Syracuse

Coronavirus instances hovering in CNY: Are we shedding management? – syracuse.com

Syracuse, N.Y. – As the number of new coronavirus cases in Onondaga County spirals toward 100 a day, it’s time to ask: Are we losing control of the virus?

For months, Central New York was a national model of how to keep the potentially deadly virus under control. In late summer, the number of new cases per day dipped into single digits. So did the number of patients in Syracuse hospitals diagnosed with Covid-19, the respiratory disease caused by the virus.

In the past few weeks, however, cases have raged. Onondaga County has averaged 76 new cases a day for the past week, more than double of just two weeks ago. Forty-two people are in the hospital, the highest since mid-July.

“I’m pessimistic that things can continue as they are without having a larger rise in cases,” said David Larsen, a Syracuse University public health professor who’s been involved in the coronavirus fight since winter. “Something needs to change.”

The county has reported 531 cases over the past seven days. On three of those days, more than 90 cases were confirmed. County officials expect that much or more today. Gov. Andrew Cuomo said today Central New York may see new restrictions; details will be hammered out over the weekend.

The rate of transmission – how many people are infected from one infectious person – is at its highest level since April. And back then, the rate was applied to a much smaller number of cases.

“Now we’re at the highest incidence we’ve been at – the number of cases a day – and the rate of growth is at the highest it’s been since the early days of the epidemic, and that’s a very concerning pattern,” said Dr. Kathryn Anderson, a professor of medicine and immunology at Upstate Medical University.

The rate of transmission, called Rt, had fallen to 0.8 in August, according to Upstate’s epidemiological model. It’s now nearly 1.4.

Not since the pandemic hit here in March have we seen numbers this high, both of cases and the transmission rate. While far more tests are being done now and uncovering cases that might have been hidden in spring, the percentage of positive tests is rising, a sign that the virus is spreading. And the doubling of hospitalizations this week is further proof that transmission of the virus is speeding up.

It’s not just happening here: Next door, in largely rural Cayuga County, the number of Covid-19 patients in isolation soared from 17 to over 120 in two weeks. New York state confirmed 2,997 new cases Wednesday, the highest single-day total of new cases since May 6.

Across the U.S., states on Thursday reported a record 121,888 cases, the third day in a row of more than 100,000.

In Central New York, the rapid spread of the virus now strains our ability to control it.

“There’s a lot of virus out there right now, which is kind of worrisome,” said Brian Leydet, an infectious disease and epidemiology professor at SUNY College of Environmental Science and Forestry. “If the numbers keep going up, it’s all hands on deck.”

Onondaga County Executive Ryan McMahon said he expects case numbers to keep climbing, and that today’s number will exceed the record of 99. That, he said, could put a strain on the health department’s efforts to isolate sick people and quarantine those who have been exposed. McMahon has said that the county health department would not be able to keep up with a sustained caseload of 100 per day.

County spokesman Justin Sayles said that contact tracing – the hunting down and quarantining of people who might have had close contact with someone who tested positive – is still being done within 48 hours.

“We have hundreds of contact tracers at our disposable (as it was a requirement to reopen our economy),” he said in an email.

Thursday’s positivity rate – positive tests divided by total tests returned – was 2%. That’s not out of control yet, Larsen said, but it’s not a good sign, either.

“The test positivity is likely lower than the majority of counties in the U.S., but it is increasing and it has been increasing since August,” he said. “The question is can we make it through the winter with this high transmission.”

Experts are worried not only by the number of confirmed cases, but by those for which there is no known exposure. More than a third of Thursday’s cases fell into the “unknown” category, which means the county health department can’t find and quarantine people who have been exposed and might be out there spreading the virus.

“What gets concerning is when we see lot of cases that are community spread or unknown, where they weren’t part of the contact tracing efforts and we don’t have any idea where they could have gotten the infection,” said Brittany Kmush, a public health professor and epidemiologist at Syracuse University. “The raw numbers are less concerning. It’s more the large-scale community spread that’s concerning.”

Overall, unknown community spread has accounted for 27% of cases since the beginning of the pandemic. That rate is increasing along with cases: Of Thursday’s 98 cases, nearly 37% came from an unknown source.

It’s not time to panic yet, Kmush said.

“There may be a lot of cases, but we generally know where most of them have gotten exposed,” she said. “But we are definitely going in the wrong direction.”

There are two major reasons for the spike in cases as the weather cools, experts say. One is the virus itself, which lives longer and spreads faster in colder, drier environments.

“The other coronaviruses that circulate in humans on a regular basis are seasonal, and this is the time of year when we start seeing increases in those numbers as well,” Kmush said.

The bigger reason is our own behavior, Leydet said.

“I think overall people are putting their guard down,” he said. “We need to remember what March was like, and we don’t want to be March again.”

We’re suffering from pandemic fatigue at the same time the weather is driving us indoors, and the gatherings and parties we could get away with in summer will help spread the virus in winter, Anderson said.

“I know people are tired of this. I’m tired of this, too,” she said. “But the cold weather is coming and we’ll be heading back indoors with a high rate of transmission.”

There are some hopeful signs. The September-like weather should stretch into the middle of next week and get people temporarily back outside, where the virus is diluted by fresh air. And we’re less than three weeks from the end of the college semester, when tens of thousands of students return home.

“With the large student population leaving Onondaga County, that will help control some of the cases we’re seeing,” said Leydet, whose lab runs saliva testing for SU and ESF. “It’s not the majority. I don’t think the college transmission is driving the community transmission.”

McMahon said Central New Yorkers have to double down in their efforts.

“A lot of people have been focused on the election,” McMahon said. “What happened there is out of our control. What is in our control is how we handle ourselves in the pandemic and get back in this fight.”

MORE ON CORONAVIRUS

Coronavirus in NY: Cases, maps, charts and resources

More men die of coronavirus in U.S. Why do more women die in Onondaga County?

Upstate University Hospital quarantines 36 doctors exposed to coronavirus at Halloween party

Complete coronavirus coverage on syracuse.com

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