If we need a booster dose, does that mean that vaccines aren't working? 

Why the move to CDC COVID-19 Community Levels?

The COVID-19 Community Levels (CCLs) combine metrics of COVID-19 hospital admissions and hospital capacity with case data to identify when a community is facing a low, medium, or high level of risk from COVID-19.

Prior to the establishment of the CCLs, public health utilized the Community Transmission Levels. The Transmission levels were based on percent positivity rates and case rates; this alone did not provide a specific metric related to severity of illness. The Community Levels, however, were designed using modeling from past COVID-19 case surges to better factor in the impact observed on healthcare capacity and hospitalization. This shift better aligns with primary pandemic goals of protecting healthcare infrastructure and ensuring the system does not become overwhelmed.

Note: the CDC continues to provide community transmission level data. However, this is only provided for use by healthcare systems, skilled nursing facilities and agencies, as required by CMS to support decision making and infection prevention practice guidelines – and not intended for broader public decision making and action.

What period of data do the community levels look at?

• At this time, the CDC calculates the CCLs on Wednesdays, the time windows used each week:
  • Hospital data will be from Tuesday of the previous week to Monday of the week the CCLs are published.
  • Case data will be from Wednesday of the previous week to Tuesday of the week the CCLs are published.

What factors should be considered when making decisions about prevention methods to reduce COVID-19 impact in local communities?

COVID-19 Community Levels can inform local COVID-19 response efforts but are intended to be paired and considered with other local data and context. When making decisions about prevention methods to reduce COVID-19’s impact in their communities, public health officials should consider local factors and data sources, including:

• COVID-19 Community Levels and underlying indicators,
• other surveillance information (wastewater, ED surveillance, LTC facility data, etc.),
• vaccination coverage,
• capacity for detecting new cases and novel variants (e.g., testing capacity), and
• health equity & local populations at risk for severe disease.

Community members and non-healthcare organizations should follow recommendations from local public health officials and agencies as these recommendations will be based off multiple factors, as previously outlined.

Additional Resources:

• COVID-19 Community Levels: https://www.cdc.gov/coronavirus/2019-ncov/science/community-levels.html  
• Science Brief: Indicators for Monitoring COVID-19 Community Levels and Making Public Health Recommendations: https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/indicators-monitoring-community-levels.html  
• Scientific Rationale Technical Brief (slide deck): https://www.cdc.gov/coronavirus/2019-ncov/downloads/science/Scientific-Rationale-summary_COVID-19-Community-Levels_2022.02.23.pptx  
• County Check Tool: https://www.cdc.gov/coronavirus/2019-ncov/your-health/covid-by-county.html  

Contact tracing has been used for decades by state and local health departments to slow or stop the spread of infectious diseases.

Contact tracing slows the spread of COVID-19 by

• Letting people know they may have been exposed to COVID-19 and should monitor their health for signs and symptoms of COVID-19
• Helping people who may have been exposed to COVID-19 get tested
• Asking people to self-isolate if they have COVID-19 or self-quarantine if they are a close contact of someone with COVID-19

COVID-19 is a disease caused by a virus called SARS-CoV-2. Most people with COVID-19 have mild symptoms, but some people can become severely ill. Although most people with COVID-19 get better within weeks of illness, some people experience post-COVID conditions. Post-COVID conditions are a wide range of new, returning, or ongoing health problems people can experience more than four weeks after first being infected with the virus that causes COVID-19. Older people and those who have certain underlying medical conditions are more likely to get severely ill from COVID-19. Vaccines against COVID-19 are safe and effective.

All individuals, regardless of vaccination status, should also wear a mask during isolation and quarantine periods to stop further community spread of COVID-19.

When to Wear a Mask During the Post-Surge Recovery Phase 
Individuals should still practice masking in high-risk congregate settings, such as long-term care and health care facilities, jails, correctional facilities, and shelters. 

All individuals, regardless of vaccination status, should wear a mask during isolation and quarantine periods. Learn more about isolation and quarantine periods. This is an important step to protect family, friends, and neighbors and stop further community spread of COVID-19. 

There may be local masking guidance, policies and/or orders from local health departments, organizations, and/or school districts that must be followed. Policies established by event organizers and businesses may be instituted to fit the specific needs of their customers and should be followed. 

Making Personal Decisions About Mask Use for Those Not In The Above Categories 
Masks are an important tool in mitigating spread of COVID-19 and individuals who feel sick, may be at higher risk of infection, or who feel better protected when masked should choose when they feel comfortable masking. 

