This spring, as mask policies loosened, indoor dining became socially acceptable and most state-to-state travel bans had been lifted, the coronavirus finish line finally appeared to be in sight. The vaccines had arrived and surely would save us all from the disease, helping New Jersey reach herd immunity and effectively eradicate the virus.
But late 2021 is now looming close on the horizon and public health experts are issuing a cold dose of reality: Sorry, folks, but another COVID winter is coming.
With temperatures plummeting, people being forced indoors and schools now open for in-person instruction, the virus is expected to surge yet again this fall and winter, experts said. The spike is likely to be fueled by the combination of vaccine-resistant adults and unvaccinated children, the closer indoor quarters and the more infectious and easily transmissible Delta variant, several experts said.
Case numbers could start ramping up in November and December, leading to what some experts believe could be a significant spike by January. The anticipated surge could close some schools or classrooms for spells, impede inter-state and especially international travel and once again make large holiday gatherings tricky endeavors.
The disruptions also are expected to be particularly difficult to navigate as researchers work to understand how long vaccine immunity lasts, and as experts continue to study which populations may or may not need vaccine booster shots. This week, the Centers for Disease Control and Prevention diverged from the agency’s independent vaccine advisers to recommend boosters for those ages 18 to 64 who are at increased risk of COVID-19 because of workplaces or institutional settings and older adults, long-term care facility residents and some people with underlying health conditions.
“My expectation is that for the rest of the fall and winter it’s essentially going to get worse,” said Brian L. Strom, the chancellor of Rutgers Biomedical and Health Sciences. “This pandemic isn’t going away. We are moving from pandemic to endemic.”
Even at present, the virus is trending in the wrong direction in New Jersey. This Saturday, the state reported another 2,200 confirmed COVID-19 cases and 17 more confirmed deaths. The seven-day average for confirmed positive tests is up more than 10% from a month ago. And the most recent 1.04 transmission rate indicates that each new case is leading to more than one additional case and shows the state’s outbreak is expanding.
All of New Jersey’s 21 counties continue to be listed as having “high” rates of coronavirus transmission, according to the U.S. Centers for Disease Control and Prevention. The CDC is recommending people in all 21 counties wear masks in indoor public settings regardless of the state’s vaccination rates.
“We’re in a spike already,” said Judy Lightfoot, the chief of infectious disease at Rowan University. “My ICUs are filled. My residents are in a surge now.”
But several experts said they fear the numbers are likely to get even worse in the coming weeks and months after an anticipated increase in cases from the Labor Day holiday and as school gets underway.
“We will have a bump. The size? I’m not sure,” said Stephanie Silvera, an epidemiologist and public health professor at Montclair State University. “We will see that post-holiday bump. We’ll see something likely after Halloween and then again after Thanksgiving and the other winter holidays.”
The frustrating part about the likelihood of another COVID winter is New Jersey is among the top states when it comes to vaccinations. More than 5.7 million people who live, work or study in New Jersey have been fully vaccinated as of Saturday, and more than 6.3 million people have received at least one dose.
Nearly 64% of the adult population in New Jersey are fully vaccinated — the sixth-best rate of any state, according to the Mayo Clinic.
And yet it still hasn’t been enough to stop the spread of the virus — especially the Delta variant, which continues to increase in prevalence in New Jersey with 99% of sampled cases in the four weeks ending Aug. 28. Delta has led to breakthrough cases in fully vaccinated people, although those patients tend to not to die or need to be hospitalized.
“Delta is phenomenally more contagious,” Strom said. “People don’t understand. When you’re looking at Alpha, the prior variant, it took six days to develop the disease. With Delta, it takes four days. And at that time the concentration of virus in your mouth, with Delta compared to Alpha, it is 1,300 times higher. It is enormously more contagious.”
Moreover, children under age 12 are still not eligible for vaccines, which further increases the state’s inability to snuff out the virus completely. At present, a quarter of all new COVID cases are kids, Strom said. Now, those same unvaccinated children are back in classrooms, and during a time of the year — cold and flu season — when illnesses of all types are thriving.
“Which is the right thing for them, but it’s also a good thing for the virus,” Strom added. “Delta is the big game changer here.”
The good news? Vaccine trials for children ages 5 to 12 are underway. But it comes with another pause for celebration: The age group likely won’t be approved for shots until early 2022.
If there’s a silver lining to a potential late 2021 surge it’s that New Jersey is well positioned to deal with another spike. Experts said they don’t anticipate any more widespread school closings, but rather more fluidity when it comes to outbreaks. Some classrooms may close temporarily or shift to virtual learning. But they don’t anticipate kids being out of classrooms for prolonged periods.
The same goes for restaurants, theaters and other social events. If anything, Strom and others believe controversial vaccine passports or showing proof of a negative COVID test will only increase in prevalence the rest of 2021.
“If businesses are smart, they will restrict their clients to people who are vaccinated, which will allow them to stay open,” Strom said. “Especially given the large portion who are vaccinated in New Jersey, it now even makes business sense. Because if 75% of the population are vaccinated and 25% are not, a lot of that 75% is not going to come if you don’t restrict yourself.”
Lightfoot maintained the most important measure remains convincing those who are unvaccinated to get the shot. Despite New Jersey’s progress in overall vaccination rates, there is still room for improvement, she said.
And if we want to avoid another COVID winter next year, getting more shots in arms remains the best course of action.
“This virus will win if you let it,” Lightfoot said. “Make no mistake, you always have to have respect for a microbe.”
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