More than 1,000 new COVID-19 cases each day in Massachusetts. A nursing home outbreak in Maine. Record peaks in infections in Connecticut. In Vermont and New Hampshire, the single highest daily caseloads since spring. In Rhode Island, the highest rate of positive tests since May.
While the nation was held rapt by a cliffhanger election, the coronavirus pandemic has surged to record levels across the United States. And this time — unlike the country’s summertime surge, when outbreaks were concentrated in the Sun Belt — New England is feeling the virus’s full wrath.
In the past week, each state has seen its own version of a pandemic nightmare unfold, seemingly with no end in sight. Surging transmission across the region has left governors scrambling to introduce new restrictions and residents wondering what went wrong.
Experts said that New England’s summertime success might have created a false sense of security, preventing officials and residents alike from seeing the approaching surge in time to stop it. Now, the region must act immediately to curb or reverse the dangerous trend, they said.
“I think we got lulled into it,” said Dr. Ashish Jha, dean of the Brown University School of Public Health. “Many of us [epidemiologists] started speaking up in September that we’ve got to act. . . . I think people thought we were being a bit alarmist, but you want to act early and not wait. We still need to act. We still need to do a lot more. But it’s going to be much more painful now, and if we decide to wait a couple more weeks, it’ll be that much more painful yet.”
On Monday, the country passed a grim milestone, with more than 10 million known cases of COVID-19 reported since February. On four of the past five days, the CDC’s count of newly-reported cases has surpassed 100,000, a height not reached in the first eight months of the pandemic.
New England states have seen troubling trends of their own.
A state-by-state assessment by the nonprofit COVID Act Now ranks Maine, Connecticut, and Rhode Island in the “active or imminent” outbreak category and deems the other three states at risk of an outbreak.
The group’s county-by-county ranking shows that some counties in each New England state (including Essex, Suffolk, and Hampden counties in Massachusetts) are experiencing “active or imminent” outbreaks. All the other counties in the region are ranked “at risk of outbreak,” except for Franklin, Lamoille, and Rutland counties in western Vermont, which are considered “on track to contain COVID.”
COVID Act Now says it develops its risk rankings from looking at five key indicators: daily new cases, infection rate, test positivity rate, ICU capacity, and contact tracers hired.
Massachusetts and Vermont have yet to reach peaks as high as those they recorded in April, though both states seem well on their way, with average case counts more than three times what they were at the beginning of October in Massachusetts, and nearly five times in Vermont. In the past week, the other four New England states have reported record cases.
Maine, which previously won praise for keeping COVID-19 under control, reported 204 new cases on Monday, marking the first time that number surpassed 200.
In a news conference, Dr. Nirav D. Shah, head of the Maine Center for Disease Control & Prevention, stressed his concern over the virus’s spread.
“My biggest concern is unchecked community transmission," Shah said. “The ground in Maine has been seeded with a lot of COVID cases.” Shah said he is concerned that today’s community transmissions could “snowball into tomorrow’s outbreaks.”
New England’s grim statistics are all the more frightening by the course reversal they seem to illustrate. By late spring, new cases in the region had dropped significantly, and low transmission continued in most states throughout the summer.
Many factors, including colder weather and associated indoor gatherings, returning college students, and continued reopening likely combined to take New England off course, specialists said. Several also said that the region’s control of COVID-19 in the summer might have led to complacency and delayed action in the fall.
Public health officials repeated a “classic mistake” seen in Europe and other parts of the country, said Jha, the Brown University epidemiologist.
“When you start at a lower level — and New England really did get the virus to a very low level over the summer — what happens is that you can miss the virus replicating in communities if you’re not looking at percent change,” Jha said. “If you’re not looking at how much things are growing and you’re just looking at the absolute level, things don’t look so bad.”
Though New England governors have thus far resisted broad new shutdowns, several have implemented restrictions in the past several days, including nighttime stay-at-home advisories, further limits on social gatherings, and mandates that residents wear masks in public, even when social distancing is possible.
Experts are divided on whether these measures are likely to prove sufficient.
Jha, who said last week that Governor Charlie Baker’s latest slate of COVID-19 restrictions did not go far enough, said that states must be prepared to shut down high-risk settings, which he classified as indoor gathering spaces “where people are not wearing masks," including, he noted, casinos.
“We can think about all of what fits that category and really push to curtail those things,” he said, adding that keeping schools open as long as possible should be a priority.
“The social events, the off-campus [college] gatherings, the neighborhood gatherings, the indoor dining, the bars — all the things that needed to be targeted earlier still need to be targeted vigorously if we are going to even blunt the rate of increase, much less turn it back,” said Robert Hecht, a professor of clinical epidemiology at Yale School of Medicine.
Dr. Tim Lahey, an infectious diseases physician at the University of Vermont Medical Center, said that he felt confident that the kind of shutdowns many cities and states experienced in the spring could still be avoided if proper steps are taken.
“If we really double down on the common-sense measures we’ve been doing, then we can keep control and not have to go to more stringent lockdown situations,” he said. “And that’s the goal.”
New England’s ability to curb infections will depend on enforcement of new measures, support of industries that have to reduce their business activity, and campaigns to raise public awareness to the pandemic’s ongoing threat, said Shan Soe-Lin, a lecturer at the Yale Jackson Institute for Global Affairs and managing director at Pharos Global Health Advisors, a nonprofit global health advisory firm based in Boston.
Ordinary residents also have a role to play, Soe-Lin said.
“Hopefully people remember what the spring surge was like, and they don’t want to do that again,” she said. Soe-Lin said that with the hopeful news about vaccine development, a light has appeared at the end of the tunnel. “If we can just hang together for another four or six months, we can get through this with a minimum of lives lost and livelihoods lost, but we have to work together.”
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