Michiganders should consider their individual and family members’ risk factors and vaccination status when making the personal decision of whether to mask. Those with chronic illness or who are immunocompromised are at higher risk for poor outcomes from COVID and would benefit most from masking in indoor settings. These risk factors may include age, medical conditions, and vaccination status. The use of a well-fitting mask provides benefits and protection to both the wearer and to those in close 
contact to the wearer. Masks help reduce inhalation of potential virus droplets for the wearer (filtration) as well as to decrease the possibility of transmission of virus to those close by the wearer (source control). 

Mask Use During Future Phases 
Recommendations regarding masking may change as conditions evolve – such changes could include the presence of a new variant that increases the risk to the public, or an increased number of cases that strains the healthcare system. During future times of surge, additional access to testing resources, vaccination clinics, and therapeutic treatment may be made available as the situation warrants.

MI Safe Start Map
CDC COVID Data Tracker
Calhoun County COVID Dashboard
Local School Guidance

What is the difference between isolation and quarantine?

Isolation and quarantine help protect the public by preventing exposure to people who have or may have a contagious disease.

• Isolation separates sick people with a contagious disease from people who are not sick.
• Quarantine separates and restricts the movement of people who were exposed to a contagious disease to see if they become sick.

Learn more here.

Why do vaccinated children not have to quarantine when exposed if they can still get sick and transmit the virus?

The data show that those who are vaccinated are much less likely to get sick with COVID-19. In instances of a breakthrough infection, including individuals infected with the Delta variant, those who are both vaccinated and unvaccinated can still transmit the virus. Like other variants, the amount of virus produced by Delta breakthrough infections in fully vaccinated people goes down faster than infections in unvaccinated people. This means fully vaccinated people are likely infectious for less time than unvaccinated people.

**Any fully vaccinated person who experiences symptoms consistent with COVID-19 should isolate themselves from others , be clinically evaluated for COVID-19, and tested for SARS-CoV-2 if indicated. The symptomatic fully vaccinated person should inform their healthcare provider of their vaccination status at the time of presentation to care.

Learn more here.

Protect yourself and those around you:

• The CCPHD recommends that everyone 5 years and older get their primary series of COVID-19 vaccines, and receive a booster dose when eligible.
• Keep physical distance of at least 6 feet from others, even if they don’t appear to be sick. Avoid crowds and close contact.
• Wear a properly fitted mask when physical distancing is not possible and in poorly ventilated settings.
• Clean your hands frequently with alcohol-based hand rub or soap and water.
• Find a COVID-19 vaccine or booster: Search vaccines.gov, text your ZIP code to 438829, or call 1-800-232-0233 to find locations near you. Or visit calhouncountymi.gov/covidvaccine to schedule an appointment with the health department.

How does the virus spread?
COVID-19 spreads when an infected person breathes out droplets and very small particles that contain the virus. These droplets and particles can be breathed in by other people or land on their eyes, noses, or mouth. In some circumstances, they may contaminate surfaces they touch. People who are closer than 6 feet from the infected person are most likely to get infected.

COVID-19 is spread in three main ways:

• Breathing in air when close to an infected person who is exhaling small droplets and particles that contain the virus.
• Having these small droplets and particles that contain virus land on the eyes, nose, or mouth, especially through splashes and sprays like a cough or sneeze.
• Touching eyes, nose, or mouth with hands that have the virus on them.

For more information about how COVID-19 spreads, visit the How COVID-19 Spreads page to learn how COVID-19 spreads and how to protect yourself. 


What is community spread?
Community spread means people have been infected with the virus in an area, including some who are not sure how or where they became infected. Each health department determines community spread differently based on local conditions.

People with COVID-19 have reported a wide range of symptoms – from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. If you have fever, cough, or other symptoms, you might have COVID-19.

Are rapid tests one of the tests used to positively identify those with COVID-19? I heard that the rapid tests are highly inaccurate and unable to differentiate between the flu and COVID-19.

While molecular tests (PCR tests) remain the gold standard when identifying COVID-19 cases, rapid tests (antigen tests) are FDA authorized and remain an important tool in augmenting testing efforts, especially in settings where molecular testing is limited or testing results are delayed. Depending on the symptoms present in the patient and knowledge of a recent exposure, a confirmatory PCR may be administered within 48 hours after a rapid test is done.

