In the last weeks of 2022, many counties crossed the Centers for Disease Control and Prevention (CDC) threshold from low and medium risk to high risk, triggering a return to mask mandates, particularly in educational settings. The goal of any standardized risk framework, such as the CDC “community risk levels” is to compare “apples-to-apples.” However, as has so often been the case throughout the pandemic, different state and local policies mean that the current COVID-19 county risk framework is comparing apples to oranges — and these faulty comparisons are impacting local policy responses and recommendations.
In February 2022, the CDC released its updated — and controversial — risk classification scheme for evaluating community COVID-19 burden. Updated weekly, the CDC’s “community risk level” map categorizes each county in the U.S. as “low risk” (green), “medium risk” (yellow) or “high risk” (red). These categories are associated with different public health recommendations; most notably about when to wear masks. According to this guidance, when a county is at low risk masks are not recommended, at medium risk masks are recommended for those at high risk of severe COVID-19, and during high-risk periods masks are universally recommended in indoor spaces. Unlike its prior risk-level map, the now one-year-old approach takes into account not only the number of new COVID-19 cases per capita but also new admissions to the hospital and the percent of inpatient beds occupied by COVID-19.
Today, it is well known that among those patients classified as “COVID hospitalizations,” some are admitted “for COVID” (as a result of COVID-19) and some “with COVID” (for other reasons but with a positive COVID-19 test). Only in Massachusetts has there been an attempt to quantify this. Since January 2022, every hospital in the state has been reporting the number of patients hospitalized with COVID-19 who have and have not received the drug dex …