A COVID-19 pause while watching for a potential new surge

While COVID-19 cases continue to recede, public health providers are also watching for a possible rebound.

On Monday, Gov. Tony Evers and the state Department of Health Services (DHS)  kicked off a state tour that will stretch over the coming weeks to celebrate local public health departments, health care providers and a wide array of other people and organizations.

Their work “has helped us get to where we are today in the COVID-19 pandemic.” said Karen Timberlake, the secretary-designee at DHS, at a mid-day ceremony in Madison. 

The pandemic isn’t over, Timberlake said in an interview after the event, held at the Alliant Center, which has also hosted mass vaccination clinics for COVID-19.

For now, “that trajectory looks quite good,” she said. “We’re at a point where we’re still seeing a few hundred cases per day — but that’s certainly substantially better than thousands.” 

As of Sunday, DHS reported that there had been an average of 341 new cases per day over the previous seven days. The most recent peak for new cases was a seven-day average of 18,798 on Jan. 19. The number of people in hospitals with COVID-19 is also down to 248 people across the state, according to the Wisconsin Hospital Association — “way better than 2,200, where we were in January,” Timberlake said.

In visits around the state, DHS will be honoring individuals and organizations who were part of the state’s efforts to combat the virus. Without their help, COVID-19 might have looked a lot more grim in Wisconsin, Timberlake believes. “Just think about the number of additional infections that we would have had with vaccination,” she said. “And without mask requirements, those additional infections would have led to so many more hospitalizations.” 

The deaths of more than 12,000 people in Wisconsin and almost 1 million in the U.S. from COVID-19 is “tragic,” she added — but without vaccines, testing, masking “those numbers would have been far, far, far worse.”

On Monday DHS honored Public Health Madison & Dane County and its director, Janel Heinrich. Timberlake and Evers also offered kudos to emergency medical responders, nonprofits that helped conduct outreach for testing and vaccination, public health departments that organized testing and vaccine clinics and various private sector businesses that played a role as well.

“They helped get the state to where it is — we’re at a place where we are living with COVID-19,” Timberlake told the Wisconsin Examiner. “It is not the emergency that it was.”

Will it stay that way?

“If there were never to be a new variant, COVID will continue to circulate at low levels, and we will be able to manage it quite effectively,” she continued. 

Variants, though, are “the wild card,” Timberlake added. And while the nature of a virus is to mutate, producing new variants, “what none of us can fully predict is whether there will be a new variant that is like omicron, that runs away with things,” or one more like the handful of unknown variants that faded without spreading much. 

For that reason, she said, continued testing, continued examination of test samples for genetic mutations and continued research are all critical to further understand the virus and how to get it under control.

To spot the next resurgence of disease, public health officials are watching the results of wastewater testing around the state for the signs of the virus. “That’s going to be our leading indicator,” Timberlake said. 

About 40% of Wisconsin residents live in areas where the wastewater is being sampled and tested for concentrations of the coronavirus responsible for COVID-19, SARS-CoV-2. Wastewater also can produce the information needed for genetic sequencing of the virus to detect new variants, she added.

“It doesn’t depend on people deciding to get tested,” Timberlake said. “And we are going to know very early if we’re seeing any kind of a concerning trend.” 

At the same time, however, it’s not entirely clear yet how to read those trends.

DHS wastewater testing data on Monday showed increased concentrations of virus over the last two to three weeks in metro areas including Green Bay, Milwaukee and Madison. But cases in all three communities continue to go down. 

Ajay Sethi, an epidemiologist and faculty director of the master’s program in public health at the University of Wisconsin, says the wastewater information could mean different things in different communities. 

“It’s going to take a little time for all of us to recognize, when do we feel like an uptick is a cause for alarm versus something to be expected,” Sethi says.

In a community with a lot of people who have developed some immunity — from vaccination or having been infected with the virus — an uptick in wastewater virus readings might be less alarming, he says. In a community with less immunity, “it could be indicative of a future surge.”

“We’ve never been in this situation before, and three months from now, we’ll be in another situation we’ve never been in before,” Sethi says. “So we’ll have to learn how to use this information accordingly.”

His message for the public is “trust your instincts.”

“If you feel comfortable wearing a mask, then you should do so,” Sethi says. For people who prefer to go without one, “it’s OK to do that right now, because transmission is much lower than it has been recently.”

But if or when transmission rebounds and public health agencies and health care providers urge greater precautions, people willing to doff their masks now will need “to not ignore those messages,” Sethi adds. “And everybody should be aware of that.”