The pandemic isn’t over, Idaho. This is what COVID looks like here, today.

Wastewater, COVID cases, hospitalizations — they’re all changing

By: - June 3, 2022 4:26 am
Nurses memorial in Washington, D.C.

In this file photo, nurses affiliated with the group National Nurses United read the names of registered nurses who died during the coronavirus pandemic while demonstrating in May 12, 2021, in Washington, D.C. The group placed a pair of shoes “for every RN who has died during this pandemic due to a lack of employer and federal government action to protect nurses and other health care workers from getting infected with COVID-19 at work.” (Win McNamee/Getty Images)

The World Health Organization declared a pandemic on March 11, 2020. The coronavirus had spread to at least 114 countries by then, and — though nobody knew it at the time — was already in Idaho.

“Pandemic is not a word to use lightly or carelessly. It is a word that, if misused, can cause unreasonable fear, or unjustified acceptance that the fight is over, leading to unnecessary suffering and death,” WHO Director-General Tedros Adhanom Ghebreyesus said in prepared remarks that day.

That was 814 days ago, and the WHO has yet to declare the pandemic over. But daily life in Idaho and much of the U.S. has resumed a kind of pre-pandemic status quo. The U.S. Centers for Disease Control and Prevention shifted its focus away from trying to keep people from catching COVID-19, toward keeping hospitals from being crushed by the disease.

But as new varieties of the omicron variant spread, Idaho heads into summer with a growing number of reported and unreported COVID-19 cases.

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How many new cases of COVID-19 does Idaho have?

New cases COVID-19 are on the rise, according to numbers reported by the Idaho Department of Health and Welfare’s Division of Public Health. The good news: That rise starts from a very low point, because the original omicron variant burned through Idaho over the winter. The bad news: Those numbers are probably a drastic undercount of cases.

Officially reported COVID-19 cases have always been a somewhat unreliable indicator of how much virus is spreading in Idaho. Some people didn’t have symptoms. Some chose not to get tested. Some people couldn’t get tested. And, according to previous Idaho Capital Sun reporting, some patients’ tests may have been reported as negative when they were actually positive.

But this year, two more factors could suppress the number of cases reported to public health officials:

  1. Home testing kits are widely available for purchase, and the federal government just opened another round of free test kit deliveries to households through the U.S. Postal Service. (The rapid antigen tests may be less effective at detecting the virus, especially with new variants circulating, according to research studies. Lab tests, conducted by health care providers or through a pharmacy or clinic, are considered the gold standard.)
  2. Congress has failed to reauthorize federal funding to support COVID-19 testing for people who lack health insurance. It is unclear what effect this had on testing for Idahoans. But if history is a guide, it has an effect. The program covered more than $22.5 million of COVID-19 tests for uninsured Idahoans before Congress allowed it to expire.

So, what are Idaho’s leading indicators for COVID, then?

Wastewater, test positivity rates and federal reports are three ways to keep tabs on the pandemic in Idaho. They each have their pros and cons.

What test positivity and wastewater say about COVID in Idaho

When more than 5% of COVID-19 tests — those officially reported to public health agencies — are positive, that means the COVID-19 virus is spreading unchecked in a community.

Idaho’s positivity rate peaked in mid-January at 37.9% as the original omicron variant rampaged through the state. Positivity dropped to record lows this spring, and is now on a steady climb. The Division of Public Health reported Thursday that Idaho’s positivity rate is now 9%, up from 7.2% last week.

The coronavirus infects virtually every organ system throughout the body. That means, when a person has COVID-19, they shed pieces of the virus in their bodily waste — especially stool — and that waste ends up in sewers.

That’s why scientists began to take samples of wastewater and look for traces of the virus in each liter they gathered.

Trends, not daily numbers, are the key. Nobody knows how much coronavirus each person sheds when they’re infected. When wastewater numbers are rising steadily, though, it generally means that more people are getting infected in the community.

There are several wastewater testing sites in Idaho. Two are in Boise, which reports coronavirus levels through a dashboard at cityofboise.org.

Dr. Christopher Ball, who leads the Idaho Bureau of Laboratories, said in a press briefing in March that 18 of 30 community wastewater sites in Idaho had agreed to participate in a statewide wastewater testing program.

