COVID-19 Community Levels

I know that most people have grown weary of the pandemic (as have I), but it’s been a while since I wrote about COVID-19. The Centers for Disease Control and Prevention (CDC) created a framework for making public health decisions based on COVID-19 hospitalization and inpatient beds occupied by patients with COVID-19.

The COVID-19 Community Levels framework is described here. It describes the community level framework (pictured above) and includes a COVID-19 County Check where users can enter their state and county to determine if their community level is Low, Medium, or High. For each community level, it describes recommended individual and household-level prevention behaviors including vaccination, masking, testing, quarantine, and other preventive methods. Also for each level, it describes community-level prevention strategies including improving indoor ventilation, providing access to testing and screening, supporting healthcare during surges, and other methods.

A CDC scientific brief is provided here. It summarizes the scientific evidence that was used to inform the CDC recommendations. Finally, a technical presentation is available in .pptx and .pdf format. Key points include:

• Vaccination is the leading public health prevention strategy to prevent severe disease and deaths from COVID-19
• People who are up to date on vaccines have much lower risk of severe illness and death from COVID-19 compared with unvaccinated people
• When making decisions about individual preventive behaviors and community prevention strategies in addition to vaccination, people and health officials should consider the COVID-19 community level
• Health departments should consider health equity, and make use of other surveillance information (wastewater, ED surveillance, etc.), if available, to inform local decisions
• Layered prevention strategies — like staying up to date on vaccines and wearing masks — can help prevent severe disease and reduce strain on the healthcare system

To illustrate how the COVID-19 Community Level is applied to an actual county, see the Los Angeles County department of Public Health press release which categorizes the county at a Medium community level as of June 24, 2022 and describes what would happen in the event that the county crosses the threshold into High community level.

Public health recommendations seem confusing to many people because they change. As difficult as it may seem to follow the changing recommendations, it is necessary to continue to modify guidance as the pandemic evolves. I hope that by shedding light on the CDC COVID-19 Community Levels framework, it will be easier to understand the rationale for our evolving public health guidance.