The table was already set for a COVID-19 winter holiday season surge in Suffolk County before the arrival of the new omicron variant in New York, including one confirmed case in Suffolk announced Thursday night.
This time a year ago, when cold weather kept people indoors and holidays brought them together, the surge began. Suffolk’s daily new cases rose after Halloween, escalated after Thanksgiving, and continued to climb through the holiday season, peaking in mid-January at more than 1,800 per day.
But that was before vaccines were available to most of the general population. It was also before the arrival of the delta variant, a more contagious variant of the novel coronavirus that originated in India last year and became the dominant variant in New York this summer and was responsible for 100% of COVID-19 infections in New York as of Thanksgiving Day.
As cold weather returned and the 2021 winter holiday season began, government and health officials were preparing for another winter surge this one fueled by delta.
“Mark my words,” Gov. Kathy Hochul said Monday, “We’re going to see a surge in the next couple of days,” she said. “And again, it takes about five days for it to manifest itself after exposure.”
New reported daily cases in December so far are right where they were in early December last year, when case numbers climbed several days after Thanksgiving. There were 1,079 new cases reported in Suffolk on Wednesday and 1,102 new cases reported Thursday. Last year, there were 966 new cases reported in Suffolk on Dec. 1 and 1,111 reported Dec. 2. And through mid-January, the numbers kept climbing. Hospitalizations and deaths followed suit.
Last winter’s COVID surge took a toll of 1,331 lives among Suffolk County residents (Dec. 1-April 30), according to data published by the Suffolk County Department of Health Services. That approached the level of the first three brutal months of the pandemic (March 12-May 31) claimed the lives of 1,909 Suffolk residents, approximately half of those were in nursing homes. (In contrast, about 15% of Suffolk’s fatalities last winter were in nursing homes.)
Delta began circulating widely in Suffolk this summer, pushing local case numbers up beginning in mid-July. Hospitalizations rose and the death toll climbed. From Aug. 1 through Nov. 30, there were 231 COVID-19 fatalities in Suffolk. During that same period in 2020, there were 24 COVID-19 fatalities in Suffolk.
According to the State Department of Health, the delta variant has been responsible for nearly all new COVID infections in New York since late July, reaching 100% of all new cases for the two weeks ending Nov. 20.
According to State Health Department data, vaccination makes all the difference in incidence of infection, severity of illness, hospitalization and death.
Breakthrough infections — infections among fully vaccinated individuals — rose sharply when the delta variant became dominant in New York. But infections among fully vaccinated adults remain low compared to infections among unvaccinated adults: 15 per 100,000 vs. 71 per 100,000.
A more striking — and more important — “delta vs. the vaccine”statistic is the hospitalization rate. Daily hospital admissions of unvaccinated COVID patients were more than six times higher than for fully vaccinated COVID patients: 6.6 per 100,000 for unvaccinated patients and less than 1 per 100,000 for fully vaccinated patients, according to the most recent data (Nov. 8) published by the state.
Vaccine effectiveness in preventing severe illness and hospitalization remained over 92% in fully vaccinated adults as of Nov. 8, according to the state health department.
Officials hope that the relatively high vaccination rate in New York will mean a less deadly winter this year. While current hospitalizations and daily new admissions are lower right now than they were at this point in 2020, fatalities are actually up a bit: 22 in the week since Thanksgiving this year, compared to 17 in the same period last year. However, the total number of COVID patients hospitalized daily is significantly lower: a seven-day average of 149 this year compared to 252 on this date in 2020. New admissions are also lower: an average of 24 per day in the past week compared to 36 per day in the same period last year.
It will take time to understand omicron and its impacts
The data presumably does not reflect any impacts from the new variant, designated a “variant of concern” and dubbed omicron by the World Health Organization just last Friday. It was identified by scientists in South Africa earlier that week. Since then, it has been detected around the world.
“We have reports of omicron in 38 countries in all six WHO regions,” epidemiologist Dr. Maria Van Kerkhove, the COVID-19 technical lead at the World Health Organization, said during a live Q&A webcast by the organization yesterday, “and we do see increasing trends in omicron in South Africa.”
Much remains unknown about how this variant behaves and what its impacts will be, Kerkhove said, though researchers around the world are working “fast and furious” to understand it.
“There is a suggestion that there is increased transmissibility,” Kerkhove said, noting the unusually high number of mutations on the spike protein, which binds the virus to human cells and the increasing case numbers in South Africa.
“What we need to understand is if it is more or less transmissible than delta. Delta is still dominant worldwide. That’s important to keep in mind,” she said. “We need to see how omicron compares with delta when they’re both circulating in the population at the same time. That will take a few more days,” Kerkhove said.
“It’s too early for us to really understand severity with omicron,” Kerkhove said.
“There are clues that there may be reduced efficacy of vaccines with omicron,” she said, but it will take from one to three weeks to understand this.
‘Keep doing what we know works’
Nevertheless, officials urge people to take the countermeasures scientists know work. First and foremost, get vaccinated, Kerkhove said.
“We’ve seen that one variant can replace another,” said Dr. Mike Ryan, WHO Health Emergencies Programme executive director, who joined Kerkhove for the Q&A. “Right now, 99% of all transmissions are delta. If we do the right things to stop that, we’ll be doing the right things to stop omicron,” he said.
Kerkhove said it is “very concerning” to see the rising number of cases around the world. This is “driven by the delta variant,” she said. What follows increasing infections are more hospitalizations and more deaths, she said.
“We’re stills seeing a high level of deaths,” Kerkhove said. Last week 47,000 deaths were reported globally.
“That number should be drastically reduced because we have vaccines,” Kerkhove said. “Vaccinations result in a massive reduction in severe disease, hospitalizations, admissions to ICU, and death,” she said. “The most important thing is to make sure you get the vaccine and receive your full course.”
Kerkhove also urged all countries to strengthen measures already in place to fight the virus. “It does not mean lock down. Take measures to drive transmission down or … keep it low,” she said.
“Keep doing what we know works,” Ryan said.
Health officials urge people to wear a mask in indoor public spaces, maintain a distance of at least three feet from other people, cough or sneeze into a bent elbow and wash your hands thoroughly and often.
And this holiday season, like last year, avoid crowded indoor gatherings.
“We just may have to curtail some of our social mixings and gatherings” in the months ahead, Ryan said.
That’s not because of the new variant, he said. “We were in that situation anyway without omicron. Omicron tells us we’re not out of this yet,” Ryan said.
Focus on global vaccine equity to end the pandemic
Both WHO scientists stressed the need to improve vaccine equity globally as the only way to defeat the virus.
“Administering boosters to otherwise very, very healthy people, younger people, and many governments have made that decision, but that puts pressure on vaccine supplies to people who have not received their first dose,” Ryan said.
Governments have to balance their responsibility to protect their own citizens and with their responsibility to the global community, Ryan said. He called this “the central struggle in this pandemic.”
“We have highly effective vaccines,” he said and we need to be “laser-focused” on getting people vaccinated equitably on a global basis.
“If we were doing a bit better on equity, we might be doing a bit better in this pandemic response.” Ryan said.
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