COVID-19 surge on Long Island: Your questions answered

One of the ways epidemiologists measure a pandemic disease’s progression is by tracking rates and raw numbers of infection, hospitalization, death and other factors, along a graph with x and y axes. The graphed trends are analogized to the waves of an ocean that can rise or fall, according to Martine Hackett, an associate professor of public health at Hofstra University. The waves of a disease can be seen rising, falling or flattening depending on these metrics. A wave is over when the metrics decrease near zero.

Since after the first wave of coronavirus in the spring, infections, hospitalizations and deaths had all been declining precipitously on Long Island and in most of New York State. That lull — through July, August and September — lasted until about late October, when all three metrics and others began increasing. There is no one definition and arbiter of the coronavirus' second wave — some argue that the first wave never ended — but "whether it’s the first wave or second wave or third wave, the main fact is that these numbers are increasing and those increases mean more risk," she said.

Based on Hackett’s back-of-the-envelope analysis of figures from the Centers for Disease Control and Prevention, weekly deaths in New York are forecast to rise about 33% by Dec. 15. Statewide, there are about 300 a week dying of COVID-19, which would rise to about 400 under the forecast. It’s likely to be a similar proportion for Nassau and Suffolk counties, she said. Dr. Bettina Fries, chief of the division of infectious diseases and professor of medicine at Stony Brook University, said she’s concerned that in two weeks, the number of hospitalized patients across the system could double. It was about 60 Tuesday. If it reached 120, that would mean a quarter of patients in the system would have COVID-19. The peak was 430 back in the mid-April, she said. Those trends would be seen across Long Island and impact medical care everywhere, she said.

It’s a mix of factors. Among then is pandemic fatigue — Long Islanders and others tiring of the restrictions such as banning gatherings and limiting indoor activity, and also of covering their faces with masks — coupled with the colder weather, in which people can’t comfortably gather outdoors and are thus heading indoors where coronavirus-containing droplets can transmit virus more easily.

Clinicians have learned a lot about how to treat COVID-19 and its complications. Ventilators — one of the main ways of treating the most dire cases initially — aren't used as much. Many people died after being put on ventilators, some studies showed. There are now monoclonal antibodies and corticosteroid drugs that weren't around or used early on. One method used to improve outcomes of COVID-19 patients is a simple one: "proning." According to research at Columbia University: "COVID-19 patients who could position themselves in a facedown, prone position while awake and supplied with supplemental oxygen were less likely to need intubation and mechanical ventilation." A study of 5,121 hospitalizations, published in October in the Journal of Hospital Medicine, found that mortality dropped to 7.6% in August from 25.6% in March, even when age and other differences are taken into account. Nevertheless, even though the virus is more treatable than in the spring, there are so many people getting it now that thousands are dying every day despite the improved medical treatments available. There is no cure, and the vaccine won't be an immediate panacea.

On Thanksgiving, Gov. Andrew M. Cuomo announced the state is readying a "winter plan" to counteract a potential resurgence after the holiday: prioritizing keeping schools open, particularly for kindergarten through eighth grade; continuing the months-old "microcluster" and zoned approach to nipping smaller outbreaks in the bud; factoring in hospitalization rates, hospital bed figures, and whether non-COVID surgeries are available. "We've been through the worst, and while we're not done yet," he said in a news release, "we are moving forward with the lessons we learned in the spring."