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Public health experts urge caution in Maryland as COVID cases, positivity rate rise

Maryland residents have reached another turning point in the coronavirus pandemic, public health experts say, as the state sees rising numbers of COVID-19 cases and a spiking testing positivity rate — signs that the public health crisis continues to rage even as more people get inoculated against it.

“This is the time for all officials to urge caution,” said Dr. Leana Wen, a former Baltimore health commissioner and public health professor at the George Washington University in Washington, D.C. “We need to keep wearing masks in public places, and we need to be very diligent about avoiding crowded indoor gatherings for those who are not yet vaccinated.”

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On Tuesday, the state’s positivity rate passed the World Health Organization’s recommended 5% threshold, the crucial metric that the agency suggests governments monitor before moving to further loosen restrictions. The 14-day average of daily cases has risen to about 1,000 in Maryland, compared with less than 800 earlier this month.

Hospitalizations have also been trending upward. More than 1,000 people in Maryland are currently hospitalized for the second consecutive day, and 245 of them are in an intensive care unit.

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Nationally, the United States has seen a seven-day average of about 60,000 new cases confirmed per day, down from a peak of about 250,000 cases per day on average in January, according to the U.S. Centers for Disease Control and Prevention.

Though the death rate has dropped significantly over the past several weeks, public health professionals say it can take about a month for the impact of a growing case count to be reflected in hospital admissions or deaths.

“I really have to stress that there are no guarantees at this point,” said Jennifer Nuzzo, an epidemiologist and senior scholar at the Johns Hopkins Center for Health Security. “It’s still possible this virus could outpace our efforts to vaccinate.”

Nuzzo and others attribute the upward tick in cases and testing positivity rates nationally to a combination of factors, including the widespread circulation of new, more contagious COVID-19 variants, the premature relaxing of restrictions by several governors and local leaders, and a false sense of security during the ongoing vaccine rollout.

“Just because it’s open doesn’t mean you need to go,” she said, referring to state governments’ loosening of restrictions on indoor bars, restaurants, shopping malls and other gathering spots.

Meanwhile, testing for the coronavirus in Maryland is down more than a third since December, according to the latest state figures. Nuzzo said the decline reflects national testing trends and might be related to the attention — and available health care staffing — shifting toward vaccinations.

Dr. Rochelle Walensky, director of the CDC, voiced concerns Monday about the “impending doom” that could accompany a rising tide of infections.

In an emotional appeal, she urged state leaders to reimpose mask mandates and other virus-related restrictions to stave off a “fourth surge” of the pandemic, which has infected more than 30 million Americans and killed at least 550,000.

“We have so much to look forward to, so much promise and potential of where we are and so much reason for hope,” she said during a White House briefing. “But right now, I’m scared.”

In Maryland, more than 2.6 million doses of vaccine have been administered. A large percentage of those considered fully immunized include older adults, nursing home and assisted living residents, and people with certain health conditions and front-line occupations — those considered more at risk of contracting COVID-19 and developing severe illness.

Nonetheless, state data shows that nearly 30% of Maryland’s population 65 and older remains unvaccinated. About 40% of seniors are fully immunized, and the other 30% have received at least one dose of vaccine.

Meanwhile, white people continue to receive more than three times the number of immunizations as Black people, and only about 4% of Latino residents in Maryland have been inoculated. Those groups have been hit particularly hard by the pandemic, especially early on.

Maryland acting health secretary Dennis R. Schrader, in a virtual meeting with state lawmakers on Monday evening, said young people were driving the surge in Maryland’s cases but not causing an uptick in the death toll. He said the state’s health department would continue monitoring the trends but would not yet recommend scaling back Maryland’s reopening measures.

“We don’t want to overreact,” Schrader said. “This is a fairly flat curve in terms of growth.”

He said Maryland’s continued mask and social distancing requirements have helped reopen the economy while also keeping the case count and hospitalization tally at relative lows. He reiterated his priority of vaccinating people 65 and older as a way of maintaining progress.

“That’s the key to this,” he said.

But Wen and other public health professionals said a failure by state and local officials to urge vigilance — and failure by the public to follow safety precautions — could jeopardize the health of young people, as well as those older adults not yet vaccinated.

“What will likely happen with this surge is that we won’t see our hospitals becoming overwhelmed, but we will see proportionally more younger people becoming ill and dying than prior surges,” Wen said.

The three authorized vaccines in the U.S., made by Pfizer/BioNTech, Moderna and Johnson & Johnson, have been touted by scientists and researchers as widely effective at preventing severe illness and death due to COVID-19. Both Pfizer’s and Moderna’s vaccines call for two doses scheduled three and four weeks apart, respectively, while the Johnson & Johnson immunization only requires one shot.

All three vaccines are most protective after two weeks. For those who get the Pfizer and Moderna vaccine, that means waiting two weeks after the second shot before acquiring broad immunity against the coronavirus. For the Johnson & Johnson recipients, maximum protection comes two weeks after the injection date.

Until the state and national case counts and hospitalizations decrease, and positivity rates dip dramatically, experts say to continue wearing masks, adhering to social distancing policies and practicing good hand hygiene.

“We very well could be putting ourselves on a path to normalcy, but that is only if we continue doing the hard work that we have been doing,” Nuzzo said. “We can turn this ship around. We just need to hold the line a little bit longer.”

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