Is a 'second wave' of coronavirus on the horizon? Experts' opinions differ

Epidemiologists and hospital executives are split on whether the region has entered a second wave of COVID-19 infections, but are in agreement that a spate of new coronavirus positives in some areas of the state are a major concern.

Health care experts added that virus numbers on Long Island could climb as cooler weather brings more indoor activities, and when families get together for the holidays.

Still, they said a second wave wouldn't be as bad as the original wave earlier this year that forced hospitals to increase bed capacity so they could treat the thousands of patients being admitted for the disease. A near shutdown of the regional economy ensued.

A lot of people think of a wave as tsunami ... What we are dealing with now are more like brush fires. 

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

"A lot of people think of a wave as tsunami, and that's where we were in March and April," said Dr. Patrick O'Shaughnessy, chief clinical officer at Catholic Health Services of Long Island, which operates six hospitals. "What we are dealing with now are more like brush fires."

Regional data from the state this month shows some ZIP codes in New York were already "hot spots" for new cases and had positivity rates ranging between 2.3% and 17.7% over a seven-day period. None of those ZIP codes have been on Long Island, but the Five Towns area of Inwood and Lawrence saw a spike of positives.

On Long Island, the positivity rate has hovered at around 1%.

Earlier this month, Gov. Andrew M. Cuomo announced new restrictions for any "hot spot" zones and surrounding areas. Those restrictions included limiting mass gatherings and closing schools and nonessential businesses.

Cuomo this week argued this wasn't a second wave, saying "we're still in the first wave, and this is just an inability to deal with the first wave nationwide."

Meanwhile, hospital executives continue to monitor COVID-19 metrics daily.

What would make a "second wave" is up to interpretation, but health experts said they look at total cases, the percentage of positive tests in a region and hospitalizations to weigh whether they should sound the alarm.

Infectious disease specialists said Long Islanders should continue to wear masks, wash hands frequently and follow social distancing guidelines.

We are seeing outbreaks in the Northeast ... and it's alarming.

Alvin Tran, University of New Haven

"We look at the total number of COVID cases over a specific amount of time, and that tells us if we are in a second wave," O'Shaughnessy said. "The key is to limit the amplitude of the wave."

O'Shaughnessy said COVID-19 stats from national, state and regional health systems help him determine if this area has entered another wave. He said the experiences from March and April should "work in our favor. We have therapeutics that reduce morbidity and mortality, and we have a much better idea of how to control the spread of the virus."

Hospitalizations were above 4,000 on Long Island during the height of the first wave of the pandemic in April, when more than 100 people were dying daily at the region's hospitals. Today, as hot spots reappear, hospitalizations on Long Island have remained below 100, according to the most recent data available. Statewide, hospitalizations have risen from 612 on Oct. 1 to 878 on Monday.

Other stats show if the second wave isn't already here, it's close, said Alvin Tran, a professor of public health at the University of New Haven in West Haven, Connecticut.

"The clues are all there," Tran said. "We are seeing outbreaks in the Northeast, and that's a strong sign, and it's alarming. The pattern is very similar to what happened in Europe, where the numbers increased again in recent months."

He pointed to Spain, which, after a quiet May through July, has seen COVID-19 cases rise again. Germany also has tightened around gatherings in Berlin and Munich, two of its three largest cities, after coronavirus infections rose, although not to the same levels as earlier this year.

Perry Halkitis, dean of the Rutgers School of Public Health in Piscataway, New Jersey, said the United States already has experienced multiple waves, and another wave is "seemingly here, as we see an increase in new infections, and the percentage of test results that are positive."

The virus never went away.

Dr. Bruce Polsky, NYU Winthrop

However, Dr. Bruce Polsky, chairman of medicine at NYU Winthrop in Mineola, said he isn't sure Long Island has ever escaped the first wave, despite a quiet summer.

"To me, a second wave would represent widespread community spread, and that is not what we are seeing," Polsky said. "The virus never went away. It's been here the whole time. I suppose it depends on how you define [a second wave]."

Added Dr. Bruce Farber, chief of infectious diseases at New Hyde Park-based Northwell Health, "The definition of a second wave is not scientific. It's more of a perception, and when we look, there isn't a significant increase throughout the region."

But Farber said indoor activities and holiday celebrations can lead to an escalation.

We may have to rethink if we are getting together for Thanksgiving.

Perry Halkitis, Rutgers School of Public Health

Halkitis said the current hot spots are connected, at least in part, to the Jewish holidays and that large, indoor gatherings are a risk. Those facts have implications for the months ahead, he said.

"I think we may have to rethink if we are getting together for Thanksgiving," Halkitis said. "I don't know how you have safe, large gatherings unless you're testing at the door. That's the sort of event where people travel, and then spread it to their home communities."

Polsky said transmission around the holidays is inevitable.

"If we are smart, we will keep the gatherings small, and try to keep it with people you've been living with," Polsky said. "I wouldn't take chances unless everyone gets tested and quarantines before seeing each other."