.

The CDC director said the agency is considering expanding its system of Covid community levels to take into account other respiratory viruses such as the flu. The system is the basis for when CDC advises the public to wear masks. But Walensky encouraged people to take proactive action.

“One need not wait on CDC action in order to put a mask on,” Walensky said. “We would encourage all of those preventive measures — hand washing, staying home when you’re sick, masking, increased ventilation — during respiratory virus season, but especially in areas of high Covid-19 community levels.”

About 5% of the U.S. population lives in counties where the CDC is officially recommending masks due to high Covid levels. The CDC continues to recommend masking for anyone travelling by plane, train, bus or other forms of public transportation, Walensky said.

People with weak immune systems and those who otherwise face a heightened risk of severe disease should also consider wearing a mask, the CDC director said.

Walensky strongly encouraged everyone eligible to receive their flu shot and Covid booster. Flu vaccination coverage is lagging for at-risk groups — children under age 5, pregnant women, and at-risk seniors — compared with last year, the CDC director said. There is no vaccine for RSV.

“I want to emphasize that the flu vaccine can be life saving and importantly, there’s still time to get vaccinated to be protected against flu this season and its potential serious consequences,” Walensky said.

The flu has arrived early and hit the U.S. hard with hospitalizations at a decade high for this time of year. More than 8.7 million people have fallen ill, 78,000 have been hospitalized, and 4,500 people have died from the flu this season, according to CDC data. Fourteen children have died from the flu so far this season.

More than 19,000 people were hospitalized with the flu during the week ending Nov. 26, nearly double the previous week, according to CDC data.

People hospitalized with Covid also increased 27% during the week ending Dec. 2, according to CDC data. And respiratory syncytial virus, or RSV, has been hospitalizing children at higher rate than in previous years. Walensky said RSV appears to have peaked in the Southeast and may be leveling off in the Mid-Atlantic, though circulation of the virus remains high in much of the nation.

“We now face yet another surge of illness. Another moment of overstretched capacity and really one of tragic and often preventable death,” Walensky said, as she thanked health-care workers for their service during the repeated surges of illness they have confronted since the Covid pandemic began.

Dr. Sandra Fryhofer, board chair of the American Medical Association, said the circulation of Covid, flu and RSV at the same is a “a perfect storm for a terrible holiday season.” Fryhofer said she understands many people are tired of receiving repeated Covid shots, but getting vaccinated is the best way to avoiding falling ill over the holidays.

“You could get really, really sick this year and ruin your holiday celebrations if you don’t get vaccinated,” Fryhofer said during Monday’s call.

The Children’s Hospital Association and the American Academy of Pediatrics last month asked the Biden administration to declare a public health emergency in response to the surge of pediatric hospitalizations from RSV and the flu.

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Health

Masks Aren’t to Blame for the Surge in RSV and Flu Right Now

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Photo: Ground Picture (Shutterstock)

This year’s flu season is shaping up to be especially bad, with the current weekly number of cases at extraordinarily high levels. Meanwhile, doctors are seeing a surge in respiratory syncytial virus, more commonly known as RSV, which generally causes mild, cold-like symptoms in adults, but can be especially dangerous for very young children and the elderly. This RSV surge has already led to an unusually high number of hospitalizations, mostly in young children. These surges in flu and RSV infections are happening at an earlier time of the year, and at higher levels than is typical.

There are a lot of unknowns about why flu and RSV are at unusually high levels. However, one thing is for certain: “Just because we wore masks all this time, it didn’t mean that we hurt our immune system,” said Raywat Deonandan, an epidemiologist at the University of Ottawa. “Your immune system is not like a muscle, where if you don’t use it, you lose it.”

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If the culprit isn’t that we wore masks for a full year, then what do we know about why this year’s flu and RSV season is higher than usual?

How does our immune system work?

Our immune system is being used a lot more than we realize, even if we aren’t getting sick. “Our immune system is not atrophying, it is not weakening, it is working on a daily basis,” said Sabina Vohra-Miller, the founder of Unambiguous Science. As Vohra-Miller points out, although respiratory viruses such as the flu were down in the 2020-2021 season, our immune system is constantly being exposed to pathogens that are in our food and water, the vast majority of which don’t ever result in illness.

