With "Community Levels" The CDC Admits COVID-19 Is Endemic

While much of the reporting of today's CDC announcement on masking guidelines focused on the changing criteria for universal masking, another equally important change is taking place: moving away from the “testing, testing, testing” mantra in favor of a surveillance system based on hospital burden.

The federal agency now says nearly three-quarters of Americans don’t need to wear masks because they live in areas with low or medium community risk from COVID-19.

The dramatic switch comes because the CDC switched from only using COVID-19 cases as a factor and are taking into account other metrics, including hospitalizations.

“This updated approach focuses on directing our prevention efforts toward protecting people at high risk for severe ailments and preventing hospitals and healthcare systems from being overwhelmed,” Dr. Rochelle Walensky, the CDC’s director, told reporters on a call.

The new guidelines are called the COVID-19 Community Levels, and call explicitly for a shift to a surveillance system, using hospitalizations and burdens on local healthcare systems (e.g., ER/ED visits) as well as environmental surveillance.

Health officials and individuals should consider current information about COVID-19 hospitalizations in the community, as well as the potential for strain on the local health system and COVID-19 cases in the community, when making decisions about community prevention strategies and individual behaviors. Communities and individuals should also make decisions based on whether they are at high risk for severe disease and take into account inequities in access to prevention strategies.

COVID-19 Community Levels can help communities and individuals make decisions based on their local context and their unique needs. Community vaccination coverage and other local information, like early alerts from surveillance, such as through wastewater or the number of emergency department visits for COVID-19, when available, can also inform decision making for health officials and individuals.

Fitting in with CDC Director Rochelle Walensky's comments in December about the accuracy of PCR testing, the CDC guidelines also mark a further shift towards the traditional definition of an infectious disease “case".

Follow CDC recommendations for isolation and quarantine, including getting tested if you are exposed to COVID-19 or have symptoms of COVID-19

Focusing testing on symptomatic patients moves the COVID-19 testing paradigm towards that which has been in place for seasonal influenza for years. It also by implication sends Anthony “the science” Fauci's “Five Stages Of A Pandemic” to the trashcan, where they belong.

Ms. Walensky does not come right out and say it but the CDC has effectively declared the “endemic phase” of COVID-19 to have arrived.