Official COVID case numbers are believed to be vast undercounts because...

Official COVID case numbers are believed to be vast undercounts because most COVID tests are now done at home with kits like these. Credit: Newsday/William Perlman

Summer was supposed to offer somewhat of a respite to Long Islanders from COVID-19. Instead, the region is experiencing its longest sustained stretch of high coronavirus rates since the pandemic began, and some experts fear this could be our new normal.

“This summer should represent what we should expect year to year, and that’s a lot of cases,” said Sean Clouston, an associate professor of public health at Stony Brook University.

Experts said less masking and other precautions and the much higher degree of contagiousness of omicron subvariants, including BA.5, are combining to keep COVID-19 rates stubbornly high — and they’re why high rates may become a way of life for the foreseeable future.

COVID-19 case numbers have gone up and down throughout the pandemic. But after rates surge, they usually drop quickly. This time, the percentage of coronavirus tests coming back positive on Long Island has remained above 7% since late April, when the highly infectious BA.2.12.1, BA.2 and BA.2.12 subvariants were responsible for almost all New York cases. The even more contagious BA.5 began dominating in the early summer.

On many days this summer, the number of confirmed cases has been 10 or more times higher than on the same days in the summers of 2020 and 2021 — even though this year’s numbers are believed to be vast undercounts, because most tests now are done at home and not reflected in official statistics.

“We have in the past thought that in the summer we'll see these diminished rates, and we won't see that many cases, and you can kind of relax a little,” Clouston said, alluding to the lower risk of coronavirus transmission outdoors, where people tend to spend more time during the summer. “This summer, we're not only seeing high positivity rates, but we're seeing a lot of cases as well. That’s a pretty big change as compared to what has happened in the past.”

During most of the summer of 2020, and from mid-May to mid-July of 2021, positivity rates were at or below 1%. They haven’t been that low since then.

Instead, caseloads rose throughout the spring, surpassing 2,000 a day on Long Island on several days in mid-May.

Positivity and case numbers are imperfect. The positivity rate is now based only on PCR results. Case numbers represent only PCR and rapid test results reported to the government, and even those don’t include reinfections.

Dr. Bruce Farber, chief of public health and epidemiology at Northwell Health, said the real case numbers are “much, much higher than those official rates, probably by a factor of 8 or 9.”

That would mean that instead of the 62,632 people officially recorded as having tested positive on Long Island this summer, the real number may be closer to half a million.

“It has been remarkable how long and aggressive” the spring and summer surge has been, Farber said.

Although hundreds of Americans currently are dying every day of COVID-19, omicron and its subvariants generally are less likely to cause severe disease and death than the delta variant, which was dominant during most of the last half of 2021, Clouston said.

Long Island positivity rates and caseloads have slowly fallen in the past few weeks, to a seven-day average of just above 8%, because “after a community is totally inundated with a variant, at a certain point in time the rates will fall,” Farber said.

But Clouston said that, with children returning to school soon, with no masking requirements, and with the possibility of new subvariants, cases may not drop much more.

"This may be our low,” he said.

Nassau and Suffolk counties — and 92% of the nation’s counties — currently are considered by the Centers for Disease Control and Prevention to have “high community transmission.” That, and relatively high COVID-19 hospitalization rates, triggered a CDC recommendation that Long Islanders wear masks in public indoor places. 

One reason that numbers remain high is that many New Yorkers increasingly ignore precautions, said Dr. Jessica Justman, an associate professor in epidemiology at the Mailman School of Public Health at Columbia University in Manhattan.

“More and more, we are using masks less, doing social distancing less, and we are deciding to engage in more indoor activities even if they have large numbers of people,” she said. “So there’s more exposure.”

For most of the summer, Long Island COVID-19 hospitalizations have been several times the levels of the summers of 2020 and 2021, state data shows. 

There also are far more deaths. From June 1 through Thursday, 218 Long Islanders died of COVID-19 — nearly three times the 74 deaths during the same time last year, according to state Health Department data.

Nationwide, an average of 400 people are dying of COVID-19 every day, CDC data shows.

“As a society, good, bad or not, this is what we’ve decided is reasonable to accept” in exchange for returning to a sense of normalcy, Farber said.

The abandoning of precautions is occurring as BA.5, an omicron subvariant dramatically more contagious than the original COVID-19 strain, continues to dominate, creating “a perfect storm to let this continue to percolate,” said Dr. Leonard Krilov, chief of pediatrics and an infectious disease specialist at NYU Langone Hospital-Long Island in Mineola.

It’s much easier to get infected now than a year ago in an indoor public space, and even socializing outdoors may be less safe, Krilov said.

BA.5 is only the latest of a number of omicron subvariants that have developed this year. Each subvariant is different enough that the immune system has a harder time recognizing it — leaving the body more vulnerable to infection, Krilov said.

Pre-omicron, people who contracted COVID-19 could count on long-lasting protection against getting infected again, Farber said. With the changing subvariants, that’s no longer true, he said.

“It’s a different virus,” Farber said.

Booster shots reduce the risk of infection — especially in the first few months after vaccination — and reduce the risk of severe illness even more, he said. But fewer than 55% of Long Islanders eligible for boosters have them, according to state data.

Vaccines that target BA.4 and BA.5 subvariants are expected by the fall. That likely will provide more protection than the current vaccines, even if a new omicron subvariant dominates instead of BA.5, Justman said.

“If a new variant comes in that’s radically different from omicron, we will not be in as good a position as we want to be,” she said.

Already, the omicron subvariant BA.4.6 is spreading in New York, comprising 8.9% of cases for the two weeks ending Aug. 13, state Health Department data shows. There’s also the threat of BA.2.75, which spread rapidly in India and is believed to be more infectious than BA.5, Clouston said.

“There’s no sign that COVID is going to stop changing all of a sudden, so we’re going to get more variants,” he said.

Some of those variants may be more dangerous than omicron, although it doesn't appear that BA.4.6 and BA.2.75 are more likely to cause severe disease than other omicron subvariants, he said. 

“We may find that we’re going to get sort of good COVID years and bad COVID years,” he said.

Despite the high COVID-19 rates this summer, Clouston said that, with omicron generally less lethal than previous variants like delta, “I would guess that this is a good one.”

Summer was supposed to offer somewhat of a respite to Long Islanders from COVID-19. Instead, the region is experiencing its longest sustained stretch of high coronavirus rates since the pandemic began, and some experts fear this could be our new normal.

“This summer should represent what we should expect year to year, and that’s a lot of cases,” said Sean Clouston, an associate professor of public health at Stony Brook University.

Experts said less masking and other precautions and the much higher degree of contagiousness of omicron subvariants, including BA.5, are combining to keep COVID-19 rates stubbornly high — and they’re why high rates may become a way of life for the foreseeable future.

COVID-19 case numbers have gone up and down throughout the pandemic. But after rates surge, they usually drop quickly. This time, the percentage of coronavirus tests coming back positive on Long Island has remained above 7% since late April, when the highly infectious BA.2.12.1, BA.2 and BA.2.12 subvariants were responsible for almost all New York cases. The even more contagious BA.5 began dominating in the early summer.

WHAT TO KNOW

  • Long Island is experiencing the longest period of high coronavirus rates than of any time during the pandemic. The positivity rate has been above 7% since late April.
  • COVID-19 deaths are up significantly compared with last summer. From June 1 through Thursday, 218 Long Islanders died of COVID, compared with 74 during the same time last year.
  • Experts say the widespread abandoning of masking and other precautions, combined with the high degree of infectiousness of the BA. 5 subvariant that has dominated the past few months, are the reasons for the sustained high numbers.

On many days this summer, the number of confirmed cases has been 10 or more times higher than on the same days in the summers of 2020 and 2021 — even though this year’s numbers are believed to be vast undercounts, because most tests now are done at home and not reflected in official statistics.

“We have in the past thought that in the summer we'll see these diminished rates, and we won't see that many cases, and you can kind of relax a little,” Clouston said, alluding to the lower risk of coronavirus transmission outdoors, where people tend to spend more time during the summer. “This summer, we're not only seeing high positivity rates, but we're seeing a lot of cases as well. That’s a pretty big change as compared to what has happened in the past.”

Real cases eclipse reported cases

During most of the summer of 2020, and from mid-May to mid-July of 2021, positivity rates were at or below 1%. They haven’t been that low since then.

Instead, caseloads rose throughout the spring, surpassing 2,000 a day on Long Island on several days in mid-May.

Positivity and case numbers are imperfect. The positivity rate is now based only on PCR results. Case numbers represent only PCR and rapid test results reported to the government, and even those don’t include reinfections.

Dr. Bruce Farber, chief of public health and epidemiology at Northwell Health, said the real case numbers are “much, much higher than those official rates, probably by a factor of 8 or 9.”

Dr. Bruce Farber, chief of public health and epidemiology at...

Dr. Bruce Farber, chief of public health and epidemiology at Northwell Health, said the real case numbers are “much, much higher" than official rates. Credit: Danielle Silverman

That would mean that instead of the 62,632 people officially recorded as having tested positive on Long Island this summer, the real number may be closer to half a million.

“It has been remarkable how long and aggressive” the spring and summer surge has been, Farber said.

Although hundreds of Americans currently are dying every day of COVID-19, omicron and its subvariants generally are less likely to cause severe disease and death than the delta variant, which was dominant during most of the last half of 2021, Clouston said.

Long Island positivity rates and caseloads have slowly fallen in the past few weeks, to a seven-day average of just above 8%, because “after a community is totally inundated with a variant, at a certain point in time the rates will fall,” Farber said.

But Clouston said that, with children returning to school soon, with no masking requirements, and with the possibility of new subvariants, cases may not drop much more.

"This may be our low,” he said.

Nassau and Suffolk counties — and 92% of the nation’s counties — currently are considered by the Centers for Disease Control and Prevention to have “high community transmission.” That, and relatively high COVID-19 hospitalization rates, triggered a CDC recommendation that Long Islanders wear masks in public indoor places. 

One reason that numbers remain high is that many New Yorkers increasingly ignore precautions, said Dr. Jessica Justman, an associate professor in epidemiology at the Mailman School of Public Health at Columbia University in Manhattan.

Vaccines that target BA.4 and BA.5 subvariants likely will provide...

Vaccines that target BA.4 and BA.5 subvariants likely will provide more protection than the current ones, said  Dr. Jessica Justman, an associate professor in epidemiology at the Mailman School of Public Health at Columbia University.  Credit: ICAP at Columbia University

“More and more, we are using masks less, doing social distancing less, and we are deciding to engage in more indoor activities even if they have large numbers of people,” she said. “So there’s more exposure.”

Summer hospitalizations, deaths higher this year

For most of the summer, Long Island COVID-19 hospitalizations have been several times the levels of the summers of 2020 and 2021, state data shows. 

There also are far more deaths. From June 1 through Thursday, 218 Long Islanders died of COVID-19 — nearly three times the 74 deaths during the same time last year, according to state Health Department data.

Nationwide, an average of 400 people are dying of COVID-19 every day, CDC data shows.

“As a society, good, bad or not, this is what we’ve decided is reasonable to accept” in exchange for returning to a sense of normalcy, Farber said.

The abandoning of precautions is occurring as BA.5, an omicron subvariant dramatically more contagious than the original COVID-19 strain, continues to dominate, creating “a perfect storm to let this continue to percolate,” said Dr. Leonard Krilov, chief of pediatrics and an infectious disease specialist at NYU Langone Hospital-Long Island in Mineola.

It’s much easier to get infected now than a year...

It’s much easier to get infected now than a year ago in an indoor public space, said Dr. Leonard Krilov, chief of pediatrics and an infectious disease specialist at NYU Langone Hospital-Long Island in Mineola.

Credit: Debbie Egan-Chin

It’s much easier to get infected now than a year ago in an indoor public space, and even socializing outdoors may be less safe, Krilov said.

BA.5 is only the latest of a number of omicron subvariants that have developed this year. Each subvariant is different enough that the immune system has a harder time recognizing it — leaving the body more vulnerable to infection, Krilov said.

Pre-omicron, people who contracted COVID-19 could count on long-lasting protection against getting infected again, Farber said. With the changing subvariants, that’s no longer true, he said.

“It’s a different virus,” Farber said.

Booster shots reduce the risk of infection — especially in the first few months after vaccination — and reduce the risk of severe illness even more, he said. But fewer than 55% of Long Islanders eligible for boosters have them, according to state data.

Vaccines that target BA.4 and BA.5 subvariants are expected by the fall. That likely will provide more protection than the current vaccines, even if a new omicron subvariant dominates instead of BA.5, Justman said.

“If a new variant comes in that’s radically different from omicron, we will not be in as good a position as we want to be,” she said.

Already, the omicron subvariant BA.4.6 is spreading in New York, comprising 8.9% of cases for the two weeks ending Aug. 13, state Health Department data shows. There’s also the threat of BA.2.75, which spread rapidly in India and is believed to be more infectious than BA.5, Clouston said.

“There’s no sign that COVID is going to stop changing all of a sudden, so we’re going to get more variants,” he said.

Some of those variants may be more dangerous than omicron, although it doesn't appear that BA.4.6 and BA.2.75 are more likely to cause severe disease than other omicron subvariants, he said. 

“We may find that we’re going to get sort of good COVID years and bad COVID years,” he said.

Despite the high COVID-19 rates this summer, Clouston said that, with omicron generally less lethal than previous variants like delta, “I would guess that this is a good one.”

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