Our immune system also has a very long memory, where it “works like a photo system,” said Colin Furness, an epidemiologist at the University of Toronto. “It’s very permanent.” Our immune system learns how to recognize specific infectious agents that it has seen before.

As we get older, our immune system will start to decline, similar to how photos wrinkle with age. However, “in kids, and in healthy adults, if you don’t have some kind of immunocompromised health condition, those photos remain very intact,” Furness said. “It doesn’t matter that you haven’t had flu in years, your body will respond to flu as it responded the last time.”

With a virus such as the flu, it can only evade the immune system by changing to the point that it is no longer recognizable, while for viruses and pathogens that don’t change very much, such as measles or the chicken pox, the immune system will be able to fight it off the next time an exposure happens, even if it has been years.

Flu and RSV are seasonal

Although not being exposed to respiratory viruses for a year won’t affect a person’s immune system, the unusually low number of cases during the 2020-2021 season may be part of why we are seeing such high numbers of flu and RSV. “There is some truth to the idea that because of pandemic restrictions holding back all kinds of respiratory illness, we are seeing a resurgence of them, in general,” Deonandan said.

However, this resurgence has to do with the seasonality of viruses such as flu and RSV, rather than a lack of infections affecting a person’s immune system. As a number of scientists predicted in a 2020 paper, the low numbers of respiratory infections, combined with the seasonality of these viruses, can lead to higher-than-usual infections in later seasons.

Right now, with school back in session, “it really rekindled the viruses within the school environment,” said Pedro Piedra, a virologist at Baylor College of Medicine. All of these viruses circulating among school kids has the ripple effect of infecting others in their social circles, such as their parents, who then spread it to their colleagues.

COVID infections may be affecting our immune system

One factor that may be contributing to this year’s unusually bad flu and RSV seasons is the effect of a COVID infection on our immune systems. As early evidence suggests, this may be playing a role. “There are a number of papers suggesting that a COVID infection might reduce our ability to fight off future infections of a variety of types,” Deonandan said.

This is not a new idea: there are a number of viruses that are known to have a negative impact on our immune system. One example is the measles virus, which can cause our immune system to “forget” past infections. As a 2019 study showed, a measles infection can have the effect of wiping out anywhere between 11 to 73% of our body’s antibodies.

It’s not yet known how much COVID can reduce our immune system response, who may be susceptible, and what the effects may be. “A lot of people have had multiple infections who are just fine,” Deonandan said. “It’s just that there may be a proportion of individuals who get infected or reinfected, and that is compromising their ability to fight off future infections.”

To reduce your risk, employ precautionary measures

The flu causes between 12-52,000 deaths per year, and RSV causes 58,000 to 80,000 hospitalizations per year in children under the age of 5. Although this year is on track to be an especially bad one, the risks are well-established. “Respiratory viral infections, before the pandemic, during the pandemic, and after the pandemic will have a significant impact on our health,” Piedra said. “None of this is new.”

The advantage is that there are a number of precautionary measures that can reduce the risk of either getting sick, or lessening the severity of these symptoms. This includes staying up-to-date on your COVID vaccinations, making sure you get your flu shot, and employing precautionary measures, such as wearing a mask, when you are in a crowded environment.

 

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Health

CDC recommends masks for 14 Michigan counties, raising from 8 last week

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Michigan has 14 counties at a high COVID-19 Community Level this week according to the Centers for Disease Control and Prevention.

The CDC uses Community Levels to determine COVID risk, putting counties in one of three buckets: low (green), medium (yellow) or high (orange).

The CDC recommends masking while indoors in public when counties are at a high Community Level, regardless of vaccination status. However, people with symptoms, a positive test or exposure to someone with COVID-19 should wear a mask regardless of where they live, the CDC says.

The 14 counties at a high level this week are: Calhoun, Clare, Clinton, Dickinson, Eaton, Ingham, Ionia, Iron, Lapeer, Macomb, Midland, Schoolcraft, Shiawassee and Washtenaw counties.

