COVID could surge again in fall
Experts say slowing vaccinations, delta variant spread could drive up cases
This time last year, Connecticut was experiencing relatively low COVID infection rates, many mandates were in place, but had been eased slightly as the pandemic loosened its grip.
Feverish work on a vaccine was underway, but a timeline for the crucial inoculations was uncertain. Then the fall came and infections, hospitalizations and deaths swelled across Connecticut in what many consider was the second wave of the pandemic.
Now a year later, and well into a massive vaccine
effort, Connecticut has come close to a pre-pandemic normal, but with fall on the horizon, some leading health experts fear infections will spike again.
“I think right now the fall is looking to be problematic. We are hoping without much evidence that the summer would be quiet,” said Dr. Rick Martinello, medical director for infection prevention at Yale New Haven Health.
There were, in fact, more new cases on average last week than there were a year ago. On July 22, 2020, there were an average of 68 new daily cases. A year later, the seven-day average of new COVID cases is 184, up from 40 a month ago.
As health and state officials look toward the fall, Connecticut is confronting the growing threat of the delta variant while the vaccine program has significantly slowed.
When asked about the pandemic’s potential impact in the fall, Gov. Ned Lamont’s office stressed the importance of continued vaccination efforts to keep infections low as the governor reviews guidance.
"Above all, we want to remind each and every resident of Connecticut that the single most important thing you can do to protect yourself, your family, and your friends from COVID-19 is to get vaccinated,” Lora Rae Anderson, a spokesperson for the governor’s office, said in a statement.
“Our vaccination rate is why Connecticut has been able to recover so successfully from the pandemic thus far — but we're not there yet. As we look toward cooler weather and evaluate new strains of COVID-19, it's important we do everything we can to keep infections low as we review guidance, and make further decisions about new policies.”
She went on to say: “That means getting vaccinated, wearing a mask indoors when you're not vaccinated, wearing a mask in health care settings and in public transit, and staying home if you feel sick.”
The vaccine efforts in the state have slowed as demand has waned and providers struggle to reach those who are reluctant.
As of last week, about 71 percent of all eligible residents are fully vaccinated, a number that has not increased substantially in recent weeks.
With the vaccine efforts flagging here, and across the country, health officials are starting to call it the “pandemic of the unvaccinated” as hospitalizations and deaths are often involving people who have not received a vaccine.
As Connecticut vaccinations have slowed, COVID cases have begun to rise in the state after a steep drop into mid-June, when the positivity rate hit a low of 0.3 percent. Now, in mid-July, the seven-day average is above 1 percent.
As of Thursday, top state health officials said the delta variant, a highly transmissible strain first found in India, contributed to 80 percent of the samples recently sequenced. In recent weeks, it quickly surpassed the alpha variant, first found in the U.K., and is believed to be 60 percent more transmissible.
“We are already seeing most of the variant being typed is of the delta variant and I think we are going to see an increased prevalence of the COVID delta in Connecticut and throughout the United States over the next months,” Martinello said.
Dr. Ulysses Wu, system director for infectious diseases at Hartford HealthCare, said he also expects cases to rise heading into the fall.
“This fall is going to look very eerily similar, maybe not the extent of the peak as last year because people are vaccinated, but there are going to be more infections,” Wu said.
Wu said the potential jump in cases may still be nearly three months away. “I predict with the weather, we are going to see it in mid-October. That’s where it’s going to start again,” Wu said.
Last July, Connecticut saw positivity rates near 1 percent, hospitalizations were between 53 and 100 and small increases in daily deaths, before the numbers jumped quickly in October and peaked in December.
One driving factor, Wu said, is people gathering more inside as temperatures cool off. He pointed out how this is similar to how cases of other respiratory illnesses pick up in colder months.
“Indoor transmission is much a different beast than outdoor transmission,” Wu said. “A lot of coronavirus spread is social behaviors.”
Pedro Mendes, of UConn’s Center for Quantitative Medicine, said there may be some seasonality to COVID-19, but the delta variant may have a stronger impact.
“I think there is some degree of seasonality to COVID-19 infections, this tends to be the case with all airborne viruses. However, any season effect is overlapping with the appearance of new variants. I think that the delta variant (being highly infectious) will have a stronger effect than the season itself (even though they will partly overlap),” Mendes said in a statement.
With concern over the recent rise in cases, it remains unknown whether the key restrictions will return by the fall.
Despite the uptick this July, Lamont has repeated that he believes Connecticut, which has a higher vaccination rate than the national average, is in good shape. But he has expressed concern with the delta variant, saying several times that he thought Connecticut “was out of the woods” before the strain surfaced.
Lamont said he has no immediate plans to restore restrictions, including the requirement that people wear masks. Though, he said people who are not vaccinated should continue to wear masks indoors.
However, Wu said, there are likely many unvaccinated people who do not wear masks indoors, despite the requirement.
“You go to the grocery store, people are expecting those who are unvaccinated aren’t wearing masks. We can almost guarantee that people who are not vaccinated are not wearing masks,” Wu said.
And the governor has yet to decide whether students and staff in schools will be required to wear masks when they return in the fall. Recent guidance from the Centers for Disease Control and Prevention said it was safe for vaccinated staff and students not to wear masks, but the American Academy for Pediatrics recommended all students wear masks regardless of vaccine status.
What happens when children return to school could impact the COVID-19 spread in the fall, according to Martinello.
While children are less likely to develop serious illness from COVID-19, many experts believe they can spread the virus to adults.
“As we see with other resporitory viruses when kids get back to school that leads to a lot more mixing. Prolonged close contact is unavoidable in schools,” Martinello said.
So action related to students may be necessary, he said, to stave off more infections in the fall. While students age 12 and older are eligible to get the vaccine, those younger still cannot get inoculated. Studies are underway to determine the efficacy and safety of the three approved COVID-19 vaccines in these age groups.
“I am hoping sooner, rather than later we can see a recommendations for children under the age of 12 be vaccinated,” Martinello said.