Furthermore, the sensitivity of antigen tests varies but is generally lower than most laboratory-based molecular tests. A highly sensitive test means that there are few false negative results, and thus fewer cases of disease are missed. The specificity of a test is its ability to designate an individual who does not have a disease as negative. The antigen level in specimens collected either before symptom onset, or late in the course of infection, may be below the tests’ limit of detection. This may result in a negative antigen test result, while a more sensitive test, such as most molecular tests, may return a positive result. Studies have shown that antigen tests have comparable sensitivity to laboratory-based molecular tests when viral load in the specimen is high and the person is likely to be most contagious. What this means is that the antigen tests are most likely to result in a FALSE negative test when the person is actually positive, especially when there is a high probability of the person having that disease (like during a High level of community transmission).

The specificity of antigen tests is generally as high as most molecular tests, which means that false positive test results are unlikely when an antigen test is used according to the manufacturer’s instructions. Despite the high specificity of antigen tests, false positive results will occur, especially when used in communities where the prevalence of infection is low – a circumstance that is true for all in vitro diagnostic tests. In general, for all diagnostic tests, the lower the prevalence of infection in the community, the higher the proportion of false positive test results.

Finally, rapid COVID-19 tests can distinguish between the COVID-19 virus and the flu.

Learn more here.

If you get COVID-19, is ivermectin or hydroxychloquine an approved treatment?

Neither Ivermectin or Hydroxychloquine are FDA approved treatments for COVID-19.

For context, ivermectin is a medication used to treat onchocerciasis (river blindness) and intestinal strongyloidiasis. Topical formulations are used to treat head lice and rosacea. ivermectin is also used in veterinary applications to prevent or treat internal and external parasitic infections in animals. When used in appropriate doses for approved indications, ivermectin is generally well tolerated. During the COVID-19 pandemic, ivermectin dispensing by retail pharmacies has increased, as has use of veterinary formulations available over the counter but not intended for human use. FDA has cautioned about the potential risks of use for prevention or treatment of COVID-19.

Hydroxychloroquine is used to treat autoimmune diseases, such as systemic lupus erythematosus and rheumatoid arthritis, in addition to malaria. On July 8 2021, The National Institutes of Health (NIH) COVID-19 Treatment Guidelines Panel recommended against the use of hydroxychloroquine for the treatment of COVID-19 in hospitalized and nonhospitalized patients.

What is monoclonal antibody therapy and who is eligible to receive it?

Monoclonal antibodies are laboratory-made proteins that mimic the immune system's ability to fight off harmful pathogens such as viruses.
The therapy is available upon request from a physician and must be administered within 10 days after a COVID-19 diagnosis. The drug is the most effective when it is administered early in the infection. Those who test positive for COVID-19 should contact their primary care doctor as soon as possible to ask about the medication.

Learn more here.

If someone who is vaccinated can pass, carry, and show symptoms, what is the point of getting the shot?

From the CDC’s discussion of vaccine breakthroughs, COVID-19 vaccines protect people against severe illness, including disease caused by Delta and other variants circulating in the U.S.

• COVID-19 vaccines protect people from getting infected and severely ill, and significantly reduce the likelihood of hospitalization and death.

• The best way to slow the spread of COVID-19 and to prevent infection by Delta or other variants is to get vaccinated.

• For people who are vaccinated and still get infected (i.e., “breakthrough infections”), there is a risk of transmission to others. That is why, if you are vaccinated or unvaccinated and live or work in an area with substantial or high transmission of COVID-19, you – as well as your family and community – will be better protected if you wear a mask when you are in indoor public places.

• People who are immunocompromised may not always build adequate levels of protection after an initial 2-dose primary mRNA COVID-19 vaccine series. They should continue to take all precautions recommended for unvaccinated people, until advised otherwise by their healthcare provider. Further, CDC recommends that moderately to severely immunocompromised people receive an additional dose.

Is it safe for me to get a COVID-19 vaccine if I would like to have a baby one day?

Yes. COVID-19 vaccination is recommended for everyone 5 years of age and older, including people who are trying to get pregnant now or might become pregnant in the future, as well as their partners. Currently, there is no evidence that any vaccines, including COVID-19 vaccines, cause infertility problems in women or men.

Learn more here.

Why should I trust that the vaccine is safe when it was developed so quickly?

FDA approves a vaccine for use only if it is proven safe and effective, after clinical trials have been conducted with thousands of people, and when its benefits outweigh any risks. The COVID-19 vaccine builds on years of scientific research and an unprecedented level of scientific investment and cooperation. Every study and every phase of every trial was carefully reviewed and approved by a safety board and the FDA. The process was transparent and rigorous throughout, with continual oversight and expert approval.