Michigan has 34 counties at a medium level and 35 counties at a low COVID-19 Community Level this week.

Here’s the latest map showing the Community Level for each Michigan county. Tap or hover over a county to see details.

(Can’t see the map? Click here.)

The CDC considers cases and hospitalizations when determining COVID risk for an area. The goal is to prevent severe disease and limit strain on hospitals.

For Community Levels, the CDC looks at three factors for each county: the percentage of staffed hospital beds occupied by COVID patients, COVID hospital admissions per capita and COVID cases per capita.

A county is at a high level when there are 200 or more new cases per 100,000 in the past week and either (a) 10-plus new COVID-19 hospital admissions per 100,000 or (b) when at least 10% of the staffed inpatient beds are occupied by COVID patients.

If hospitalizations are particularly high, even a county with low cases can be at a high level, per the CDC formula.

(Not every county has a hospital, so each one is assigned a health services area, a geographic region that contains at least one hospital. Counties are attributed the metrics calculated for the entire area, weighted based on each county’s population.)

Here’s more on the state of COVID-19 in Michigan.

Michigan is reporting 2,086 new, confirmed cases per day in the past week

Reported COVID cases are up 16.0% from last week, as the state had 2,086 new, confirmed cases this week.

Michigan has hovered around the 2,000-case-per-day mark for most of the summer.

Michigan also reported 539 “probable” COVID cases per day this week.

Cases are “confirmed” when there’s a positive result from an NAAT/RT-PCR test. Cases are “probable” when there’s a reported antigen (rapid) test or if somebody has symptoms and was exposed to a person with COVID-19.

All graphics in this story except the initial one (which uses CDC case calculations) are based only on “confirmed” numbers.

The Michigan Department of Health and Human Services reports COVID cases once per week. The department announced 18,375 confirmed and probable cases this week.

Michigan has reported 2.4 million confirmed COVID cases and nearly 378,000 probable cases since the pandemic began.

The chart below shows the seven-day average for new, confirmed COVID cases throughout the pandemic.

(Can’t see the chart? Click here.)

Michigan ranks 8th in the U.S. in new cases per capita

Michigan’s COVID rate was the eighth highest in the U.S. in the past week, according to the New York Times.

Michigan had fewer COVID cases than last week, but managed to move up the list for highest COVID rate because 46 of the 50 states saw their rate decline in the past week.

West Virginia, Kentucky, South Carolina, Alaska, North Carolina and Ohio had the most COVID cases per capita this week. Nevada, California, Washington, Utah, Montana and Wyoming had the lowest COVID rates.

For COVID hospitalizations, Michigan ranked 14th of 50 this week. The state also had the fourth-most COVID deaths per capita this week.

42 counties saw rise in cases in last seven days

Of Michigan’s 83 counties, 42 had more cases this week than last week.

Many of Michigan’s larger counties had big increases in cases. Ingham County was up 39% compared to last week, Kalamazoo County increased 34%, Wayne County jumped 32%, Oakland County was up 23%, Washtenaw County jumped 20%, Macomb County increased by 19% and Kent County rose 8%.

See the database below to search by county and sort by most/fewest cases. The chart also shows the percent change from week to week and the seven-day case average per capita.

(Can’t see the database? Click here.)

37 Michigan counties at highest risk for cases

There are 37 counties at the highest risk level (Level E) for cases, down from 43 counties last week.

The MDHHS has five risk levels for COVID cases:

  • Level A: 7-19 cases per day per million
  • Level B: 20-39 cases per day per million
  • Level C: 40-69 cases per day per million
  • Level D: 70-149 cases per day per million
  • Level E: 150+ cases per day per million

The counties with the highest COVID rates in Michigan this week were Iron, Dickinson, Washtenaw, Midland, Schoolcraft and Ingham counties.

The lowest COVID rates were in Alcona, Huron, Presque Isle, Leelanau, Antrim and Cheboygan counties.

The map below is shaded by the state’s six risk-assessment levels from A to E. This is based on new cases reported per day per million people from Sept. 7-13.

