Worcester County on Maryland’s Eastern Shore has reported just 286 COVID-19 cases, disproportionately low for even this mostly rural county.
But with summer in swing, people are flocking to the county’s beaches. Ocean City can pack in hundreds of thousands of people a week, and crowd-weary state and public health officials are keeping an eye on the sand — and warning Maryland will reimpose restrictions if needed to stem any surge in infections.
Cases have skyrocketed in states including Florida, Texas, California and others that lifted restrictions, leading more people to gather. Those and smaller, new outbreaks in the nearby Delaware beach towns of Rehoboth and Dewey have so far bypassed Maryland, though no one believes the pandemic is over.
“Vacation tends to put one into a relaxed state of mind,” said Rebecca Jones, health officer for Worcester County. “However, as a reminder we are still in a State of Emergency in Maryland and our expectation is that persons visiting our beach exert personal responsibility.”
Since the pandemic arrived in mid-March, Maryland has reported more than 67,500 coronavirus cases and more than 3,000 deaths. Its overall infection rate remains higher than in many of the states now seeing surges, but cases, deaths and hospitalizations have been on a mostly downward trajectory since Maryland’s peak in late April, after Gov. Larry Hogan issued a stay-at-home order.
Since then, the state has expanded testing to more than 200 sites and the number of contact tracers to more than 1,300, and the positivity rate among those tested has dropped below 5%, a threshold set by the World Health Organization showing that most cases are being identified.
Hogan has lifted many restrictions in the state, though he gave local jurisdictions flexibility to continue tighter measures. Worcester has followed the governor’s orders along with many other counties, which means a lot of businesses could reopen with limited capacity, mask use and other restrictions.
The governor plans to issue public health guidance ahead of the Fourth of July weekend, “reinforcing the importance of masks, physical distancing, avoiding large indoor gatherings, noting that standing in bars is not permitted,” said Michael Ricci, a spokesman for Hogan.
Ricci said the state has partnered with Worcester County to open a free testing site in Ocean City for the summer.
The Maryland Department of Health attributes the downward trends in the state to the early and sustained efforts by state leaders and “incredible sacrifices of Marylanders,” and officials continue to encourage vigilance.
“As the July 4th holiday approaches, and more people venture out, it is strongly encouraged that they practice social distancing, wear a mask and proactive adequate hand hygiene,” said Charles Gischlar, a department spokesman. “If major outbreaks or clusters of cases occur, the state will take fast mitigation actions to protect the health and safety of Marylanders, including potentially rolling back some of the reopening steps.”
The health department already is advising visitors to Maryland from out of state to get tested. The state has not asked visitors from out of state to self-quarantine as other states experiencing fresh outbreaks such as New York, New Jersey and Connecticut have asked of travelers from 16 states.
Dr. Anthony Fauci, a Trump administration adviser as director of the National Institute of Allergy and Infectious Diseases, warned this week that aggressive action may needed as the pandemic begins to spiral out of control.
Other states with mounting cases have begun slowing their reopenings or reversing previous orders lifting restrictions. Some states, such as California, Florida and Texas, are reclosing bars and restaurants. Some, including California and Florida, are closing beaches, too.
This week, the Delaware Division of Public Health asked people at its beaches to get tested for the virus after a cluster of cases likely resulted from people not wearing masks or keeping their distance at area bars, restaurants and parties. Gov. John Carney on Tuesday ordered beach bars to close ahead of the Fourth of July weekend.
“Make no mistake, continuing this behavior is a recipe for disaster,” said Dr. Karyl Rattay, Delaware’s public health director, in a statement. “It is a sure way for us to end up with widespread infection that ultimately may not be contained in the beach area.”
On Maryland’s shore, Worcester officials continue to expand testing and contact tracing, with more than 600 people monitored for symptoms through daily communication for at least two weeks.
Jones, the county health officer, said she knew there would be more crowds after the state loosened restrictions and also stressed the importance of preventive measures such as masks and distancing.
While many flock to local and national beaches, there’s evidence the uptick in cases in so many states is getting the public’s attention.
The latest Axios-Ipsos Coronavirus Index, an ongoing poll, found that fears of the virus are as high as ever. In the poll released this week, about 84% of Americans said they were very or somewhat concerned. About three-quarters were concerned the community was reopening too soon.
The poll found 78% felt attending a Fourth of July holiday event was a large or moderate risk. An earlier poll in May found three-quarters believed vacationing was risky and half had canceled summer vacation plans.
The concern is warranted, said Dr. Anne Schuchat, principal deputy director at the U.S. Centers for Disease Control and Prevention. In a video interview this week with the Journal of the American Medical Association she likened the pandemic to the 1918 flu pandemic that infected 500 million globally and killed 50 million.
The coronavirus has infected 10 million people globally so far, a quarter in the United States, and killed more than 500,000, according to data from the Johns Hopkins University.
“I think there was a lot of wishful thinking,” Schuchat said. “Hey, it’s summer and everything will be fine. But we’re not over this. We’re not even beginning to be over this.”
In Maryland, work to contain the virus and maintain preparedness never ceased, even with easing of restrictions.
The state continues to expand testing and add contact tracers. Officials have launched educational campaigns urging mask-wearing, distancing, hand-washing and working with contact tracers. They also continue to track resources and maintain a hospital overflow unit at the Baltimore Convention Center that has been only lightly used.
Officials meet via conference calls multiple times a week for information sharing and planning.
“Everyone is keeping their eye on the ball,” said Dr. Ted Delbridge, executive director of the Maryland Institute for Emergency Medical Services Systems, or MIEMSS, which coordinates the state’s emergency services. “We are preparing for the next wave.”
MIEMSS has been keeping a count of available hospital beds, including ICU beds. Delbridge said there are more than 1,700 beds available in Maryland hospitals, or about 25 percent of all beds. That’s up from about 900 or so during the peak in the state.
The hospitals added capacity on an order from Hogan to add 6,000 beds to handle possible COVID-19 cases, but many hospitals have since reduced their staffing, turning more attention back to elective procedures that were banned for a time.
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There are about 450 people hospitalized now with COVID-19, according to state data.
Delbridge said the hospital systems could reverse course easily to make room for another wave of COVID-19 patients.
“We don’t want the system to get overwhelmed,” he said. “We have resources in place, but we also know more now about how to prevent cases. Hopefully, people will take personal responsibility.”
That means all those safety measures must continue until there is a vaccine, said Dr. Georges C. Benjamin, executive director of the American Public Health Association and former Maryland health secretary.
He said the state has responsibilities, too, to increase testing and tracing, and offer clear and consistent messaging. Officials should reopen slowly, “pausing when necessary and [using] targeted reclosures as soon as we see an uptick,” Benjamin said.
With summer here, people should not let down their guard and “stay a safe distance even on the beach,” he said.
“The bottom line is we will get an increase in cases no matter what we do pending a vaccine,” he said. “The goal is to manage the increase as carefully as we can.”