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Health experts: Expect a 'second wave' of COVID-19. How big? Depends on you.

Long Islanders waited on the Long Beach boardwalk

Long Islanders waited on the Long Beach boardwalk to pay their entrance fee to go on the beach last month. Credit: Newsday/J. Conrad Williams Jr.

Hospital executives and epidemiologists say that, while the number of COVID-19 patients in the region remains low, a second wave will come, and much of its trajectory will depend on whether Long Island residents follow social distancing guidelines.

The timing and strength of the potential wave, however, is difficult to predict, experts said, adding that better testing and contact tracing should help keep the region from reaching April’s peak COVID-19 levels.

"If we do all the right things, we can control it and minimize it," said Dr. Reynold A. Panettieri Jr., professor of medicine at Rutgers Robert Wood Johnson Medical School in New Brunswick, New Jersey. "But it's a fait accompli, it is going to come. This has been the case in Europe, and there is no reason to believe the United States, including this region, will be any different."

Germany, for example, had nearly 7,000 daily cases in late March, before cases fell to a few hundred per day in June and July. On Aug. 21, more than 1,700 new cases were reported there, still much less than the peak.

"It is going to come. This has been the case in Europe, and there is no reason to believe the United States, including this region, will be any different."

Dr. Reynold A. Panettieri Jr., Professor of medicine, Rutgers Robert Wood Johnson Medical School

Gov. Andrew M. Cuomo last week warned that an increase in COVID-19 cases would come, and said the fall would create a "host of complexities," including an expected increase in seasonal flu and the reopening of schools throughout New York.

Long Island, and the state as a whole, has successfully navigated through the summer months, according to COVID-19 statistics compiled by Newsday. New cases, hospitalizations and deaths have remained low.

New cases in Nassau and Suffolk counties have stayed well under 200 over the last two months, and mostly under 100 per day in August, while hospitalizations in the region have fluctuated between 85 and about 150 COVID-19 patients since July. 

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Hospitalizations were above 4,000 during the height of the first wave of the pandemic in April, when more than 100 people were dying daily at Long Island hospitals.

Behavior affects virus' spread

Another wave won't bring numbers of that magnitude, said Dr. Patrick O'Shaughnessy, chief clinical officer at Catholic Health Services of Long Island, which operates six hospitals.

"We are basing the idea of another wave on modeling, which looks at infectivity rates, but the real increase would be impacted by how compliant people are to help mitigate the spread," O'Shaughnessy said. "People are generally following guidelines, which include using a mask, social distancing and practicing good hygiene.

"Most everyone has taken their role in this seriously, and we will need to continue to take it seriously, because the fall and winter are going to be critical," he said. "We will see small brush fires, but the key is not to let it coalesce into an inferno."

"... We will need to continue to take it seriously, because the fall and winter are going to be critical. We will see small brush fires, but the key is not to let it coalesce into an inferno."

Dr. Patrick O'Shaughnessy, Chief clinical officer, Catholic Health Services of Long Island

At Northwell Health, the largest health system in the state, hospitalizations have plummeted from about 3,400 in April to about 70 as of Monday, and the intensive care units have remained quiet, said Dr. David Battinelli, chief medical officer at Northwell.

Battinelli said more widespread testing would keep numbers lower. However, he said, "people are getting less careful, and this theoretical second wave happens if we aren't careful."

He said behavior at college campuses nationwide will play a role in how the virus spreads, especially since students travel around the country to attend universities.

"Right now, the prevalence of COVID is less, and people without the virus can't give it to each other," he said. "But when someone travels into the area, well, yes, that changes the dynamic."

Indoor gatherings as a factor

School reopenings and cooler weather also will lead to an increase in indoor gatherings, and that could accelerate COVID-19 cases on Long Island, said Dr. Bruce Polsky, chairman of medicine at NYU Winthrop in Mineola.

"Indoor activities, even if they're small groups with precautions, could be a risk," Polsky said. "When you look at what's happened at college campuses across the country, an uptick seems inevitable. The question is if we can maintain it."

Polsky, however, added that while having teachers, staff and children together is a risk, "There is also the concern of the well-being of children, and most childhood development experts agree that it's important to — at whatever level we can — get kids into a live educational format."

Schools will have varying levels of success in keeping kids safe, said Alvin Tran, a professor of public health at the University of New Haven in West Haven, Connecticut.

"Some schools are going to have better resources," Tran said. "This includes being able to limit class sizes, access to masks for everyone and ventilation. Areas that are well ventilated are less risky."

Tran added that schools, like the public at large, will be more successful at controlling outbreaks with effective testing and contact tracing efforts.

"Testing, contact tracing and messaging at schools about the shared responsibility involved in avoiding an outbreak will make a big difference," he said.

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