The arrows on each county show if new cases this week are up or down compared to the previous week. Put your cursor over a county to see the underlying data. (Hint: Drag the map with your cursor to see the entire U.P.)

(Can’t see the map? Click here.)

COVID case totals don’t tell the whole story. At-home tests are not reported, so those aren’t included in the data. That’s why it’s also key to look at percent positivity of reported tests and data on hospitalizations and deaths.

Average test positivity is 18%

About 18 of every 100 COVID tests reported to the state on Monday, Sept. 12, came back positive.

The positivity rate has hovered between 18% and 19% in the past week.

The World Health Organization considers there to be a substantial level community transmission when positivity rates are above 5%.

Michigan’s rate peaked at 35% in January. It dipped as low as 2% in early March before climbing again.

The graph below shows the percentage of COVID-19 tests reported that came back positive throughout the pandemic.

(Can’t see the chart? Click here.)

Eaton County had the highest positivity rate of all Michigan counties this week, at 30.5%. Baraga, Keweenaw and Lake counties all had a positivity rate less than 5%.

To see the COVID test positivity rate for your county, see the searchable table below.

(Can’t see the database? Click here.)

The interactive map below shows the seven-day average testing rate by county. Put your cursor over a county to see details.

(Can’t see the map? Click here.)

Hospitals treating 1,145 confirmed or suspected adult COVID-19 patients

Michigan had 1,145 adults in hospitals with confirmed or suspected COVID as of Wednesday, Sept. 14. That’s down slightly from 1,172 adult hospitalizations last week.

Before this week, Michigan COVID hospitalizations had risen in eight of the previous nine weeks.

Of the 1,145 adults in the hospital with COVID on Wednesday, 148 were in intensive care and 69 were on a ventilator.

There were also 46 kids hospitalized with COVID in Michigan as of Wednesday.

Michigan is reporting 21 new COVID deaths per day in the past week

Michigan averaged 21 COVID deaths per day this week, the highest mark since March.

But it’s still far fewer COVID deaths than Michigan had during omicron’s winter peak. Michigan was averaging more than 100 COVID deaths per day during parts of January.

Michigan has had 34,970 confirmed COVID-19 deaths and 3,347 probable COVID deaths since the pandemic began. Put another way, roughly one in every 287 Michigan residents have died from confirmed COVID.

Below is a chart illustrating the seven-day average for reported deaths throughout the pandemic.

(Can’t see the chart? Click here.)

Vaccinations: 63.4% of residents have received at least one dose

About 63.4% of Michigan residents have gotten at least one COVID shot, 58.3% have received the full original regimen and 33.9% have been boosted.

The omicron-specific COVID-19 booster shot is now available in Michigan from both Pfizer and Moderna.

The new shots are authorized for use as a single booster dose, administered at least two months after a previous COVID vaccine. Moderna’s shot is authorized for people 18 and older, while Pfizer’s is for those 12 and older.

Below is a vaccination breakdown by age group of Michiganders who have gotten at least one shot (initiated) and those who are “completed,” meaning two shots of mRNA vaccines or one Johnson & Johnson shot, as of Wednesday, Sept. 14:

  • 75 and older: 87.1% initiated; 81.3% completed
  • 65 to 74: 90.4% initiated; 85.4% completed
  • 50 to 64: 76.9% initiated; 72.2% completed
  • 40 to 49: 67.6% initiated; 62.4% completed
  • 30 to 39: 65.9% initiated; 59.6% completed
  • 20 to 29: 55.6% initiated; 49.4% completed
  • 16 to 19: 56.6% initiated; 51.6% completed
  • 12 to 15: 49.8% initiated; 46.1% completed
  • 5 to 11: 30.3% initiated; 27.3% completed
  • Younger than 5: 6.2% initiated, 1.5% completed

Below is a chart that ranks counties from most vaccinated to least vaccinated.

(Can’t see the chart? Click here.)

For more statewide data, visit MLive’s coronavirus data page.

