Doom or hope? Message can be muddled
Vaccinations, new cases both rising across state
In Connecticut and elsewhere, the simultaneous rollout of COVID-19 vaccinations and increase in coronavirus cases and hospitalizations have created dueling messages for residents seeking to make sense of the pandemic: Are things getting better, or should we still be worried?
On one hand, the good news: About 32% of Americans and 38% of Connecticut residents have received at least one COVID-19 vaccine dose, according to The New York Times. Plus, research has shown the existing vaccines to be highly effective in combating the disease — including its most dangerous variants. As vaccinations increase, COVID-19 will begin to fade.
Onthe other hand, the bad news: COVID-19 cases and hospitalizations have increased in Connecticut in recent weeks, due in part to the spread of highly contagious strains and a rise in gatherings and other social activities. Last week, U.S. Centers for Disease Control and Prevention Dr. Rochelle Walensky said she has felt a sense of “impending doom” as metrics show budding hot spots across the country.
“We have at least one variant that is highly transmissible, more contagious,” said Dr. David Banach, epidemiologist at UConn Health. “But on the other hand, what we’re seeing with the vaccine data is very promising that these vaccines can prevent infection even with the emerging variants that we’re seeing.”
The competing messages — one of hope and one of warning — may seem like a recipe for whiplash. But experts say that both sides can be true at once. There can be light at the end of the tunnel, even while there’s also a need for continued vigilance.
“On the one side you have
impending doom and on the other side everything is great, so it’s a very fine line we have to tread,” said Dr. Ulysses Wu, an infectious disease specialist at Hartford Health Care. “If we slip too far on one side, we risk losing the message.”
The hope
Connecticut, and the United States as a whole, has progressed steadily toward its ultimate goal: having enough residents vaccinated that the coronavirus can no longer spread easily from person to person.
With more than 80% of Connecticut residents 65 and older having already been vaccinated, the state has expanded eligibility to all adults. Gov. Ned Lamont has said he anticipates vaccine supply will outpace demand by the end of April.
“I’m very optimistic with what we’re seeing with vaccination rollout,” Banach said, “and I’m also optimistic about the protection that these vaccines offer, both in keeping people healthy and also having the means to restore normalcy.”
Dr. Scott Gottlieb, a former Food and Drug Administration commissioner who has advised Lamont during the pandemic, said Monday he expects Connecticut’s numbers to decrease in the coming weeks.
“I think that this month we’re going to see a tipping point,” Gottlieb said. “I think that you’re going to see hopefully a situation over the course of this month where you really start to see cases decline, hospitalizations decline more dramatically.”
Connecticut’s vaccine rollout has already shown results. Cases and deaths at nursing homes have almost disappeared, while cases and deaths among older age groups more generally have decreased as well. With many of the state’s oldest residents vaccinated, COVID-19 deaths have decreased significantly.
Dr. Thomas Balcezak, Yale New Haven Health’s chief clinical officer, pointed to low case and hospitalization numbers among groups that have already been vaccinated as evidence of vaccine success.
“The first group vaccinated were our employees, our health care workers, and we’re seeing very very few cases now among our employees and health care workers,” Balcezak said. “We’re seeing much less hospitalization among the 70 and above. So, [there’s] good empiric evidence that vaccinating works.”
Hartford HealthCare CEO Jeffrey Flaks said the hospital system’s nursing homes, which saw high rates of vaccination, had no active cases. Meanwhile, as of last week, all of the system’s hospitalized COVID-19 patients were unvaccinated, he said.
“It gives us that confidence that the vaccine is working,” Flaks said.
Perhaps feeling that same confidence, Lamont has dramatically eased coronavirus restrictions in recent weeks, allowing residents to congregate indoors and signaling that the worst of the pandemic has passed.
Though some experts have called reopening dangerous or premature, others have said the time is right — provided it comes with proper caution.
“With the reopening, there is an inherent societal contract that says we can reopen but we have to do it safely,” Wu said.
The warning
But even as vaccinations become more widespread, the virus is not yet under control. As Connecticut residents wait to be vaccinated, many more may catch — and possibly die from — COVID-19.
In recent weeks, Connecticut has recorded more and more new cases. The state now ranks fifth nationally in new cases per capita over the past seven days, according to The Washington Post. And with rising case counts have come rising hospitalizations: In the nine-day span ending March 30, Connecticut’s hospitalizations spiked from 389 to 518, an increase of more than 30%.
When asked about the rising numbers last week, Yale New Haven Health CEO Marna Borgstrom said, “I think that it would be crazy not to be concerned.”
Connecticut’s spike in numbers is driven in part by the prevalence of new, more contagious variants of the virus, experts say. The B117 strain, which was first identified in the United Kingdom, now accounts for nearly 40% of cases in Connecticut, according to researchers at the Yale School of Public Health, while the B1526 strain, first identified in NewYork, has also taken hold as well.
Both strains are cause for concern, experts say, because more contagious variants mean that more people could catch the virus and become ill. And the B117 variant appears to also be more infectious for children and younger people. The strains, combined with a general relaxation of gathering and travel discipline, have triggered rising case and hospitalization rates among people under 40.
With some European countries seeing a spike in cases yet again, experts say that the U.S. is now facing a battle between vaccination efforts and a looming wave of the virus.
“We’re back to that race where we know that the vaccines are going to protect the population, but the people who are not vaccinated are going to be at high risk, potentially even a higher risk, because of these more transmissible variants,” Banach said.
Although the Northeast has reemerged as a relative hotspot in the country — of the five states with the most new cases per capita, four are in the Northeast — concerning trends have popped up across the nation. Michigan, for example, has a 15% positivity rate and is in the midst of a COVID-19 surge.
Walensky, the CDC director, was responding to the nation’s overall rising case, hospitalization and death counts when she warned of that “impending doom.”
Some Connecticut medical experts take issue with Walensky’s word choice — but not with her overall message.
“Impending doomis a possibility if we take our feet off the gas, if we rush out and wedon’t pay attention to what is going on around us,” Wu said. “I am dismayed a little bit by some of the numbers as well.”
‘It’s a real balance’
While hope and doom may seem like polar opposites, medical experts say the two can coexist.
As vaccinations have helped reduce hospitalizations and deaths among the vaccinated (a reason for optimism), more contagious variants and more lax behaviors are still spreading the disease (a reason for caution).
“It’s a real balance at this point,” Banach said. “The message is a bit nuanced, and it’s hard to convey that in short, concise messages.”
Keith Grant, Hartford HealthCare’s senior director of infection prevention, said the state and the country are just on the brink of getting COVID-19 under control. But in order to fully tame the virus, basic precautions remain crucial.
“We’re closer than we’ve ever been,” Grant said. “Our message should be that it’s very important to keep our eyes on the things that have gotten us to a very good place.”
While people who are vaccinated can safely gather in small groups, particularly if those gatherings are held outside, experts emphasize the continued need for masking and social distancing in public places.
If people drop those precautions and return too quickly to pre-pandemic behaviors, Connecticut could see the finish line moved ever further away. Ultimately, Balcezak said he hopes that that won’t happen.
“I’m hopeful that because the weather is better, we’re more likely outside and the percentage of our population that’s vaccinated is going up and up and up,” Balcezak said. “I think we’re going to dodge a bullet.”