ALBANY COUNTY — On Monday, as the world entered its third year of dealing with the pandemic, the COVID-19 death count hit the 6 million mark.

According to records kept by Johns Hopkins University, the United States is closing in on a million deaths — with 961,935 confirmed as of Wednesday.

While surges are growing in other places in the world, like New Zealand and Hong Kong, and remote Pacific Islands are just now experiencing their first deaths from the virus, the United States, for the most part, is now defined by the Centers for Disease Control and Prevention as having “low” or “medium” transmission rates.

Scattered counties — with notable concentrations in West Virginia and neighboring portions of Virginia and Kentucky — are labeled as having “high transmission.” New York State currently has no counties defined by the CDC as “high” — and Albany County remains “medium.”

Masks are not required in counties labeled “medium” or “low.” The level is “determined by looking at hospital beds being used, hospital admissions, and the total number of new COVID-19 cases in an area,” the CDC says.

Most of the deaths from COVID-19 in the United States are of patients who were not vaccinated against the disease, a proportion that remains stubbornly more than a quarter of the eligible population.

A Johns Hopkins map shows China, which maintains it zero-COVID strategy, with over 90 percent of its population vaccinated, compared to over 80 percent in Canada, most of Europe, and Australia, and 65.9 percent in the United States.

Half of the Russians are vaccinated and Africa remains the least vaccinated continent — with most of its countries having less than 20 percent of the population vaccinated against COVID-19.

Against this global backdrop, guidance for dealing with COVID-19, on both the state and federal levels, continued to evolve this week.

This week, the federal government started offering a second set of four free COVID-19 tests to American households; they can be ordered at https://www.covidtests.gov/.

On Monday, New York City, which had had some of the nation’s strictest pandemic requirements, allowed restaurants and entertainment venues to stop requiring proof of vaccination for patrons to enter, and, at the same time, masks became optional in city schools — nearly a week after the governor had lifted the school mask mandate.

Last Wednesday, the state’s health commissioner, Mary Bassett, issued the latest in mask-wearing requirements, which apply to health-care settings, adult-care facilities, correctional facilities, homeless shelters, and public transportation hubs.

Also on Wednesday, the White House, echoing points President Joe Biden had made the night before in his State of the Union address, posted a four-pronged National COVID-19 Preparedness Plan, stating, “This plan lays out the roadmap to help us fight COVID-19 in the future as we begin to get back to our more normal routines.”

Testing and treatments will be expanded as the nation prepares for new variants, said Biden, calling for an end to the shutdown of schools and businesses.

The new plan includes a test-to-treat proposal such that someone who tested positive for COVID-19 could immediately get, for free, antiviral pills.

Last Monday, the CDC had released new guidance for state and local governments, saying, “Universal case investigation and contact tracing are not recommended for COVID-19.” Rather, health departments should “prioritize specific settings and groups at increased risk,” the CDC says.

Albany County had stopped tracing in January, in the midst of the Omicron surge, after the state urged “self-management” when a person has been exposed to, or infected with, COVID-19.

The CDC now says health departments should prioritize high-risk congregate settings such as long-term care facilities, correctional facilities, and homeless shelters for case investigation and contact tracing.

Those are some of the same settings in which Bassett has announced masks must still be worn.

Other priorities are “unusual clusters of cases” and investigation of “novel or emerging variants that may pose significant risks for severe disease, hospitalization, or death,” the CDC says.

State: Masks required

“As of February 28, 2022, COVID-19 cases (7-day average 10.6 cases per 100,000 persons) have declined to levels last observed in July 2021, but levels of hospitalization (7-day average 1.2 new admissions per 100,000 persons and over 1,900 persons currently hospitalized) and death (7-day average of 29) remain high at levels last observed in November 2021,” Bassett writes in her March 2 directive.

She goes on to site studies showing that masks reduce the spread of droplets that spread the virus, including multiple “real-world” studies. Bassett lists two from the Centers for Disease Control and Prevention:

— Depending on mask quality, 56 percent to 83 percent of over 3,000 participants demonstrated lower odds of contracting the virus among those who reported always wearing a mask in indoor settings compared to those who didn’t; and

— A study of household transmission found that, in households with an index patient infected with the Omicron variant, household contacts who wore masks had a 43 percent lower chance of becoming infected compared to those who did not wear a mask.

Bassett’s masking directive applies to staff and visitors older than 2 at health-care settings; adult-care facilities regulated by the health department; incarcerated and detained people as well as staff and visitors at correctional facilities and detention centers; clients as well as visitors and staff at homeless shelters; and public transportation conveyances, like trains and buses, as well as transportation hubs, like airports and bus or train stations.