To find a testing site near you, check out the state’s online test find send an email to COVID19@michigan.gov, or call 888-535-6136 between 8 a.m. and 5 p.m. on weekdays.

If you have any COVID-19 questions, please submit them to covidquestions@mlive.com to be considered for future MLive reporting.

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World

If North Korea has Covid beat, why buy 1 million face masks from China?

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Pyongyang last week declared victory over the coronavirus, ending a little-detailed fight against “fever” cases that had risen to 4.77 million in the country of around 26 million people. It has registered no new such cases since July 29.

Still, China exported 1.23 million facial masks to North Korea in July, worth $44,307, surging from 17,000 the previous month, according to data released by Chinese customs at the weekend.

From January to July, the last month for which data is available, the North bought more than 11.93 million masks from China, data showed.

North Korea did not import any Covid-19 prevention and control products from China in May, the data showed.

China’s overall exports to North Korea surged to $59.74 million in July from $19.05 million in June.

Top exports were semi- or wholly milled rice, cigarettes, disodium carbonate and smoked sheets of natural rubber.

North Korea bought $5.16 million worth of semi- or wholly milled rice, $1.98 million of soybean oil and fractions, and $1.21 million of granulated sugar in July, the Chinese customs data showed.

China suspended cross-border freight train services with North Korea following consultations due to Covid-19 infections in its border city of Dandong, China’s Foreign Ministry said on April 29.

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Science

Update Alert 8: Masks for Prevention of Respiratory Virus Infections, Including SARS-CoV-2, in Health Care and Community Settings

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This is the eighth update alert for a living rapid review (1) on the use of masks for the prevention of respiratory virus infections, including SARS-CoV-2, in health care and community settings. The first 3 updates (2–4) were monthly, after which the interval was switched to bimonthly (5, 6). Beginning in June 2021, the interval was extended to biannually. For this update, searches were done from 3 December 2021 to 2 June 2022 using the same search methods as the original review. Inclusion was restricted to randomized trials and observational studies that controlled for confounders. Non–peer-reviewed studies were excluded unless they were based on data collected after February 2021 to capture evidence on mask use in the B.1.617.2 (Delta) and B.1.1.529 (Omicron) variant predominant periods. The update searches identified 1592 citations. No new randomized controlled trials (RCTs) and 5 new observational studies on the association of mask use and SARS-CoV-2 infection met inclusion criteria (Supplement Table 1). Three studies were done in community settings (7–9), and 2 studies (10, 11) were done in health care settings. One preprint study (9) of mask use in community settings collected data during Delta and Omicron predominant periods; the other studies were done before the emergence of these variants. All studies had methodological limitations, including unclear or low participation rate, potential recall bias, and failure to report attrition or missing data (Supplement Table 2).

Community Settings

Three new observational studies (7–9), all done in the United States, evaluated the association between mask use in community settings and risk for SARS-CoV-2 infection.

In previous updates, the evidence for mask use versus no use for prevention of SARS-CoV-2 infection in community settings was assessed as low to moderate strength favoring mask use, based on 2 RCTs (12, 13) and 8 observational studies (14–21). For this update, 2 new observational studies were consistent with prior evidence finding mask use associated with reduced risk for SARS-CoV-2 infection (Supplement Table 3). The adjusted odds ratio (OR) for mask use in public indoor settings versus no use was 0.51 (95% CI, 0.29 to 0.93) in 1 new study (7). The second, non–peer-reviewed study evaluated mask use for any interaction within a distance of less than 6 feet (excluding household members) (9). Wearing a mask for at least 1 day for such interactions within the preceding 10 days was associated with decreased risk for SARS-CoV-2 infection versus no mask use. The reduction in risk was similar in the pre-Delta (July 2020 to June 2021; adjusted OR, 0.60 [CI, 0.52 to 0.70]) and Delta-predominant (July 2021 to November 2021; adjusted OR, 0.65 [CI, 0.53 to 0.81]) eras but attenuated in the Omicron-predominant era (December 2021 to February 2022; adjusted OR, 0.86 [CI, 0.76 to 0.97]). Because the new studies were observational and had methodological limitations, the evidence for benefits of mask use versus no use for prevention of SARS-CoV-2 infection in the community remains low to moderate (Supplement Table 4).

