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Multiple Reasons Behind the Recent SARS-CoV-2 Surges in the US

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Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

Are SARS-CoV-2 variants of concern behind the recent jump in COVID-19 cases in states such as Florida, Michigan, New Jersey, and New York? Does the relaxation of public health protection measures play a role as well?

It depends on whom you ask.

Anthony Fauci, MD, cautioned that the recent rise in cases could stem from variants of concern, although the scenario is likely more complicated. 

Although the SARS-CoV-2 variants first identified in the United Kingdom and South Africa are “playing a part” in the upsurge of new COVID-19 cases, Fauci also told CBS’ Face the Nation on March 29 that an increase in spring break travel and the easing of mitigation methods have also contributed.

“Several states have done that,” he said, referring to lifting mask mandates. “I believe it’s premature.”

The states most affected by recent COVID-19 case surges include Florida, Michigan, New Jersey, and New York. Other states seeing troubling trends, particularly among younger residents and visitors, include Illinois, Iowa, New Hampshire, Pennsylvania, and Vermont.

The State in New Jersey

“Cases are rising, hospitalizations are up by 200 to 300 over the past week to 10 days,” said New Jersey Governor Phil Murphy during a press briefing Q&A March 29. The state predicted and expected this increase, he added.

COVID-19 fatigue and variants are both contributing to the increase, Murphy said. In addition, “we don’t have the weather we need yet. We just aren’t in the position like many states in the South are that can conduct a lot of their lives outside,” Murphy said.

There are multiple factors. The state’s population density, having New York City right across the river, and “yes, the variants are playing a role as well,” Edward Lifshitz, MD, medical director of the New Jersey Department of Health, said during the briefing.

In answer to a question about allocating vaccines to areas with higher rates of variants of concern, Murphy said, “Even though we are assiduous in telling you what we know about variants, we’re assuming they are in the state, all over the place.”

New York Is Sequencing

Jonah Bruno, director of public information for the New York State Department of Health, did not answer directly when Medscape Medical News asked if the variants or more relaxed public health protections are playing a role in the state’s surge.

Instead, Bruno offered that New York is sequencing COVID-19 virus specimens selected at random from around the state at a rate of about 90 per day to track variants of concern.

“It’s normal for a virus to mutate,” he said, and reiterated a list of COVID-19 protective measures such as masks, social distancing, and getting vaccinated when possible as “the best way for New Yorkers to protect themselves.”

Michigan More Direct

A spokesperson for the Michigan Department of Health and Human Services (MDHHS), Lynn Sutfin, said, “The presence of more infectious variants, such as the B117 [UK] variant, threatens our progress in control of the epidemic and MDHHS will be monitoring data closely.”

“Our goal is to reengage while reducing public health risk, which is why we move slowly to maintain progress and momentum with thoughtful public health measures,” Sutfin added.

“We will continue to monitor the data to make decisions including three key metrics: case rates, percent positivity, and hospitalizations,” she said. “It is critical that we not let up now and remind Michiganders to continue to mask up, wash their hands, social distance, get tested, and get vaccinated as soon as it is available to them.”

Florida on the Forefront?

Florida has gone the furthest in lifting pandemic protection measures, the New York Times reported March 28, and therefore is seen as a “national COVID bellwether.”

However, at time of publication, Florida had yet to respond to a request for additional perspective on the recent increase in COVID-19 cases in the state.

In the meantime, the big picture with increasing numbers of COVID-19 cases nationwide appears ominous, according to Centers for Disease Control and Prevention (CDC) Director Rochelle Walensky, MD. She warned of “impending doom” as she made an impassioned plea during a White House media briefing March 29 for Americans to continue taking recommended precautions to curb the spread of SARS-CoV-2.

For updates on this evolving situation, the CDC is tracking variants of concern B117, B1.351 (South Africa), and P1 (Brazil) on a US map that displays the number of cases reported for each state.

Damian McNamara is a staff journalist based in Miami. He covers a wide range of medical specialties, including infectious diseases, gastroenterology, and critical care. Follow Damian on Twitter @MedReporter.

For more news, follow Medscape on Facebook, Twitter, Instagram, and YouTube.

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