COVID rates are rising again. Who's most at risk?
As the percentage of people testing positive for COVID-19 continues to rise on Long Island, experts say those who didn’t contract the coronavirus in the past few months are most at risk, but if they’re vaccinated, their vulnerability drops.
The spread of the highly contagious omicron subvariant BA.2 and a decline in mask-wearing are causing the rise in rates after they declined sharply following the omicron surge earlier this winter, said Dr. Leonard Krilov, an infectious disease expert and chief of pediatrics at NYU Langone Hospital-Long Island in Mineola.
The positivity rate likely will continue to rise somewhat, but he didn’t expect a major new wave of infections.
“The immunity levels in the population are pretty good” because of vaccination and the large number of people infected with the coronavirus in recent months, he said. “I’m guardedly optimistic we won’t see major blips.”
WHAT TO KNOW
- The percentage of people testing positive for COVID-19 continued to rise on Friday, to 2.31%. It had been 1.99% on Tuesday.
- Experts don’t believe there will be another major surge, because there is relatively strong immunity from the vaccines and from infections during the winter omicron spike.
- A second booster shot may be advisable in the near future, especially for older adults and those with certain medical conditions, experts say.
After the Long Island positivity rate reached nearly 27% in early January, it fell to 1.52% by March 9. But it’s been steadily rising since then, with the increase accelerating in recent days, going from 1.99% on Tuesday to 2.31% on Friday.
Dr. Bruce Farber, chief of public health and epidemiology for Northwell Health, said people who both contracted the virus in recent months and are vaccinated, and especially those who also received booster shots, are most protected against new infection. But immunity gradually wanes over time, he said.
"Every month that goes by and we’re further away from January, when most of those people got infected, the number of vulnerable people is going to grow," he said.
Farber said that, to limit the spread of the virus, “the things we can do are give another booster or change our lifestyles again." But, he said, "there’s no appetite in our country" for reinstituting restrictions such as mask mandates.
"The only remaining option is really boosters," he said.
Considering a 2nd booster shot
It’s unclear when a second booster shot is advisable, Farber said. Earlier this month, Pfizer and BioNTech asked for Food and Drug Administration authorization for a second booster for those 65 and older, and Moderna asked for authorization for additional boosters for all adults.
The Biden administration is planning to allow everyone 50 and older to receive a second booster of the Pfizer-BioNTech or Moderna vaccine, although it would only be an option, not a recommendation, according to multiple news outlets. The proposal was first reported late Friday in The New York Times. The FDA could authorize a second booster in the next several days, the reports said.
Krilov said focusing on older age groups first is logical.
“The argument for it, and it makes some sense, is that after 50, 60, you don’t respond as well, your immune system isn’t quite as robust,” he said. “To boost that population does make some sense. … Everybody’s felt that we’re going to at some point need additional boosting. It’s figuring out the timing of it.”
Data out of Israel, which for months has allowed second boosters for people 60 and older and other vulnerable groups, is promising, Farber said. But the results are from two months after the booster was given, and “normally we don’t make decisions based on two-month follow-ups,” he said. It’s unclear how quickly protection wanes after two months, he said.
Farber worried that if the FDA gives older adults an option for a second booster, but not a full recommendation, it could be confusing and lead “to very mixed messages among the public.”
Farber said people 60 or 65 and older probably should get a second booster, if authorized. For people in their 50s, it would depend on how much time they spend in crowded indoor spaces and whether they have health conditions making them more vulnerable, he said.
“A healthy 50-year-old may want to pass on a booster right now, but a 50-year-old with asthma, chronic obstructive pulmonary disease, heart failure, that’s a whole different picture,” he said.
56% of eligible NYers boosted
In New York, 56% of those eligible for a booster have received one, and 76.1% of the population has received at least two vaccine doses, or one of the Johnson & Johnson, according to state data.
Unvaccinated people 12 and older are more than three times as likely to test positive for the coronavirus than boosted people, and 21 times more likely to die of COVID-19, according to the Centers for Disease Control and Prevention.
The timing of a second booster would be a judgment call, Krilov said. With the positivity rate still relatively low, it may make more sense for many people to wait until just before the fall, when the risk likely will be higher.
“On the other hand, if I have multiple risk factors, I’d probably say get it as soon as it’s approved,” he said.
The number of COVID-19 hospitalizations rose on Long Island, from 119 on Thursday to 123 on Friday, state data shows. But that was after a large drop, from 143 patients on Wednesday. More than 58% were admitted for a reason other than COVID-19.