One of the new fair-quality studies (7) found surgical masks (adjusted OR, 0.34 [CI, 0.13 to 0.90]) and N95 or KN95 respirators (adjusted OR, 0.17 [CI, 0.05 to 0.64]) each associated with reduced risk for SARS-CoV-2 infection versus no mask use (Supplement Table 3). Cloth mask use was also associated with a reduced risk for infection compared with no use, but the estimate was imprecise (adjusted OR, 0.44 [CI, 0.17 to 1.17]). The study did not report risk estimates comparing mask types. On the basis of the adjusted estimates for masks versus no masks provided in the study, we calculated adjusted ORs for N95 and KN95 respirators versus surgical masks (adjusted OR, 0.50 [CI, 0.10 to 2.48]) and surgical versus cloth masks (adjusted OR, 0.77 [CI, 0.20 to 3.03]), which were imprecise. The correlation among the adjusted ORs was not reported; we assumed correlation equals 0, resulting in wider CIs than if correlation was present. The new fair-quality study provided insufficient evidence for N95 versus surgical mask (no prior studies) and did not change previous assessments (Supplement Table 4) of low strength of evidence for surgical masks versus no masks in community settings (based on 2 prior RCTs [12, 13] and 1 observational study [15]), low strength of evidence for no difference between surgical and cloth masks (based on 1 prior RCT [13] and 1 prior observational study [15]), and insufficient evidence for cloth masks versus no masks (based on 1 prior RCT [13] and 1 observational study [15]) and N95 respirators versus no masks (no prior studies).

One other new study (8) evaluated the association between adherence to mask use among health care workers when outside of work and risk for SARS-CoV-2 infection, but the estimate was imprecise (for adherence all of the time versus most of the time, some of the time, or never: adjusted hazard ratio, 0.8 [CI, 0.5 to 1.6]). The strength of evidence for consistent or always mask use versus inconsistent mask use in the community is insufficient (no prior studies) (Supplement Table 4).

Health Care Settings

Two new cohort studies (10, 11) evaluated mask use and risk for SARS-CoV-2 infection in health care settings (Supplement Tables 2 and 4). One was a secondary publication (11) for a previously included study (22). In univariate analysis, it found N95 respirator use associated with increased risk for SARS-CoV-2 infection versus nonuse (OR, 7.8 [CI, 4.0 to 15.2]) (Supplement Table 3), but in multivariate analysis, the association between N95 respirator use was not statistically significant enough to be included in the multivariate model (criteria for selecting variables for model not reported); thus, the observed univariate association was likely related to confounding due to increased exposures or other factors in health care workers using N95 masks. The new study did not change the previous assessment of evidence on N95 versus no masks as insufficient (based on 3 prior studies [23–25]) (Supplement Table 4). One other new study (10) evaluated the association between consistency of mask use and risk for SARS-CoV-2 infection, but the estimate was very imprecise (for mask use at work all or nearly all of the time versus less than nearly all of the time (adjusted OR, 4.0 [CI, 0.7 to 19.5]) (Supplement Table 3). Therefore, the evidence on consistency of mask use remains insufficient (Supplement Table 4).

Although this was planned as the final update, a large randomized trial of N95 versus surgical masks (26) has been completed, although results are not yet published. Because this trial could affect findings for this comparison, 1 additional update will be done after its publication.

References

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Health

Orange County enters COVID-19 ‘high’ transmission level, but no indoor mask mandate expected

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SANTA ANA, Calif. (KABC) — Orange County health experts are once again keeping a close eye on COVID-19 cases as the county moves to “high” community transmission.

“Right now we’re certainly seeing a surge in cases,” said Dr. Matt Zahn, deputy health officer for the Orange County Healthcare Agency.

He said transmission in the community is up due to the highly transmissible omicron subvariants.

“We have such an overlap in terms of our populations from Los Angeles County and us and other surrounding counties,” Zahn said. “It’s fair to say we’re all seeing this increase in cases. We’re all in this together.”

