Will it be different this time around? Coronavirus case counts and other key metrics are ticking up again in Massachusetts, a distressing development in a state that has already endured massive disruption, illness, and loss of life from the pandemic.
The seven-day average of confirmed coronavirus cases climbed to 141 on Wednesday, up from a low point of 52 it had reached on June 28, according to Department of Public Health data. The seven-day average rate of positive tests has also been edging upward.
The numbers remain at extremely low levels compared with the state’s first surge in the spring of 2020 and second surge this past winter.
But the increases are consistent with a national rise seen as a result of the fast-spreading Delta variant, lagging vaccination rates, and Fourth of July gatherings. And they come after weeks of euphoria over pandemic numbers that were dropping and vaccination numbers that were rising - and growing hope that the pandemic might finally be crushed.
We asked experts to weigh in on the situation in highly vaccinated Massachusetts, including whether people should start taking precautions again. Here’s what they said.
How concerned should we be?
“Any increase in numbers of cases is of concern,” said Dr. Daniel Kuritzkes, chief of infectious diseases at Brigham and Women’s Hospital. But for now, the number of new cases is “still quite low,” he said.
And because most of the new cases are in otherwise healthy young adults, “It’s not yet having a huge impact on hospitalizations here in Massachusetts,” said Kuritzkes.
Dr. Philip Landrigan, director of the Global Public Health Program at Boston College, said it’s important to keep the uptick in perspective.
“Even though it’s real and even though it’s not good, the numbers are still incredibly down from where they were a few months ago,” he said — a fact he attributes “almost entirely” to the fact that Massachusetts is a national leader in vaccinations.
“The vaccine is highly effective and it’s effective even against the Delta variant,” Landrigan said. Both in Massachusetts and across the U.S., “virtually every case is occurring in somebody who’s not vaccinated.”
“I think something’s going on. I’m worried,” said Dr. David Hamer, a physician at Boston Medical Center and a Boston University epidemiologist. “I think that it looks like the United States is starting to have an uptick in cases on average across the whole country. ... And therefore this may be spreading into Massachusetts, so we need to increase our guard.”
He said he was worried about the virus spreading both among unvaccinated people and vaccinated people, saying he’d like to see more data on how effective the shots really are against the Delta variant.
Kuritzkes noted that any time there is more virus circulating in the community, the more opportunity there is for vaccinated individuals to become infected — a particular concern for those with weak immune systems.
“I think we all have to be concerned until everybody is vaccinated and protected from this virus,” said Dr. Helen Boucher, interim dean of the Tufts University School of Medicine. “We’re not all safe until everyone is safe, not just here in Massachusetts but actually around the world.”
What should people do?
“I don’t think we need to be making any significant changes at this time — although obviously we need to keep a close eye on the numbers,” Kuritzkes said. “I think people who are fully vaccinated, unless they are immunocompromised, have every reason to believe that they are fully protected.”
Kuritzkes said shopping “is not a problem,” but recommended that individuals be a “little more conservative” at large indoor events, like concerts.
“Even if you’ve been vaccinated, you might want to think twice about going into an intensely crowded situation,” Landrigran agreed.
Boucher said unvaccinated people should always wear masks indoors.
Hamer advised people, even if they have been fully vaccinated, to resume wearing masks in indoor public spaces, such as restaurants, bars and movie theaters.
“People should wear masks at least as much as feasible in indoor settings,” he said. He said he himself wears a mask when he goes into stores.
Dr. Paul Sax, clinical director of infectious diseases at the Brigham, also sounded a cautious note, saying that while all outdoor activities are generally safe, he and other infectious disease specialists “have continued to wear masks in indoor public spaces, especially if crowded. This includes stores, supermarkets, and public transportation.”
As for dining, he said in an e-mail, it’s a risk and “each person needs to make the decision for themselves.”
“People should remember that COVID is still very much with us. While socializing with other vaccinated people is generally safe, crowded indoor spaces where vaccinated and unvaccinated people mix can definitely lead to transmissions – even among those who are vaccinated,” he said.
What about vaccinations?
Getting people vaccinated remains crucial, the experts said.
“One of the messages should be that anyone who has not been vaccinated really should be strongly encouraged to do it as soon as possible,” Hamer said. He said hospitals and colleges are doing the right thing by requiring workers and students to be vaccinated.
“People who are not vaccinated really must get vaccinated, both to protect themselves and to protect other people,” Landrigan said. Anyone who is unvaccinated is “gambling with their lives. They’re gambling with their parents lives. They’re gambling with their children’s lives.”
If they still choose not to get the shot, they “have to behave responsibly and not go into group settings where there’s the risk of spreading the disease,” he said. “Anybody who’s not vaccinated who goes into a group setting is just setting themselves up for disease and death.”
Boucher pointed to a recent study by the Commonwealth Fund, a nonprofit research group, that found that vaccinations have already prevented close to 280,000 deaths and up to 1.25 million hospitalizations in the United States.
It’s summer. What about everybody’s vacation?
Landrigan said it’s fine for fully vaccinated families to head out on vacations — so long as the case rates are low at their destinations.
”If they and their family are fully vaccinated, I would have no problem at all with them going to the Cape or any place in New England,” he said. “If they were going to go to Alabama, there’s going to be more risk because it’s just a lot more virus circulating around in most of the Southern states.”
Families with children under age 12 who have not been vaccinated, or family members who are immunocompromised, should be extra cautious, he said.
”That person is going to be at some risk if they go to the South,” Landrigan said. Anywhere in New England, though, should be fine.
Landrigan said he and his wife spent time at the Cape last month and only wore masks a few times inside particularly crowded stores.
Will this be as bad as the last two times?
Hamer said if the uptick is the beginning of a sustained rise in cases, the impact could be smaller because of the amount of people who have already been vaccinated. “I think it could be less intense because I think there’s going to be reduced risk of more-severe disease and therefore hospitalization,” he said.
He emphasized that it didn’t mean there was no risk at all once you’re vaccinated, but he said that “the good level of vaccine coverage we have in the Commonwealth will mitigate the potential impact of a third wave.”
Sax said he strongly suspected the impact of the Delta variant would be “blunted” by the vaccines, pointing to Israel, where the variant has caused case numbers to increase, while hospitalization and death numbers have remained low.
To Kuritzkes, the current small increase in cases is actually proof that vaccines are working.
“The fact that we’re not seeing the kind of spread in Massachusetts that is being seen in other parts of the country — like in Missouri and Mississippi — is evidence of effective herd immunity,” Kuritzkes said.
“Overall, the message is that we’re doing well, but people can’t let down their guard,” Landrigan agreed.
Boucher said, “COVID has not gone away as much as we wish it would. That’s the message. The other message: it’s not too late to get your vaccine.”
Material from The Associated Press was used in this report.
Martin Finucane can be reached at martin.finucane@globe.com. Camille Caldera can be reached at camille.caldera@globe.com.
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