HANCOCK — COVID cases are at their highest level locally since January.

As of Oct. 18, the case level in Houghton County stood at 381 weekly cases per 100,000, more than triple the level at the start of September.

The same trend can be spotted elsewhere in the Copper Country. Baraga County is at 743.1 cases with a 30.6% positive rate, followed by Keweenaw County (472.8, 22.7% positive tests). Ontonagon County also saw an increase, though less drastic (192.3, 9.7%).

Kate Beer, health officer for the Western Upper Peninsula Health Department, said she’s concerned about what will happen to the COVID rates over the next few months.

“As we move forward with the year here and the colder weather takes place, we’re going to see people congregating a bit more, and the concern there is further spread,” she said.

At the same point last year, Houghton County was at 143 weekly cases per 100,000. That was a lull between peaks in September and December where cases rose to more than 500.

With mitigation measures like mask-wearing or hand-washing less prevalent, the flu — virtually non-existent last year — could also rebound, Beer said.

Some mild flu cases are already popping up. Beer encouraged people to get their flu vaccines early. This fall is also seeing a higher-than-average number of respiratory illness among both children and adults, Beer said.

“It absolutely complicates the situation because people are unsure if their child is symptomatic with COVID or symptomatic for other reasons,” she said. “We are encouraging people to get tested, and to follow up with your primary care physician.”

As cases have shot up, young people are making up a greater share of the infected, Beer said. School-age children account for about 24% of the current cases, double the rate at the start of the school year, Beer said.

“We’ve seen where family members have passed it on to the school-age population, and we’ve also seen where the people that have attended school have passed it along to other classmates or teachers,” she said.

The chance of a severe outcome increases exponentially with age. The Centers for Disease Control and Prevention data from September found compared to 18- to 29-year-olds, 50- to 64-year-olds were four times as likely to be hospitalized from COVID, and 30 times as likely to die; for 85-year-olds, that number rises to 15 times and 570 times more likely, respectively.

Across the Upper Peninsula, 59 adults are hospitalized with COVID, up from 29 in early September.

None of the recent young cases have needed to be hospitalized, Beer said. However, the health department numbers don’t indicate how many may have gone to an emergency room but not needed to be admitted, she said.

Data from the University of Michigan and state health department found COVID transmission rates were 62% higher in August and September K-12 students in schools without mask requirements.

“We would expect that if they’re masking, there would be a lower incidence of transmission,” Beer said.

In the WUPHD’s five-county area, the only students under mask requirements are kindergarten through sixth grade in Bessemer, Beer said.

Kids under 12 aren’t expected to be eligible for vaccination until December or January, Beer said.

The vaccination rate is at about 56.3% across the five-county area. Since the end of August, the overall vaccination numbers have only gone up about 3%, Beer said.

“We really wish those would be a little bit higher going forward,” she said. “The boosters will add another layer of protection, but it’s also another layer of deciding what’s right for each individual.”

The health department is still waiting for guidance on which booster shot will be best for whom, and what the dosage will be. The expectation is that the booster shots, and any vaccine doses for children, will be smaller, Beer said.

Boosters for those who are eligible are being given at many of the same venues that provided the original vaccine shots, Beer said. Available sites can be found at coppercountrystrong.com.

Boosters are available for those who received the Pfizer vaccine and are 65 and older, or are 18 and older and have underlying medical conditions or live in high-risk settings. Immunocompromised people can also get boosters for Moderna — the ones primarily used at health clinic sites.

More people could be able to get them soon. A Food and Drug Administration panel is expected to decide on booster shots for Moderna and Johnson & Johnson this week, along with mixing and matching booster shots.

WUPHD staff, like all health care staff, have gotten fatigued as the pandemic has worn on and more people refuse to cooperate with the department, Beer said.

“We find that people are less likely now to report close contacts or to answer our calls and our questionnaires,” Beer said. “So it just makes the process of case investigation and contact tracing difficult and frustrating.”

Beer said the health department would likely move toward more of a focus on education, such as explaining how long people should quarantine. Another reason for that is the uptick in people taking home tests.

Unlike tests from a clinic or a hospital, positive home tests are not formally reported into the system, making it difficult to track those cases or do contact tracing, Beer said. As it is, the seven-day average positive test rate in Houghton County reached 19.5% on Saturday, the highest rate seen during the pandemic.

Many of those who tested positive in home tests have asked the health department for guidance on what they should do next. Beer encourages them to follow up with a PCR test at one of the local testing sites. They should also reach out to anyone who was a close contact — within six feet for more than 15 minutes — during the time they might have infectious. That generally starts two days before symptoms appear, Beer said.

Beer stressed that people who haven’t been feeling well or have recently been in contact with someone with COVID should get tested.

“At a minimum, contact those people you’ve been in close contact with and let them know so they can monitor themselves for symptoms for about 14 days,” she said.