Syracuse, N.Y. – When will central New York see the worst of the coronavirus pandemic? And what happens after that?
No one is certain. Although it seems eternal from the start, experts say the pandemic is still at the beginning and it is difficult to make predictions.
Here’s what they’re agreeing on, for the most part, right now:
* We are not yet at the top. The number of people tested positive and hospitalized continues to increase.
* We will reach a peak after New York. Estimates for the Downstate Peak range from this week to April 18. The upstate should be a few weeks late.
* We will not know immediately when the peak reaches. It will take some time to determine whether a decrease in the rate of new cases is real or an anomaly.
* There can be multiple peaks, not just one. Multiple waves of infections could continue to roll until 2021.
Experts say the pandemic is just beginning in New York. Confirmed cases of COVID-19, the disease caused by the virus, continue to increase in New York and Onondaga County. The same goes for the number of people sick enough to be hospitalized.
Governor Andrew Cuomo announced Monday that 1,200 people have died, mostly in New York City and surrounding counties. This figure increased by 200 people for the third day in a row. Cuomo said 9,517 were in hospitals.
Onondaga County confirmed its first case of COVID-19 on March 16; on Monday, there were 228. The number of people in the hospital increased from five to 23 in one week. One person died.
“Onondaga County is still in its infancy,” said Brian Leydet, who teaches courses on infectious diseases and epidemiology at SUNY College of Environmental Science and Forestry. “It is too early to predict the peaks. We will not know when it will happen until it gets closer.”
Focusing on “rush hour” can also be misleading. If the school closings and other restrictions put in place in recent weeks work as expected, the case peak would be much lower, but the pandemic would continue for months. This is exactly the point of social distancing: not to keep people from getting sick, but to get sick at the same time and overwhelm hospitals.
In daily briefings in Syracuse, Onondaga County Director Ryan McMahon said the drop in demand for testing is a sign that social distancing is working. However, two hours west, Erie County Director Mark Poloncarz painted a darker picture, saying Friday that the peak in the Buffalo area is still a few weeks away. Poloncarz said the county plans to convert a convention center to a field hospital.
Governor Andrew Cuomo said New York City would be the first to reach the summit, but no part of New York State would be spared.
“Current projections indicate that New York City will face the first high water mark, but then you will see Westchester, Long Island behind, then Upstate New York,” Cuomo said on Sunday. “So if you’re not in a very infected health zone now, that doesn’t mean you won’t have a real situation to deal with, because those numbers are just going to increase across the state.”
Cuomo says the peak of the Downstate epidemic, when the largest number of patients flock to already overcrowded hospitals, is still two to three weeks away. New research from the University of Washington, where Seattle was fighting the virus even earlier than New York, shows that New York City could peak this week or next.
There is no shortage of pandemic forecasts, as researchers from Seattle to Boston published articles last week showing how the virus could manifest itself. Some of these models show very different results, from everything from when the virus peaks to the effectiveness of social distancing measures.
It may take weeks before the effects of social distancing become clearer. Schools and restaurants were closed just two weeks ago and, on Friday, McMahon banned social gatherings. As the number of positive cases and hospitalizations continued to increase on Monday, McMahon remained optimistic, saying the backlog of tests was almost gone and more people were recovering from the disease.
“There are many things that can go wrong if the community does not react well to social distancing,” he warned. “If these things start to happen and in the next two to three weeks we are really going to starve, I think we will be in good shape.”
The virus is so new – it first appeared in China just four months ago – that epidemiologists find it difficult to design precise models that project its arc. They are hampered by the scarcity of relevant data and dependence on untested hypotheses, which can create great disparities between models, or even within the same model. Epidemiologists who respond to the FiveThirtyEight blog, for example, give an estimate of American mortality from 36,000 to 1.3 million.
Trying to understand how the virus will unfold on a smaller scale, like Onondaga County, is even more difficult, as the virus has been studied more in high density areas in other countries.
“I think it’s too early to tell,” said Dr. Sharon Brangman, chair of the geriatrics department at Upstate Medical University. “If we look at what has happened with other countries like China and South Korea and Italy, we know that we are not at our peak yet.”
We might not recognize the peak when it occurs, at least not right away. Day or even week data, especially on a small scale such as a county, may be more influenced by random fluctuations than in a heavily populated area with more cases. If the rate of new cases or hospitalizations starts to stabilize or drop, we will have to hold our breath to see if it holds.
Lowering the COVID-19 peak in hospitals was the main objective on the first day of the pandemic. After this day, however, the problem is far from over. The virus is not going to go away, and social estrangement could help create a second wave of infections this summer or fall. A recent study from the University of Massachusetts indicated that there was a 73% chance that a second wave would occur between August and December.
All these people who stayed at home will have to emerge at some point to go to church or have their hair cut. And when they do, they will move from the category that scientists call “deleted” to a category called “sensitive”. Their bodies will have no way of repelling a virus from which they are essentially hidden.
“What happens in two, three or four months from now when you have this influx of sensitive people?” Leydet asked. “Once the vulnerable population has shrunk, you will see a further increase in infections.”
Another reason why we might have an autumn hatch is the weather. If the new coronavirus hates heat and humidity as much as the flu and other coronaviruses, infections will decrease in the summer. But then he could roar in fall and winter
By then, doctors and scientists hope that we will be in better shape to help people who fall ill next fall. Hospitals will not be overcrowded, and some infected people will now be immunized, so the virus will find itself in a dead end with them. Over the next year, doctors hope that better treatments and possibly even a vaccine will be developed.
There is a growing feeling that we are on the long term on the virus. Cuomo postponed the presidential primary to be held on April 28 and ordered that school board elections be postponed from May 19 to at least June 1. President Trump, after saying he wanted to see churches packed for Easter on April 12, extended federal guidelines on social distance until April 28.
Epidemiologists say that we may need to maintain strict social distancing measures for months to make sure that we have flattened the curve. They speak of the 1918 flu pandemic, when restrictions in the spring dampened infections and deaths. In the fall, however, the flu sounded and killed more people than in the spring. This could happen again with the coronavirus, experts say.
“I have seen places in China where they have relaxed the measures and they have seen an increase in cases,” said Brittany Kmush, professor of public health at Syracuse University. “We have to be careful not to jump the gun.”
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