The Covid-19 pandemic didn't improve locally in October, but no one is certain exactly why that's so.
For the past several weeks, Western New York has continued to slog along with daily positivity rates of more than 5%, while downstate areas sit at 2% or less.
Caseloads have increased, including in public schools, though school officials insist only a small percentage of students who are being quarantined after an exposure have actually contracted the virus from someone at school.
Hospitalizations, on the other hand, have seen an undeniable uptick of late.
Between Oct. 28 and Tuesday, Erie County went from 117 hospitalized patients to 151. The latter figure is a 29% increase in six days, and Western New York's regional hospitalization total, 232 patients on Thursday, was the highest since May 7.
Thursday's report of 454 positive tests in Erie County was the second-highest one-day number since April. The highest since spring was 510 on Oct. 28.
Meanwhile, New York City, the epicenter of the pandemic in its early days, saw its positivity rate fall below 1% for a few days last week.
With so much conflicting data here and other areas seeing trend lines pointing down, it begs a question: Why can't Western New York get over the Covid hump?
Maybe it's because of high downstate vaccination rates, said Dr. Thomas Russo, chief of infectious diseases at the University at Buffalo's Jacobs School of Medicine and Biomedical Sciences.
New York City and its immediate suburbs have adult one-dose vaccination rates ranging from 83% to 95%. Erie County's figure for people who have received at least one dose is 79%, and Niagara County's is 74%.
Other Western New York counties' vaccination rates range from 52% in Allegany County to 69% in Genesee County.
"Cases are going to be dictated by a combination of exposure and the proportion of the population that's susceptible," Russo said Friday. "As we go more from outdoor activities to indoor activities, that increases exposure. As, over time, for people that were previously infected and/or vaccinated, protection will wane and susceptibility will increase. If you get new people vaccinated and/or boosters, that decreases the proportion of the population susceptible."
Charlene Ludlow, head of the Covid Task Force at Erie County Medical Center, said ECMC had 26 Covid patients Thursday. On Nov. 4, 2020, it had two.
The good news, said Ludlow, is that the staff knows how to treat them now, and the illnesses don't seem to be as severe.
Only seven of the 26 ECMC patients have been vaccinated, but they also have pre-existing medical conditions that increase their risk, vaccinated or not, Ludlow said.
"The people who are vaccinated with no comorbidities, we're not seeing them come into the hospital," Ludlow said. "There is a large number of people with positivities out in the community. They're not as sick as they used to be, since they're vaccinated."
The evidence of the waning effectiveness of vaccines after several months is growing, Russo said.
"I don't want to give the concept that the vaccines are failing us, but that's contributing to our cases," he said.
"People are out there getting boosters, which is very important," Ludlow said. "If people are vaccinated for Covid and vaccinated for influenza, we are not anticipating the numbers being as high as they were last year."
Niagara County had 619 active Covid cases on its weekly report Wednesday, the highest number in many months. But only 22 of them were hospitalized.
About half of the new Niagara County cases are breakthroughs, Public Health Director Daniel J. Stapleton said.
The high positivity rate – 5.9% in Erie County and 6.5% in Niagara County Thursday – has lasted for about six weeks, Stapleton said.
He said he has no explanation.
Stapleton said the new cases don't seem to be concentrated in one age or occupation.
The number of Covid-19 cases in public schools in Erie and Niagara counties jumped from 853 on Oct. 1 to 2,487 on Monday.
Those figures – the total of reported cases among students, teachers and staff – are "very misleading," said Michael Cornell, Hamburg Central superintendent and president of the Erie-Niagara School Superintendents Association.
"Probably 90-some percent of the cases we report were contracted outside the school environment," Cornell said. "There's very little transmission that happens in our schools. There's masks, distancing, air flow. There's never been any real evidence that Covid transmits in school."
Fewer than 2% of the children who are ordered quarantined because they came in close contact with a confirmed Covid case end up testing positive for the virus themselves, Cornell said.
The students and staff are catching the virus outside school, said Mark R. Laurrie, superintendent of the Niagara Falls schools, where student Covid cases rose during October from 16 to 128.
"We get a lot of cases after the weekends," Laurrie said. "I think there's a lot of congregation of kids on the weekends."