The northeast recorded at least 126 new infections per 100,000 people last week, double the rate a month ago. It is still well below the 2,200 cases per 100,000 people recorded during the peak in mid-January in the Northeast amid the micron outbreak. New infections in the Northeast were more than double those in the West, Midwest and Southeast last week, according to federal data.
It remains to be seen whether the latest uptick in the Northeast is the start of a larger increase or reflects a minor bump on the road to recovery from the punishing Omicron wave. Several experts said a more optimistic future seems likely, pointing to promising recoveries in Britain and other European countries that often foreshadow the course of the pandemic in the United States. Experts also expected an uptick with mask orders ending and more people scrambling after the Omicron wave.
“It's premature to call this a wave as opposed to a period of increased transmission,” said David Rubin, who tracks coronavirus trends for the PolicyLab at the Children's Hospital of Philadelphia. “This is what living with the virus means: You're aware of what's going on, you hear about cases in your community, and you might decide to wear your mask to the market or change your routine for a few weeks.”
Official case counts do not provide a complete picture of the pandemic because many home test results are not reported to government agencies.
Other data points suggest the Northeast is now bearing the brunt of BA.2 because the states reporting the largest increases in infected patients admitted to hospitals and emergency department visits are heavily concentrated along the Interstate 95 corridor.
Those increases are modest, and overall hospital admissions are steady in the Northeast and beyond after bottoming out a month ago. Waves of BA.2 infections have taken a mixed toll on hospitals in other countries, leading to an increase in imports in Britain and Hong Kong but not in South Africa.
Some experts believe that US hospitals are doing better because of immunity from the explosion of micron cases, although that could change if elderly and vulnerable people who lay low to avoid micron in the winter become infected with BA.2.
“BA.2 will infect many people who have so far avoided the virus,” said William Hanage, an epidemiologist at the Harvard TH Chan School of Public Health. “The question is how many of them are vulnerable to serious consequences. Hopefully it's not a lot, and hopefully it'll be easily dealt with.”
The Centers for Disease Control and Prevention has moved away from relying on infections to depict the severity of the pandemic in a community, shifting to numbers that show the strain on the health care system. Most of the northeast remains a green zone according to CDC counts, with some exceptions in parts of Upstate New York and northern Maine.
“What we're seeing now doesn't call for action at the community level,” said Shira Doron, a hospital epidemiologist at Tufts Medical Center in Boston. “This is not to say that nothing is happening behind the scenes as a result of the increased cases. We in healthcare are watching. We are preparing our systems to do what we need to do to scale up testing and treatment should there be a need to do so.”
Craig Spencer, an emergency room doctor who works at two hospitals in northern Manhattan, says he hasn't seen any patients with the coronavirus in recent weeks, even as New York City's average daily cases have risen from 700 in early March to about 1,900. last week, according to city data. It's the first time during the pandemic that a spike in infections circulating in the city isn't showing up in emergency rooms, he said, though he expects more patients in the coming weeks.
“We want to continue to be vigilant, but we should also celebrate the fact that as of now, really sick Covid patients don't seem to be overwhelming hospitals,” Spencer said.
The rise of BA.2, now estimated by the CDC to account for 86 percent of new infections, provides an early test for Democratic politicians who recently said it's time to learn to live with the virus and for vulnerable people to be protected.
Anthony S. Fauci, President Biden's chief medical adviser on the pandemic, cautioned against dismissing the milder infections associated with BA.2 as trivial.
“We must not pooh-pooh ourselves. It's not like there's death, hospitalization and anything less than hospitalization is OK,” he said, adding that some people can be sick for many days and “there's always the risk of long-term Covid.”
The Biden administration is considering whether to extend the mask mandate for planes, subways and other forms of public transportation that expires next Monday. Ashish Jha, the White House's new coronavirus czar, told NBC News' “Today” show Monday that an extension is “absolutely on the table.”
Democratic governors in the Northeast who lifted mandates on masks and other measures to control the virus in February and March have signaled no plans to reinstate sweeping measures to control the latest surge. Locally, Philadelphia emerged as an exception this week when it became the first major jurisdiction to reimpose a mask mandate, effective Monday, in response to rising infections.
After emerging from the micron wave, Philadelphia here are measurements to automatically reinstate indoor mask requirements if the city saw a spike in infections and recorded more than 50 hospitalizations or an average of 100 daily cases. The city will reinstate the vaccination requirement for entry into restaurants and other public establishments if conditions worsen.
Philadelphia Commissioner of Health Cheryl Bettigole said the city is trying to intervene before hospitalizations spike, pointing to racial and class disparities in victims in one of the nation's poorest big cities.
“We lost 750 people in the micron. That's why we're trying to intervene,” Bettigole said, and with a mitigation method that allows the city to stay open and with any luck will be short-lived. “We want people to enjoy their lives – but with a mask on.”
As residents processed the news of the order's return, some gave up on masks as a staple of life.
“I suspected it would come back,” said Imani Sullivan, 22, who works as a caregiver and had to continue wearing masks even after the city lifted its order. Some family members also insisted on covering when they met. “At this point it's just normal.”
Hannah Dart, 26, a graduate student at Drexel University, said the new order would help clarify some rules that didn't make sense to her. At Drexel, she said, she had been asked to wear a mask in class but not in the hallway.
“I will do it personally, until we see no more spikes,” he said.
Julia Reifman, an assistant professor of health law, policy and medicine at Boston University, praised Philadelphia for quickly reinstating the mask mandate before a potential outbreak.
“What looks like a small increase can quickly turn into a much larger increase by an exponential difference. Acting only when we see the wave going straight is too late,” Raifman said.
While omicron was less likely to cause serious illness in individuals, it was so contagious and infected so much of the nation that more than 100,000 died, hospitals were overwhelmed, and the country suffered economic disruptions as key workers fell ill.
“When we downplay the threats of the virus, when we don't take steps to address it, we end up with much more damage,” Reifman said.
In Philadelphia, cabinet ministers Eric Nay, 51, and Colin Scarborough, 34, mocked the return of mandatory masks.
“I don't like it,” said Nye, who commutes from a nearby suburb that doesn't have a mandate. “If you want to wear a mask, it's up to you. Same if you don't want to wear one,” Nay said.
“It's really hard to breathe in the summer,” Scarborough added. “It's a pain to come down here to work with a mask.”
As Hugo Chavez, 31, cut sausages for his meal in downtown Rittenhouse Square, he wondered why the city didn't immediately enforce its mask mandate if conditions were so bad.
“Philadelphia has so many problems. But all we care about are masks and plastic bags,” he said, referring to the recent ban on single-use plastic bags.
Recent polls have shown that many Americans are treating the pandemic with less urgency.
One Value-Height Research conducted over the weekend found that 73 percent of Americans described the coronavirus as a manageable problem. In addition, 17 percent did not think it was a problem and only 9 percent thought it was a severe crisis.
In the Washington area, there are signs of an escalation from very low transmission rates of the virus a few weeks ago. The seven-day average per capita rate rose last week in the District to 22 per 100,000, and more sharply in Virginia and Maryland to 16 and 14 per 100,000, respectively. This still places the case rate well below the winter micron maximum.
An official in the D.C. mayor's office said shortly after Philadelphia lifted its mask mandate on Monday that D.C. had no current plans to do so.
Nirappil, Achenbach and Keating reported from Washington. Julie Zauzmer Weil in Washington contributed to this report.