The requirement does not apply to buses or vans operated by schools, including early care and childcare programs.

Although the statewide mandate for school masking was lifted on March 2, the directive says, “Current CDC guidance recommends masking in schools when there is a high level of community COVID-19 burden, in order to keep children in school without risking close contact exposure that may lead to infection.

“While this determination does not mandate universal masking in schools, nothing in this determination shall be construed as limiting a county, city, town, health department or school district from requiring the use of face coverings in schools.”

White House plan

The new White House plan, at about half the length of the Biden administration’s original 200-page plan for coping with the coronavirus, has much in common with that first plan.

“We look to a future when Americans no longer fear lockdowns, shutdowns, and our kids not going to school,” says the opening of the plan, which then goes on to outline the recent history of the pandemic in the United States.

The plan has these four prongs, each outlining financial backing needed from Congress:

— Protecting against and treating COVID-19

The nation has been through five waves of the pandemic since 2020, including three in the past year driven by new variants.

“Vaccinated and boosted people are 41 times less likely to die of COVID-19 than unvaccinated individuals …,” the plan says. “A December 2021 estimate suggested that vaccines saved over 1 million American lives and successfully prevented over 10 million hospitalizations.”

Currently, about a quarter of Americans remain unvaccinated.

The plan stresses the importance of equity and says the United States has initiated widespread testing strategies.

“Because we have these tools, we can begin to get back to our more normal routines safely and the use of public health mitigation measures like masking can be less frequent,” the plan says.

The plan goes on to list the initiatives that will require federal funding, including increasing manufacturing of vaccine, vaccinating the youngest children once a vaccine is approved, ensuring treatments for every American who needs them, sustaining and increasing manufacture of COVID-19 tests, ensuring equitable access for COVID-19 health care, and helping Americans suffering from long COVID;

— Preparing for new variants

This includes enhanced collection, production, and analysis of data, and expanded electronic case reporting as well as building a robust emergency response infrastructure.

The plan calls on Congress to improve data collection and wastewater surveillance; to support new Food and Drug Administration processes to speed review of variant-specific vaccines and treatments; and to add at-home tests, masks, and antiviral pills to America’s stockpile;

— Preventing economic and educational shutdowns

At the beginning of last year, the plan says, only 46 percent of K-12 schools were open for in-person learning, and millions of businesses had closed and tens of millions of Americans had lost their jobs in 2020.

Today, with investment from the American Rescue Plan, about 99 percent of K-12 schools are open for in-person learning, the plan says, and the United States was the first major economy to exceed its pre-pandemic economic output.

The plan calls for Congress to give schools and businesses tests and supplies to stay open; to give paid sick leave to workers who are out with or caring for someone with COVID-19; and to expand service at public-facing federal offices; and

— Leading the effort to vaccinate the world and save lives

“Fighting this virus abroad is key to America’s effort to protect people and stay ahead of new variants .…,” the plan says. “The President committed that the United States would be the world’s arsenal for vaccines — both because it’s the right thing to do and in our collective interest.”

The plan calls for Congress to increase efforts at worldwide vaccination and to save lives by solving the oxygen crisis and making emergency supplies widely available.

Albany County

This week, Albany County’s 104th — two years — of coping with the coronavirus, Executive Daniel McCoy announced three COVID-related deaths: a woman in her sixties, a woman in her eighties, and a man in his eighties.

However, McCoy said that these deaths were previously unreported and came to light when data was reviewed.

Albany County’s COVID-19 death toll now stands at 531.

All week long, McCoy reported new daily infection counts well under 100 as hospitalizations and deaths also continued to decline from the January high brought on by the Omicron surge.

In his Tuesday morning COVID release, McCoy reported 37 new cases of the coronavirus.

The county’s seven-day average of new daily positive cases is now at 41.5, up from 38 a week ago. Albany County’s most recent seven-day average of cases per 100,000 is at 10.3, up from 9.7 a week ago, and its infection rate is 2.6 percent, down from 2.8 percent a week ago.

On Tuesday morning, McCoy reported there are now 24 county residents hospitalized with the coronavirus, with four of them in intensive-care units.

As of Tuesday, 81.2 percent of all Albany County residents have received at least a first dose of vaccine, and 73.8 percent are now fully vaccinated. The first-dose vaccination rate for county residents 18 and older is 89.7 percent.

Statewide, 89.2 percent of New Yorkers have received at least one dose as have 95.0 percent of New Yorkers 18 and older, according to the state vaccine tracker; also, 75.7 percent of New Yorkers are fully vaccinated as are 85.7 percent of New Yorkers 18 and older.