Confirmed cases of COVID-19 in Wisconsin have been easing in the two weeks since Thanksgiving. But state health officials worry that the coronavirus isn’t in retreat — just hiding.
On the surface, the number of newly recorded cases every day suggests that a much-feared Thanksgiving surge — brought on by larger gatherings that increase the risk of transmitting the virus — didn’t happen.
In theory, that could show that state residents heeded the pleas of public health professionals in the weeks leading up to the holiday to stay home and keep the feast to their immediate household.
But Wisconsin’s top health official, Secretary-designee Andrea Palm of the Department of Health Services (DHS), said Thursday it’s still too soon to make that assumption — because too few people are getting tested.
The state’s COVID-19 database added 4,034 new cases Thursday, bringing the total number to 426,099. The daily average for the last seven days was 3,770 new cases.
“And that is lower than it was a month ago,” Palm told reporters during a media briefing. “But our testing numbers are also down. And that is concerning.”
Palm said she would like to hope the lower numbers reflect a decline in the actual number of people getting infected. Yet 28% of the people tested over the last seven days had a positive test.
From that high positive-test rate, “We know we are not testing enough people to get an accurate picture of the virus here in Wisconsin,” Palm said.
And that’s why public health practitioners aren’t ready to declare victory in the effort to persuade people to avoid larger holiday gatherings.
“We think that part of what’s contributing to not seeing an additional spike is that we, maybe, are not having as many people getting tested as we’d like to see,” said Tracy DeSalvo, acting director of the DHS Bureau of Communicable Diseases.
False sense of safety
Palm said that while Wisconsin residents “do take COVID-19 seriously,” nationwide many people still traveled over Thanksgiving. Even as people “are all working to do everything we can … there is also some false sense of safety within our bubbles,” she added. “Everyone thinks that their bubble is safe, that the folks they know, the folks they are closest to, are safe.”
But between Wisconsin’s continued intense community spread and the findings that, as often as half the time, the virus is transmitted by people who don’t have symptoms, “We need to do more things to be safer, because we’re still seeing considerable transmission,” Palm said.
When people who have no symptoms and are unaware that they have the virus spread it “it’s not like people are doing it on purpose,” she added. “I think this asymptomatic thing — if you can’t see it, it must not be happening — gives us all a false sense of the disease.”
Why fewer people are seeking tests isn’t clear.
“We’re all sort of scratching our heads about it,” Palm said at Tuesday’s COVID-19 briefing. At the same session, DeSalvo observed that when the state first topped an average of 1,000 cases a day last summer, that “seemed very high.” While the current number of new cases a day may be lower, “it is still a very large number of cases.”
Even as the daily case numbers have eased, however, COVID-19 deaths have remained sharply higher — reaching 3,944, with 57 new deaths recorded Thursday. There were 81 on Wednesday and 68 on Tuesday. As of Thursday, the average number of deaths recorded per day over the previous seven days was 55.
Positive test numbers are newly detected cases, while deaths are a lagging indicator. During the virus’ 14-day incubation period, many who get it don’t show symptoms, while others not only get symptoms but go on to get sick enough to go to the hospital — or to die.
“The deaths that we are seeing now — that continued, high level on a daily basis — are the result of infections that happened previously,” Palm said Thursday. Looking back at the record numbers of cases in mid-November, “a lot of those new daily cases are now what you are seeing in our death numbers.”
In the coming weeks, death numbers may help show whether or not the current rate of positive tests is artificially low because more people aren’t getting tested. If the number of confirmed cases continues to stay at or below current levels, Palm said, public health providers would hope to see the daily number of deaths decline as well.
Message: Stay safe, get tested if you need it
With the ambiguity in what current COVID-19 numbers really mean, the surest way to combat the virus remains the combination of staying home as much as possible, washing hands frequently, wearing a mask in public — and, for those who should get a test, getting a test.
“Testing is a key tool to box in the virus, because it informs our decisions,” Palm said Thursday. “If you know that you’re infected, and you do not interact with other people, you help prevent transmission and that stops the spread.”
Get tested, and then follow up on the results, she said.
“If you’ve been exposed to COVID-19, get tested. If you have symptoms of COVID-19, get tested,” Palm said. “Please quarantine while you wait for your results. If you test positive, be sure to notify your contacts and limit your contact with other people in your household to try to prevent transmitting the virus further. If you test negative, please keep staying home and monitor your symptoms.”
Early in the COVID-19 pandemic, lab and testing resources were scarce. No more.
“We have a strong network of labs here in Wisconsin and the capacity to process tests is almost 60,000 per day,” Palm said. “Our lab capacity is only helpful if we use it. So please get a test.