Others are displayed on the CDC’s wastewater testing website, but several of the new sites have limited data, and even long-standing sites in Ada and Latah counties don’t always show up with recent data on the CDC map.

The testing company Biobot Analytics Inc., which has a nationwide testing program, shows recent data for both Ada and Latah counties on its website, biobot.io/data. The current levels in both counties are at peaks that rival the last big surge, according to Biobot.

Haley Falconer, the city’s environmental division manager, told Boise State Public Radio in December that, watching the COVID-19 presence in wastewater during the pandemic, there was “about a five-to-seven day leading indicator from an increase in viral load in the wastewater to an increase in clinical cases.”

Colin Hickman, communications senior manager for the city of Boise, told the Idaho Capital Sun that the city delivers wastewater samples to a laboratory at Boise State University three times a week — Monday, Wednesday and Friday — except for federal holidays.

“We get data either that same day or up to 1-2 days later if the lab does not have the capacity to test samples” due to limited staff, Hickman said in an email.

The city’s COVID-19 wastewater dashboard automatically updates at noon every day, Hickman said.

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The CDC’s mixed message on COVID in communities

This year, the CDC shifted its public message on COVID-19 risks — creating two sets of guidelines and maps.

Map showing community transmission levels according to the CDC
A map created by the CDC shows COVID-19 transmission levels in Idaho for the final week of May 2022. (Courtesy of the Centers for Disease Control and Prevention)

One set shows how much COVID-19 is spreading in a community. Those “community transmission” levels, which reflect how much virus is spreading in the community, were previously used to set guidelines for the general public. The CDC now says they’re meant for health care organizations. The corresponding map of Idaho on June 2 showed the state almost entirely at “high” transmission levels. Several counties had “moderate” or “substantial” transmission rates, but only Idaho’s most sparsely populated counties were at a “low” level.

Map showing community levels for COVID-19 according to the CDC
The CDC based these community levels on new COVID-19 cases per capita, COVID-19 hospital admissions per capita and percent of hospital inpatient beds occupied by COVID-19 patients. (Courtesy of the Centers for Disease Control and Prevention)

The CDC built a new set of “community level” guidelines and maps for the general public. It is based on how much of a burden COVID-19 is putting on the community as a whole — how many hospital beds are taken by COVID-19 patients, for example. The corresponding map of Idaho on June 2 was almost entirely green, at a “low” community level, with “medium” and “high” levels emerging in the Southwest. Adams and Payette counties were at the yellow “medium” level. Washington County reached the red “high” level.

The CDC still published status reports on a daily and weekly basis, though, that can provide more insight into what is happening in Idaho.

The CDC’s Community Profile Report gives an update on COVID-19 across the country, every week day. The report’s maps for June 1 show rapid rises in cases in the Treasure Valley and part of North Idaho, with a “sustained hotspot” in the Treasure Valley, but nowhere else in Idaho as of May 31. That makes it a community with “a high sustained case burden” that may be at risk of straining their health care resources, the CDC says.

Many Idaho counties have high, and rising, rates of test positivity. Almost all counties also saw an uptick in COVID-19 hospitalizations. Nowhere in Idaho does COVID-19 take up more than 15% of ICU capacity, and deaths remain low, the maps show.

The CDC also publishes a weekly report by state. Idaho’s report for May 27 showed cases per capita rising 30% from the prior week; positivity rate up to 11.5% from 9.8%; and the number of hospital admissions per capita up 43% from the prior week.

A more transmissible subvariant of omicron, BA.2.12.1, is starting to gather steam. It made up a growing share of infections, an estimated 10% of all cases, the report said.

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Audrey Dutton
Audrey Dutton

Audrey Dutton, senior investigative reporter, joined the Idaho Capital Sun after 10 years at the Idaho Statesman. Her favorite topics to cover include health care, business, consumer protection issues and white collar crime. Dutton hails from Twin Falls. She attended college at Hamline University in St. Paul, Minnesota, and received a master's degree in journalism from Columbia University in New York City. Before coming home to Idaho, Dutton worked as a journalist in Minnesota, New York, Maryland and Washington, D.C. Dutton's work has earned dozens of state, regional and national awards for investigative reporting, health care and business reporting, data visualization and more.

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