Omicron data gives local leaders lessons for COVID waves to come

For local leaders, the Omicron wave hit so hard and so fast that the question wasn’t whether they could “flatten the curve” of infections so much as “soften the spike.”

The Omicron variant of the virus that causes COVID-19 is so infectious that caseloads shot up quickly to record levels just about everywhere. The resulting surges in hospitalizations and deaths linger on in many cities even as the number of new infections are falling fast. 

But as this Johns Hopkins University analysis exclusive to Bloomberg Cities shows, not all cities experienced Omicron quite the same way. It also suggests that cities that had proactive policies around vaccines and face masks—like those that hundreds of mayors focused on throughout the pandemic as part of the Bloomberg Philanthropies COVID-19 Local Response Initiative—may have seen less severe outcomes.. 

In a sample of 16 cities and counties across the country, we looked at how quickly different communities reached their peak level of infections in the Omicron wave. We also looked at local vaccination rates, as well as whether policies were in place to require people to mask up or show proof of vaccination to enter establishments. 

The trendline is clear: Localities with lower vaccination rates and no policies in place tended to experience the sharpest rise in cases and reach their Omicron peaks the fastest—just 13 days in Indianapolis, for example, or 16 days in Kansas City, Kan. Those with higher vaccination rates and public-health policies in place tended to have a longer runway—30 days in Los Angeles County, or 37 days in Honolulu. 

Those extra days make a difference for public health, and especially for local hospital systems. 

Honolulu and Kansas City make an interesting comparison. Both places saw infection rates locally reach staggering new highs with Omicron. And both cities reached their peak infection levels at almost the same time—January 19 in Kansas City’s case and January 21 in Honolulu’s. 

But the two cities handled the wave much differently. Wyandotte County, with which Kansas City forms a unified government, lifted its mask mandate in mid-December, just as Omicron was picking up steam. By contrast, Honolulu in early January tightened up already stringent public health rules around face coverings and capacity of indoor events. 

The two cities are seeing very different outcomes. By February 11, the percentage of ICU beds used in Wyandotte County was nearly as high as it’s been through the entire pandemic. Meanwhile, ICU usage in Honolulu remained far lower than levels reached during the city’s previous waves. Since January 1, Honolulu has seen about one-third the number of COVID-related deaths as Wyandotte County, on a per-capita basis.

In other words, Honolulu’s protective measures didn’t stop people from getting COVID. But they did protect the health system from getting overwhelmed, and gave local leaders and healthcare facilities time to plan and adapt.

Fortunately, the Omicron wave is now receding. But before we put this latest chapter of the pandemic behind us—and as mask mandates fall in one state after another—there are two lessons local leaders should take away from this. 

One is that protective measures like mask and vaccine mandates work. They’re not forever policies. As mayors heard from experts in the earliest sessions of the Bloomberg Philanthropies COVID-19 Local Response Initiative, protective measures can be dialed up and down as needed. That’s still true today as we prepare for a time when COVID becomes endemic. 

Many local leaders have learned to become quite agile about navigating these kinds of decisions over the past two years by following the science and taking responsible public health measures to protect residents and safeguard health care capacity. And they’ve become well versed at using data to communicate with residents about what is happening in their communities and how they can protect themselves and neighbors. Keep it up!

The other is that to make these sorts of nimble decisions, we have to keep investing in the data systems we’ve built up during the pandemic and using them in new ways. We’re at a crossroads moment in public health, where local leaders and residents alike get it: They’re seeing the power of data to help them make choices in their communities and in their own lives. Imagine if we trained this new capability on opioid abuse, traffic fatalities, or even gun violence.

Unfortunately, many states are going in the opposite direction by reducing the frequency at which they report figures on COVID cases, tests, vaccines, and deaths. Florida now reports most of this data just once a week and has stopped reporting testing data entirely. Local leaders rely on this information to know what’s happening in their communities and make smart decisions. Without good data, they’ll be flying blind if—or perhaps when—the next variant surges into town.

Beth Blauer is the Associate Vice Provost for Public Sector Innovation at Johns Hopkins University.

[Send an email to CoronavirusResponse [at] Bloomberg.org to be alerted for future sessions of the Bloomberg Philanthropies COVID-19 Response Initiative, featuring expert guidance from the Johns Hopkins Bloomberg School of Public Health and the Bloomberg Harvard City Leadership Initiative.]