TOMPKINS COUNTY, N.Y.—For the last two or three months, it was nice to have a few days of headlines that weren’t about the ongoing COVID-19 pandemic. That seems poised to change.
Cornell University’s announcement Wednesday showed as much, with the school saying it would move to a “yellow” COVID-19 alert level, indicating that the spread of the virus on campus has become higher than anticipated. Cornell reported 263 active student cases as of Tuesday, March 22. A few days of higher test figures in the greater Tompkins County population has left the county with 344 active cases, though no hospitalizations.
At least since the beginning of the year, the COVID situation on campus has ebbed and flowed, with days of low positive test cases before blips of high tests, then returning to low numbers (albeit with lower surveillance testing participation than previous semesters during the pandemic). But the emergence of the BA.2 variant, subset of the Omicron variant, has increased concerns that a more sustained period of rising positive cases could come to the area.
While there have not been any confirmed cases of the new variant, Public Health Director Frank Kruppa acknowledged that there’s a high chance that the BA.2 variant has already arrived in Tompkins County.
“There are screeners that allow them to give us a general idea if something is Omicron versus BA.2, and we’re definitely seeing BA.2 in the community now,” Kruppa said. “There’s still additional full sequencing that needs to occur to confirm all of that, but it’s safe to say that just like we’re seeing around the state and the rest of the country that BA.2 is going to become the most prevalent strain.”
The sequencing process that has determined the arrival of prior variants takes several weeks to complete, Kruppa said. When it is determined that a variant has arrived locally, public health officials won’t definitively know until weeks after it has already established.
While the Delta and Omicron variants, which rose to the most prevalence of the post-original COVID variants, both had escalated transmissibility, Kruppa said he isn’t sure yet if BA.2 represents yet another escalation beyond Omicron. But, he said, it would indeed still be categorized as highly transmissible, like Omicron.
“We’re starting to see BA.2 take over as the predominant strain,” Kruppa said. “It’s an evolution of COVID, we expected there would be additional variants. It doesn’t appear, at this point, that it’s causing more severe illness, which is what we’re most focused on at this point. But it’s certainly still highly transmissible, and I think it’s definitely going to drive case numbers over the coming weeks and months.”
As he has before, Kruppa’s emphasis on hospitalizations is clear—the county has openly stated that is now their primary COVID-19 gauge as COVID variants prove to be more and more infectious but less lethal to those who are infected, with the unfortunate exception of those with pre-existing conditions, those who are unable or unwilling to get vaccinated, and the elderly.
For some of those populations, and even people who are vaccinated and boosted, catching COVID regardless of variant could still have damaging effects, though it seems settled at this point that the vaccine and booster regiment has done well to mitigate the worst outcomes.
“I think we’re going to see case numbers fluctuate over the next few weeks as it becomes more predominant,” Kruppa said. “Really, what we’re focused on, and have been for a while, is how severely people become ill, namely our hospitalization numbers which continue to be low.”
Hospitalizations have indeed remained low, though it would be early to make any definitive judgments on that trend remaining steady. Over the last week, the number of hospitalizations has hovered between one and zero. During that same time period, the positive test rate of PCR (lab-based) tests is 3.5 percent, or 287 positive tests out of 8,097 analyzed.
“We expect that we’ll see these bumps now and again,” Kruppa said. “We hope that we can keep these numbers reasonably low, and keep the hospital numbers where they are.”
Kruppa acknowledged that the rise in people using home tests to determine if they are positive for COVID or not does hamstring the county’s ability to effectively track different variants, since those home tests are not being submitted to Cornell for sequencing. The more comprehensive testing that the county is still offering and conducting should provide a decent enough window, he said.
“We still have enough lab-based testing occurring that ultimately we’ll be able to know the information about variants through sequencing,” Kruppa said.
Kruppa said that the county has the testing capacity to handle waves of cases, like those seen in Tompkins County in January 2021 and December 2021, the two most prevalent months of infection locally.
Kruppa said, “The capacity for doing lab testing hasn’t really changed, it was more the community appetite for it and the proliferation of at-home tests as a screening tool,” Kruppa said.
One of the looming questions in the face of another possible wave is what impact the dropping of certain COVID response measures, like mask mandates for one, will have on spread and how difficult it would be to put safety measures like that back in place. Kruppa said the county would not be hesitant to reimplement measures they felt were necessary.
“We never know the evolution of this disease or if there is a new novel disease that put us in a position where we need to take some pretty significant steps through a public health intervention,” Kruppa said. “All of those tools are always in the toolkit. Where we’re at now is we know more about the disease, we have more tools in the toolkit, and the severity of the illness has reduced. […] As far as the tools we’ve used in the past, of course, we would make them available and use them as appropriate if something changed with COVID or a new disease we needed to address.”