New COVID-19 admissions per 100,000 population (7-day total)
Percent of staffed inpatient beds occupied by COVID-19 patients (7-day average) 3 New COVID-19 admissions per 100,000 population (7-day total) 2 (per 100,000 population in the last 7 days) COVID-19 Community Levels, Indicators, and Thresholds New Cases 1 To inform prevention measures that aim to minimize severe illness and healthcare strain, CDC recommends that public health officials monitor COVID-19 Community Levels.ĬDC recommends the use of three indicators to measure COVID-19 Community Levels: (1) new COVID-19 hospital admissions per 100,000 population in the last 7 days (2) percent of staffed inpatient beds occupied by patients with confirmed COVID-19 (7-day average) and (3) new COVID-19 cases per 100,000 population in the last 7 days (Table 1).
2,6,15 Consequently, measures of community transmission provide different information in the context of high population protection compared to previous points in the pandemic with lower vaccination coverage and fewer people with prior infection. With high levels of population immunity from vaccines or prior infection, 5-7 breakthrough cases and reinfections more frequently result in asymptomatic infections or milder illness in most persons. However, neither of these metrics directly reflects the risk of medically significant disease or healthcare system strain. 14 Public health practitioners, schools, workplaces, businesses, and community organizations also relied on these metrics to inform decisions about other preventive measures. 12 These indicators of community transmission were used to inform mask recommendations 13 and setting-specific guidance such as screening tests in schools and alert the public to community transmission levels. Starting in September 2020, CDC recommended the use of two metrics to assess the level of community transmission: new COVID-19 cases per 100,000 persons in the last 7 days and percent of SARS-CoV-2 diagnostic nucleic acid amplification tests (NAATs) in the last 7 days that were positive. How community metrics and actions should inform the prevention decisions of local authorities A comprehensive approach to assessing COVID-19 community levels can inform decisions about layered COVID-19 prevention strategies (Figure 1), including vaccination and masking, with explicit goals of reducing medically significant disease and limiting strain on the healthcare system. 10-11 Accordingly, at this stage of the pandemic, data on disease severity and healthcare system strain to complement case rates are more informative for public health recommendations for individual, organizational, and jurisdictional decisions than data on community transmission rates alone.
A burdened healthcare system is associated with increased mortality associated with COVID-19 9-10 and limits capacity and resources for medical care for non-COVID-19 conditions. 29 These changes make it more feasible to minimize medically significant disease and prevent excessive strain on the healthcare sector, even in the occurrence of SARS-CoV-2 transmission. Despite high volume of hospitalizations due to high caseloads, the emergence of Omicron as the dominant variant reflected lower virulence and disease severity. Widespread uptake of COVID-19 vaccines that are highly effective against severe illness and death, 1-4 the accrual of high rates of vaccine- and infection-induced immunity at the population level, 5-7 and the availability of effective therapeutics 8 have moved the pandemic to a different phase.
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