Pandemic notebook: Hospital numbers push Monroe County community spread level to “medium”

Monroe County’s community spread level for the COVID-19 virus has increased from “low” to “medium” as defined by the Centers for Disease Control.

The number of cases per week per 100,000 residents is still below 200, which would put the county in the “low” category. But the latest CDC number for new COVID-19 hospital admissions per 100,000 population is 13.4. That number needs to be less than 10 for a county to stay in the “low” category.

The CDC’s guidance for counties in the “medium” category looks like this:

• If you are immunocompromised or high risk for severe disease:
  Talk to your healthcare provider about whether you need to wear a mask and take other precautions (e.g., testing)
  Have a plan for rapid testing if needed (e.g., having home tests or access to testing)
  Talk to your healthcare provider about whether you are a candidate for treatments like oral antivirals, PrEP, and monoclonal antibodies
• If you have household or social contact with someone at high risk for severe disease:
  consider self-testing to detect infection before contact
  consider wearing a mask when indoors with them
• Stay up to date with COVID-19 vaccines and boosters
• Maintain improved ventilation throughout indoor spaces when possible
• Follow CDC recommendations for isolation and quarantine, including getting tested if you are exposed to COVID-19 or have symptoms of COVID-19

The CDC uses a 200 cases-per-week per-100,000 population metric as the  threshold for its “medium”community spread level.

That threshold translates into about 39.9 cases a day for Monroe County. Based on the current 155 cases per 100,000 per week, Monroe County would remain classified as having “low” community spread—except for the hospitalization numbers.

Under the scheme used last year by the state of Indiana to classify community spread, the weekly per-100,000 population threshold for the next-to-worst (orange) category of community spread was 100. So Monroe County would now be orange on that metric. Here’s the latest Monroe County numbers that the CDC is using to assign the category of spread:

Case Rate per 100,000 population: 154.95
New COVID-19 admissions per 100,000 population: 13.4
% Staffed inpatient beds in use by patients with confirmed COVID-19: 9.4%

The hospitalization numbers for Monroe County’s region of the state in early April were tiny, but they have continued to creep up. Indiana’s Health District 8, which is made up of 7 counties including Monroe, had a census of 18 COVID-19 patients in mid-May. But that number now stands at 34.

The CDC thresholds for hospitalization are finer-grained than just the current census of patients. They are defined in terms of admissions per 100,000 population and the percent of staffed inpatient beds in use by COVID-19 patients.

Here’s how the CDC classification scheme works: