While the omicron variant is taking over as the predominant strain of COVID-19 in Tompkins County, Public Health Director Frank Kruppa said the hospitalization rates are mostly due to carry over from the wave of the delta variant. As of Jan. 10, there are 16 people hospitalized, a number higher than the usual range of eight to 10, but half of the peak of last winter.
Case numbers in the county have fluctuated dramatically over the course of the past six weeks, hovering at around 200 at the end of November and jumping to 2,000 by Dec. 18. As noted by Kruppa, with the departure of the college students around that time, cases dropped back down to around 1,000 at the end of December.
At a COVID Town Hall meeting on Jan. 6, Kruppa said over the past few weeks about 70% of people with COVID discharged from the emergency room had the omicron variant, while 75% of the people admitted had the delta variant.
“So the severity that we see reflected in our hospitalization numbers are the delta variant,” Kruppa said. “As omicron becomes more predominant, we’ll see hospitalizations decline even as case numbers continue to grow.”
Kruppa anticipates higher case numbers due to the fact the omicron variant seems to be significantly more transmissible than other variants. He said at this point, the potential for exposure is significantly higher.
“It’s everywhere,” Kruppa said. “COVID is out there, and you can get exposed in most any place you go in public.”
He also cleared up some confusion about quarantine and isolation times, as there have been changes with CDC recommendations recently. Tompkins County has adopted the New York State Department of Health guidance, which Kruppa said means most people will be in isolation or quarantine for five days. If you test positive or have symptoms, you must stay home for five days from the onset of symptoms or from receiving a positive test. If you are ill and still have symptoms after five days, you must remain in isolation for the full 10 days. Kruppa said it’s also recommended that immunocompromised folks who test positive should also expect to stay in isolation for 10 days, since a weakened immune system means they could be shedding the virus for longer.
If you are fully vaccinated with a booster shot, exposed to the virus and not displaying any symptoms, you will not need to quarantine. If you’ve been fully vaccinated, are eligible for the booster but have not received it, and have been exposed to the virus, you will need to quarantine.
Kruppa explained that the omicron data so far is showing people are mostly infectious in the two days prior to showing symptoms and the three days post onset, hence the change to a five day isolation period.
“It’s not everyone, but what we are doing is having to weigh the public health intervention mechanisms against the impact of those interventions,” Kruppa said.
He noted that in March 2020 when the pandemic first took foot in the United States, everything shut down because there was no information on the virus and no ways to fight it.
“We didn’t have tools like vaccines and antivirals, so it was necessary to take significant public health measures to stop spread. And our community did that,” he said. “Now we have omicron and we know more about it. It’s less severe but more transmissible. We’re not eliminating requirements, but when you measure the impacts of longer quarantines, there’s a significant impact on the ability to operate as a community.”
After the five-day mark, Kruppa said you should still wear a well-fitting mask with a nose piece and two layers of cloth when around others.
Because of the rise in cases, there have been some delays in getting test results back. Kruppa said with shorter isolation times there is going to be a shift to a self-responsibility model, as the Health Department likely won’t be able to get a hold of everyone in a timely manner.
“If you test positive or have symptoms and don’t get tested, you should act as if you’re positive and isolate yourself for the five days,” he said. “Our community has proven they will do what’s important and what’s necessary to protect each other.”
Kruppa suggests getting a PCR test if you’re symptomatic, as they’re still the “gold standard,” and more likely to detect the disease early and at lower levels in your body compared to other tests. As far as self-tests, Kruppa said he doesn’t know what the federal distribution plans are yet, but that Tompkins County received some from the state in December. He said they were turned over to BOCES for distribution. The Health Department also received another 4,600 self-tests last week and distributed them to local municipalities to pick up and distribute to individual communities.
“We asked them to focus on people without means to purchase a test, so they’re going to do some targeted work,” Kruppa said. “It’s 4,600 tests, it’s not a lot when there are 100,000+ in our community. They will go quickly.”
If you do get a self-test and test positive, there is a form on the Health Department’s website (tompkinscountyny.gov/health) to fill out, and you will receive an automated email back with information about what steps to take.
Kruppa also addressed the Test to Stay program, a tool being used in school districts throughout the country to keep kids in school. If a student is a close contact with a case and is asymptomatic, they can continue to go to school by testing negative in a series of rapid tests throughout the quarantine period. This is currently not being used in Tompkins County.
“The challenge is that it's very labor intensive and tests are in short supply,” he said. “It’s a significant logistical lift with minimal value for keeping folks in school, particularly with the change to a five-day quarantine.”
Moving forward, Kruppa said he hopes the focus will be able to shift back to vaccines and making sure first and second doses, as well as boosters, are readily available in the community through healthcare providers and pharmacies.
As for what the future holds, Kruppa said he wishes he had a crystal ball, and that he’s not sure if people will need more boosters.
“We have to see how the vaccine works against the evolution of the disease,” he said. “The flu vaccine we ask people to get every year. COVID could be that. Or the booster could provide long-term protection. We don’t know and won’t until there’s time to research and learn.”
He said despite the uncertainty, for now vaccines are keeping people out of the hospital. And there’s an antiviral from Pfizer that should be hitting the market relatively soon that could mitigate symptoms. So overall, Kruppa is feeling hopeful.
“I think this is the first time in two years that I feel comfortable saying that in this year, we’re going to feel normal again,” he said. “I don’t know when that’s going to happen, but we’re heading toward that. Folks should feel good about that.”