The identification of what is approximately a less than 2-in-a-million risk of a blood clotting disorder associated with the Johnson & Johnson vaccine is a sign that the nation’s safety monitoring system for COVID-19 vaccines is working. After any vaccine is successful in clinical trials and authorizes it for use, the FDA continues to monitor it for safety. The pause in the use of the J&J vaccine allowed scientists to evaluate each incident of the clotting disorder. They determined that the level of risk was very low and that the benefits of continued use of the J&J vaccine greatly outweigh any risk associated with it.

The likelihood of a medically significant reaction is extremely low. Temporary side effects like soreness, headaches, or a mild fever are signs that the body is responding and building an immunity to the virus. They typically go away in a day or two.

Learn more here.

How can I be sure the long-term side effects of the vaccine won’t be worse than having COVID-19?

The threat of COVID-19 is real and urgent, and the benefits of getting vaccinated far outweigh any risks. The risk of severe adverse events after any COVID-19 vaccination remains very low, and far lower than the risk of adverse health outcomes associated with contracting COVID-19. More than 600,000 people in the U.S. and millions worldwide have died from COVID, and we’re still learning about “long COVID” — symptoms and adverse health outcomes that continue to impact people long after the initial infection.

Learn more here.

What does it mean that the Pfizer vaccine has full FDA approval?

On August 23rd, the FDA issued full approval to the Pfizer COVID-19 vaccine, now known as Comirnaty. The vaccine has been fully approved for use in individuals age 16 and older, with a two-dose regimen spaced at least three weeks apart. The full approval by the FDA means that the Comirnaty vaccine now has the same level of approval as other vaccines routinely in use in the U.S., such as vaccines for hepatitis, measles, chicken pox, and polio.

On top of the rigorous testing and trials that went into Emergency Use Authorization of the Pfizer vaccine, the FDA analyzed additional and follow-up data from the ongoing clinical trial to determine the safety and effectiveness of Comirnaty, including:

• The analysis of effectiveness data from approximately 20,000 vaccine recipients and 20,000 placebo recipients age 16 and older, which found that overall, the vaccine was 91% effective, with 77 cases of COVID-19 occurring in the vaccine group and 833 COVID-19 cases in the placebo group.

• The analysis of safety data in approximately 22,000 vaccine recipients and 22,000 placebo recipients age 16 and older. More than half of participants were followed to monitor safety for at least four months after the second dose; approximately 12,000 vaccine recipients have been followed for at least 6 months.

• Rigorous evaluation of safety surveillance data regarding myocarditis and pericarditis. Data demonstrated an increased risk for vaccine recipients, which was higher in males under 40, particularly males 12-17. Comirnaty prescribing information will include information about this risk, and in addition to these analyses, the FDA is requiring the company to conduct postmarketing studies to further assess the risks of myocarditis and pericarditis in vaccinated individuals. It is important to note that reports of these complications are rare, and most patients who received care responded well to treatment.

The vaccine also continues to be available for adolescents age 12 through 15 and for the administration of a third dose to specific populations.

Learn more here.

What is the difference between emergency use authorization and full approval?

Emergency Use Authorization (EUA) allows the FDA to authorize the use of yet to be approved drugs, or unapproved uses of approved drugs, for life-threatening conditions when there are no other adequate, approved, and available options and other conditions are met. In the case of COVID-19, the FDA issued EUAs for the Pfizer, Moderna, and Johnson & Johnson vaccines, and has now issued full approval for the Pfizer COVID-19 vaccine, now known as Comirnaty.

In an emergency when lives are at risk, like a pandemic, it may not be possible to have all the evidence that the FDA would usually have before approving a vaccine or drug. If there’s evidence that strongly suggests that patients have benefited from a treatment, the agency can issue an EUA to make it available. For the COVID-19 vaccines, FDA required two months of safety and efficacy data before the EUA was granted. That included clinical trials with tens of thousands of people and rigorous testing and review, and all the vaccines continue to be closely monitored. Compared to emergency use authorization, FDA approval of vaccines requires even more data on safety, manufacturing, and effectiveness over longer periods of time and includes real-world data.

Learn more here.

What is the Omicron variant? 

Omicron is a new variant of the virus that causes COVID-19. The Omicron variant has been detected in all 50 of the United States. 

Are the vaccines effective against the variant?