CAPITAL REGION — Four of the eight Capital Region counties now meet the threshold for precautionary masking set this week by the Centers for Disease Control.
The newest CDC guidelines call for face coverings in enclosed public places in counties with “substantial” or “high” transmission risk, as judged by the number of infections or percentage of positive tests in the past seven days, whichever is worse.
In the Capital Region, Greene, Rensselaer, Saratoga and Schenectady counties are “substantial”; Albany, Columbia, Warren and Washington counties are “moderate.”
While the number of new COVID infections is still small in the eight county region — 109 confirmed Thursday among 1 million-plus residents — its positive rate is the highest in the state and has been rising almost daily since July 4.
Meanwhile, some counties have begun to publicize another metric: breakthrough infections, which are new COVID-19 infections in people who were fully vaccinated more than 14 days earlier.
Saratoga County has the highest positive test rate in the state as averaged over the past seven days, and 45% of the new infections in that period have been breakthrough infections.
As of Friday, 82 known, active infections in Saratoga County affect fully vaccinated people and 125 affect those not fully vaccinated.
Interim Schenectady County Public Health Director Keith Brown, commenting Friday shortly after the CDC moved the county from moderate to substantial risk, said it’s a continuation of an upward infection trend the Public Health Department has been tracking and is prepared for.
The Public Health Services staff had already begun masking when two or more people were in the same indoor space, and will now discuss the message it will broadcast to county residents.
The CDC issued guidance, not a directive — no one who’s vaccinated is obliged to mask up at this point.
Saratoga County on Thursday announced formation of the Saratoga Health and Readiness Planning Task Force for the purpose of deciding how to respond to state and federal COVID guidance, and to the increasing level of infection in the county.
The announcement specifically cast doubt on directives and mandates as a public health strategy, however, and said the task force would focus on educating the public so it could make its own decisions.
Greene County also avoided any directives, but made a public request in a Facebook post Wednesday: “We ask everyone to please wear a mask in public indoor settings to help prevent the spread, whether you are vaccinated or not.”
Greene County was the first in the region to be ranked a “substantial” risk; outside the Capital Region, the other counties are all in the Hudson Valley and downstate.
Brown said school districts are still awaiting state and federal guidance on how to operate in the coming school year. Indications at the end of July point to in-person instruction of masked students in grades K-12, he said, and extensive evidence shows that this can be done safely with a multilayer strategy of precautions.
The phenomenon of breakthrough infections is neither new nor unexpected.
From the outset, the vaccines were known to be less than 100% effective at preventing new infections, though so far they have proved extremely effective at preventing serious infections or death. Most COVID infections in vaccinated people appear to be milder on average than those in non-vaccinated people.
What may be new is the rise in numbers.
Nearly half of all recorded breakthrough infections in Saratoga County have come in the last seven days, the county’s online dashboard indicates.
The rise comes as the earliest vaccine recipients hit the six-month mark after their shots; There has been some indication the vaccine will gradually become less effective without a booster. (Israel on Thursday authorized a third-shot booster for its older citizens.)
Neither the Centers for Disease Control nor the state Department of Health maintain a running tally of breakthrough cases in the extensive collections of COVID data they make public.
Greene County reported Wednesday that 13 of 70 new infections confirmed since June 1 have been in fully vaccinated people and two in partially vaccinated people.
Warren County reported three of the 15 new infections Wednesday and Thursday were breakthrough cases.
Washington County on Friday reported two out of 14.
Schenectady County can cross-reference new infections against the state vaccination database and tally the breakthrough cases, Brown said, though he couldn’t immediately generate the data on Friday.
He’s worried that the apparent increase in breakthrough infections will fuel the anti-vaccine sentiment a significant portion of the population harbors.
“We’re in a strange information struggle here: Any piece of information immediately gets filtered through people’s beliefs about the vaccine,” Brown said.
“Getting vaccinated is not about putting a wall up around you,” he added, it’s about adding the best protection available against a disease blamed for the death of more than 600,000 Americans.
With a sustained public campaign that has vaccinated people both in masses and in ones or twos, Schenectady County Public Health Services has helped get at least one dose into 82.3% of the county’s adult population, a rate second only to Nassau County (82.4%) in New York.
As of midday Friday, 99,889 of the county’s roughly 155,000 residents were fully vaccinated, a rate well above the state and national rates.
Brown said Public Health Services is seeing more of the holdouts come in for vaccination now, worried about the delta variant, which the CDC said Friday spreads as easily as chickenpox.
More from The Daily Gazette: