Cases are rising around Maryland and much of the Northeast so fast it seems that everyone knows someone who has COVID-19. Some of those infected had it before, while others have it for the first time.
“This isn’t over,” said Crystal Watson, public health lead in the Johns Hopkins Center for Health Security’s Coronavirus Resource Center, during a news conference Friday marking the United States reaching the milestone of a million COVID-19 deaths earlier in the week.
“We are in the midst of a surge,” she said.
It may not be like the pandemic peak over the winter of 2021-2022, Watson said, “but it’s still important to be actively vigilant about preventing infection.”
That’s not a message people want to hear, public health experts and officials acknowledge. But it’s necessary.
The U.S. Centers for Disease Control and Prevention officials said Thursday that the third of the country with high numbers of cases, including the Northeast and Midwest, should mask up again indoors and in crowded spaces.
Baltimore City and a dozen counties in Maryland, including Anne Arundel, Baltimore, Harford and Howard, have moderate levels of community spread of the coronavirus, and public health experts say people should consider wearing masks here, too, given the upswing and the highly contagious nature of the omicron subvariants that are circulating.
The Maryland Department of Health reported 3,016 new cases Friday, the most in a single day since Jan. 28.
Watson and others say the numbers may not look as bad as when they peaked earlier in January, but there are certainly far more infections than reported because a lot of people now test at home and don’t report results.
She doesn’t want people to tune out the guidance. That some people do is disheartening to some public health experts, even those who don’t believe this wave — fueled by those omicron subvariants — will grow much bigger.
The University of Washington’s Institute for Health Metrics and Evaluation models show this surge peaking by the end of May, dropping over summer and not leading to significantly higher levels of hospitalizations.
Ali Mokdad, a professor in the institute, said so many people have been vaccinated or infected that they are not getting severely ill, though with waning immunity over time, they still can catch the virus if they are exposed. The omicron subvariants that are now dominating cases also don’t seem to be more virulent than previous ones, despite being highly contagious.
“The main reason for the rise in infections is behavioral change,” Mokdad said. “People assume there is no more COVID. People aren’t masking, their mobility is high, with spring break and vacations. People are letting their guard down.”
That also means more kids are getting infected now, and are spreading the virus at school and to their parents and neighbors. They may not end up hospitalized. But, particularly if they are unvaccinated, they risk long COVID, the condition where people have symptoms for weeks or months.
They also perpetuate a cycle of infection, Mokdad said.
And some people do get sick enough to need treatment as inpatients at hospitals. There were 426 people hospitalized for COVID-19 in Maryland on Friday, the most since mid-February but still far below the January peak that exceeded 3,200.
That concerns hospital administrators, as beds are full with other patients and many staff positions, particularly nursing jobs, are unfilled.
“Hospitals are keeping an eye on nearby states and national trends,” said Bob Atlas, president and CEO of the Maryland Hospital Association.
“Currently, COVID-19 patients make up only 5% of the hospital volumes, but we are constrained by all the other necessary medical care and persistent staffing shortages,” he said. “We strongly recommend everyone get the fullest course of vaccination that they are eligible for and continue to use common sense when protecting themselves and their families.”
The current surge, while smaller than the large one last winter, is significant. The state reported 11,623 cases in the past week, nearly twice as many as a week earlier. The percentage of tests done in labs in the state that come back positive is about 8.4%, above the standard threshold of 5% that indicates cases are widespread.
Public health officials and experts say there are signs that the public is already in a summer frame of mind and skipping resuming precautions.
Local health departments hand out home test kits, but there is no scramble to get them. The federal website that mails them for free is offering them for a third time.
Mask use has dropped from about 67% in January to about 29% now, according to national surveys by the Institute for Health Metrics and Evaluation, the lowest use since the institute began tracking.
State health officials continue to provide and advertise vaccinations, but the long lines are gone. The officials have taken to texting and calling eligible adults about getting another booster shot, but demand for those appears to have tapered off, too.
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The national vaccination rate has stagnated at about two-thirds, with about half of those eligible getting a booster, according to the CDC. Maryland has a higher rate of fully vaccinated people at about 76%.
Chase Cook, spokesman for the Maryland Department of Health, says officials have focused on pushing extra shots because “maintaining that immunity by getting boosted enables Marylanders to learn to live with the virus. We encourage every eligible Marylander to get boosted as soon as possible.”
The department sent a memo Friday to all providers in the state that incudes updated guidance on vaccines and boosters authorized by the U.S. Food and Drug Administration, including a booster dose of vaccine for kids ages 5 to 11 that the federal government authorized a day earlier. The memo also instructs the providers to allow people to simply state that they are eligible for a shot.
Experts say some people may feel the vaccines they have on board are enough. Or they are waiting until the fall, when there could be a combined flu-COVID vaccine or a nasal vaccine that could be more effective in preventing infection and rather than just reducing the risk of severe illness. But the experts recommend getting available shots now, particularly those most at risk for severe disease.
Dr. Brian Garibaldi, medical director for the Johns Hopkins’ Biocontainment Unit, also said in the Friday news conference that people infected and at risk for severe disease should ask for treatments. There is a monoclonal antibody therapy that works on the omicron subvariants and also oral antivirals, such as Paxlovid, that if taken early can prevent hospitalizations for COVID-19, he said.
But Garibaldi and others say they hope people don’t give up on preventing infection to begin with.
“We know masks work; we know they prevent disease and save lives,” he said. “It’s not just about you, but those around you.”