According to the Centers for Disease Control and Prevention’s COVID-19 data tracker, Los Angeles County’s COVID-19 community level is now in the “high” category.

Ventura and Orange counties also moved into the “high” level this week based on elevated rates of people being infected with the virus.

San Bernardino and Riverside counties are currently in the “medium” category.

“Whenever we’ve seen an increase like this in the past during the pandemic there usually was an increase in ICU cases and also deaths. We’re not seeing that,” said Jose Arballo, public information officer for the Riverside County Department of Health.

If L.A. County stays at the “high” category for two weeks straight, officials say it would trigger a new indoor mask mandate.

It’s a move residents in some neighboring counties should not expect to see.

“We’ve always followed the state guidelines and mandates,” Arballo said. “I believe we will continue to do so. That’s the instruction we’ve been given.”

“In Orange County, we are not moving toward mandates at this point,” Zahn said.

Right now, health officials said anyone who feels safer wearing a mask should continue to do so especially in public places and indoors, and they encourage folks to get the COVID-19 vaccine or booster if eligible.

Copyright © 2022 KABC Television, LLC. All rights reserved.



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Health

Can Masks Prevent the Spread?

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Face masks played a key role in preventing the spread of coronavirus. In many countries, wearing them was mandatory and is still common practice across the globe.

Now, there is another virus making headlines: monkeypox.

Monkeypox is a rare viral infection, usually only recorded in areas of western and central Africa. In recent weeks however more than 1,000 cases have been recorded across 29 countries, according to Centers for Disease Control and Prevention (CDC) data.

For most people the virus is not dangerous—most make a full recovery. However as the world emerges from the worst of the coronavirus pandemic, discussions are circulating as to how best to prevent its spread.

A stock photo shows a monkeypox rash and woman wearing a mask. There is indication that the virus can be airborne, meaning masks could prevent its spread.
iStock / Getty Images

Monkeypox and coronavirus are very different, and most media coverage on monkeypox centers on only caught through direct contact—although it requires more research, there is indication that it is spread through sex and other close contact.

However the CDC has recently updated its guidance on virus, including recommendations for those infected to wear masks. This presents a question that has not yet been widely touched on: can monkeypox be airborne too? And if so, can wearing masks prevent it from spreading?

How Airborne Is It?

Airborne transmission occurs when a virus travels through the air, in the form of small respiratory droplets caused by coughing or sneezing.

Most monkeypox cases can be traced back to a patient having direct, close contact with an infected person or animal. However in some circumstances this has not been the case—meaning the transmission must have been airborne.

In a 2017 study during an outbreak in Nigeria, scientists found that two health care workers had become infected with the virus while having no contact with the patients they were treating. In these cases, it is likely that masks could have prevented transmission.

Since the most recent outbreak, scientists have stressed that not enough is known about the virus to determine how exactly it is transmitted. While it appears it can be airborne, scientists believe it still cannot be sustained over large distances.

A stock photo shows a man wearing a mask. The CDC has updated its guidance on monkeypox and masks.
sibway/Getty

Should I Wear a Mask?

The CDC has recently updated its guidance on masks and monkeypox. It issued an update advising travelers to wear a mask to protect themselves in countries where monkeypox has been detected. However, the New York Times reported that it then took this guidance out, stating that it “caused confusion.”

However the CDC still advises that those infected with monkeypox to wear a surgical mask, “especially those who have respiratory symptoms” such as a cough, sore throat or shortness of breath.

The CDC also advises that if this is “not feasible,” other household members should wear a mask to protect themselves. At this stage, it also advises health care workers to protect themselves with a mask.

The New York City Department of health and mental hygiene also issued a statement last month, stating that “masks can protect against monkeypox, as well as other viruses circulating” the city, and advises people to wear them in most public settings.

However there have so far been no recommendations for the general public to wear a mask specifically to prevent the spread of monkeypox. Most mask guidelines remain in place due to COVID-19, which is spread through the air far more easily.

Update 06/08/22, 6:29 a.m. ET: This article was updated to include a picture.

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