Cases drop, hospitalizations plateau in D.C. region following Delta surge Public health experts are looking towards the fall with cautious optimism.
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Cases drop, hospitalizations plateau in D.C. region following Delta surge

Cases are dropping in the region after spiking in a delta-variant driven surge in late August and September. Tyrone Turner/WAMU/DCist hide caption

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Tyrone Turner/WAMU/DCist

After a fourth surge of the coronavirus, driven by the highly contagious delta variant, case counts, hospitalizations, and deaths in the D.C. region have started plateauing or dipping down in October.

Whether this decline will persist through the coming months remains to be seen, but public health experts say that the region can avoid another wave this winter if vaccination rates increase and more young children become eligible for their shots.

"I think we're getting close to a situation where we really can live with this virus," says Amira Roess, a professor of global health and epidemiology at George Mason University. "Small things can happen that can change the equation, but it really looks promising and that maybe the worst is behind us."

New infections in D.C., Maryland, and Virginia all declined by at least 10% in the first full week of October. The three jurisdictions are reporting an average daily case rate around 3,500 — a roughly 30% decrease from the worst of the delta surge in September, but still similar to the case load reported in February, before vaccines were widely available.

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According to Roess, it's difficult to pinpoint one specific reason for the case drop locally (and nationally). One factor, she says, is that more people have been vaccinated and more people have been infected, meaning a larger portion of the population has some type of immunity.

"We're still trying to learn about what might be causing this [latest decline]," Roess says. "The thought is since so many people have become vaccinated or have been naturally infected, that there are going to be fewer susceptible individuals in the coming months."

D.C.'s case rate per 100,000 residents peaked in mid-September to its highest point since the previous surge in January 2021, and has since fallen by almost 50% as of Oct. 11. Unlike during previous surges, the consequent rise in hospitalizations and deaths did not mirror the scale of the rise in cases — a testament to the effectiveness of vaccines, according to public health officials.

"When I look at the numbers here, really what I pay attention to more and more is things like disease severity, the hospital capacity, deaths," Roess says. "We've done very well in this area in large part due to the relatively higher demand for the vaccine and the higher vaccination rates. That really changes the equation."

In D.C., nearly 70% of eligible residents are at least partially vaccinated. In Maryland, roughly 84% of eligible residents have at least one shot, and in Virginia, 81% of eligible residents have at least one dose.

Prince George's and Montgomery Counties in Maryland saw similar delta-driven spikes in cases in September, and are now seeing similar declines in new infections. Both jurisdictions are reporting an average rate of new infections per 100,000 residents below the statewide rate. While the statewide rate is around 18, Prince George's County reports an average rate of 15. Montgomery County, which boasts the highest vaccination rate in the region, reports an average rate of new infection per 100,000 of 9.

Virginia is still reporting the highest average rate of daily infections per 100,000 residents of all three jurisdictions, but in the Northern Virginia suburbs, cases have declined and hospitalizations have stabilized this month. In Alexandria, new infections began trending downward in late September, and now appear to be plateauing at a level similar to February this year.

While infections and hospitalizations from COVID-19 still remain higher than last fall, public health experts are largely hopeful that vaccinations will ward off another surge as severe as what occurred last winter. This week, the country's top infectious disease expert Anthony Fauci gave trick-or-treating the green light, and also painted a hopeful picture for holiday get-to-togethers. Roess largely agrees.

"We're in a very different place than we were last year, we know a lot more about this virus," says Roess. "When individuals become very sick and are hospitalized, we have better treatment protocols. We have a vaccine, and we have a large percentage of adults in this area who are vaccinated, and that really has changed the equation."

But there are still variables that could thwart the region's possibility of avoiding another uptick in cases this fall. Roess says that boosters will be important to combat any waning immunity after initial inoculation — especially for elderly residents or those with underlying health conditions, who may face a more severe breakthrough infection. Regionally, all local jurisdictions have followed the Centers for Disease Control's latest guidance and expanded booster eligibility to the groups approved by the federal agency.

There's also the question of kids' vaccinations; later this month, the Federal Food and Drug Administration is set to consider Pfizer's request for approval of its vaccine in children ages 5-11. If approved, focusing vaccine uptake on that younger cohort will be key to limiting transmission this fall, according to experts, as most students are back to school in-person full-time.

Another point of concern is the annual flu. While last year saw record low incidence of influenza, largely due to lockdowns, mask mandates, and remote school and work, already this year doctors and public health officials are concerned about a rise in flu cases coinciding with coronavirus infections, and overwhelming hospitals.

"I think it's sort of, in a way, a perfect storm for why we might see increases in influenza virus," Roess says. "We've gotten COVID somewhat under control — a lot of adults in our area have gotten vaccinated, lots of older children have gotten vaccinated, but there is fatigue, and there is more in person activity."

According to Roess, the region's relatively high vaccine uptake compared to other parts of the country, which saw more severe surges in delta, positions the D.C. area well headed into the winter, but that the area isn't out of the woods yet. A focus on vaccinations and mask-wearing indoors, she says, should likely remain throughout the coming months.

"I think in our area, we still have to be vigilant as we are heading into the colder months, and we will be indoors more. We do need to continue to get out there and vaccinate individuals who are eligible and have not been vaccinated, and we also need to continue to wear masks when we're indoors in crowds to further reduce the risk of transmission," Roess says. "It's going to have to be a gradual, slow process and not a big rush to go back to life completely as it was pre-pandemic.

This story is from, the local news website of WAMU.

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