Will it fade, or will it surge again?
Variables make it hard to predict what’s next regarding COVID-19
Dr. Ulysses Wu has seen the statistical models suggesting the Connecticut’s COVID-19 transmission will continue to decline over the coming weeks and months. And he is not convinced.
In fact, with the weather cooling and activity moving indoors, Wu thinks Connecticut is headed for a lighter version of the winter surge that walloped the state a year ago.
“Do I think we’re going to be anywhere close to last year? I don’t think so,” said Wu, an infectious diseases specialist with Hartford HealthCare. “But I do think it’s going to rise.”
As COVID-19 cases decline in Connecticut following a surprising surge fueled by the delta variant, the state appears to face several possible scenarios. Transmission could continue to slow, as the region eases into a world where the disease lingers in some quantity but everyday life continues around it. Or, as the weather cools, the virus could ramp up once again.
“There are a lot of variables that are going to be influential as far as what we see next,” said Dr. David Banach, an epidemiologist at UConn Health. “There are variables related to seasonality — in the winter respiratory viruses tend to circulate more frequently, especially in certain climates. And then variables regarding human behavior may also play a role. … And then lastly, the vaccinations are going to be influential.”
Low transmission, high vaccination
An optimist might look at Connecticut’s COVID-19 metrics and see cause for encouragement all around.
COVID-19 cases and hospitalizations are considerably lower now than they were in August (even if they remain much higher
than in June and July). In fact, Connecticut currently ranks as the state with the second fewest cases per capita, behind only Hawaii, and the third fewest hospitalizations per capita, behind Vermont and Massachusetts.
Meanwhile, Connecticut is among the nation’s most vaccinated states, with about 70% of residents and about 80% of those 12 and older fully inoculated. When younger children become eligible for vaccination, possibly in the coming months, even more Connecticut residents will be protected.
These factors, plus the emergence of new treatment options, have Dr. Tom Balcezak, chief clinical officer at Yale New Haven Health, thinking positively.
“The combination of good vaccination rates, the possibility of a vaccine that can be used in kids in the next couple of weeks, and novel therapeutics gives me hope that we’re going to be in good shape,” Balcezak said Friday.
COVID-19 won’t entirely go away, experts say, but could become a manageable part of life, much like the flu and other similar diseases.
Pedro Mendes, a computational biologist at UConn Health, runs a series of models designed to predict COVID-19 hospitalizations in Connecticut weeks in advance. At the moment, his models are optimistic.
“Right now my model predicts that hospitalizations will keep going down,” Mendes said. “According to the model, by Nov. 8 we should have very low numbers — as low as we had in June.”
Cold weather on the way
Mendes notes, however, that his models ignore one factor that may play a role in determining whether COVID-19 surges again: the weather.
Many respiratory viruses, including influenza, are worst in the winter months, and some experts fear COVID-19 may follow a similar pattern. Indeed, after a summer with little transmission, Connecticut was hit last winter with a devastating surge that resulted in several thousand deaths.
As the weather cools this fall and more gatherings move indoors, some experts fear transmission will pick up again, particularly among unvaccinated people. Already, cases have begun to increase in cold-weather states such as Michigan, Minnesota, Colorado, Vermont and New Hampshire.
“When the weather gets colder, people move inside,” Wu said. “And when people move inside, it’s easier to transmit. When people have parties for the five major holidays, it’s easier to transmit.”
Unlike last year, Wu noted, Connecticut has few COVID-19 restrictions in place and does not require masking indoors statewide, which could facilitate easier spread.
Dr. Scott Gottlieb, a former Food and Drug Administration commissioner who has advised Gov. Ned Lamont during the pandemic, predicted recently that while COVID19 cases will continue to decline nationwide, they may increase in the Northeast, which was not hit as hard as other regions this summer.
Even experts who are less concerned than Wu about a winter surge say cold weather and a rise in indoor gatherings could cause some uptick in cases.
“The seasonality and the temperature changes, they play a role,” Banach said. “But it’s hard to know exactly how much of a role.”
Balcezak said it’s too early to tell whether colder weather will lead to more COVID-19 but cites another reason for caution: the possibility of new strains. Just as the delta variant caused an unexpected surge this summer, a yet-unknown variant with the right properties could do the same in the future.
“Until global transmission gets stomped out, we’re still at risk for development of variant,” Balcezak said. “Until we get the planet vaccinated, there exists a possibility that a new variant could emerge.”
Uncertainty lingers
Ultimately, there remains a lot that even the most informed experts don’t understand about COVID19. What factors — beyond differing levels of immunity and control measures — determine why the disease surges in one place but not another? Why do peaks seem to follow two-month cycles? What role does seasonality play?
As frustrating as this uncertainty may be to Connecticut residents looking to plan holiday gatherings or deciding when to wear a mask, Balcezak says it’s simply part of the scientific process.
“We still have a long way to go,” Balcezak said. “We still don’t understand lots of things about infectious diseases, but jeez, we don’t know a lot of things about a lot of other diseases — heart disease cancer, big killers like that.”
And so Connecticut won’t know for sure whether another COVID19 surge is coming until it arrives — or doesn’t.
“There are too many variables,” Wu said. “A lot of variables are going to be dependent on herd immunity from natural infection, who decides to get vaccinated, who decides to get boosted, who decides to wear a mask. And we can’t predict any of that, at all.”