Last holiday season saw a deadly COVID surge. Here's what doctors say to expect this year.

On Halloween 2020, there were 186 active cases of COVID-19 in Dutchess County. On Martin Luther King Jr. Day the following January, there were 2,335.

The holiday season birthed a surge in confirmed cases previously unseen during the pandemic, and resulted in 217 county residents dying from Dec. 1 to March 1 alone.

Much about the pandemic has changed in the past year. But, the holiday season is back, and health officials are warning there are precautionary measures everyone – even those who are vaccinated – should take.

Although vaccinations for more than 60% of the county’s population make it unlikely the coming months will have the deadly impact of a year ago, questions remain that make it difficult to predict what the immediate future holds. That’s despite the county seeing a downward trend for cases and positivity rate.

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Dr. William Begg, vice president of medical affairs at Vassar Brothers Medical Center, said “we, as a society, are at risk for a much quicker bump in COVID cases” than a year ago, given that more than 30% of county residents have not received a single vaccine dose.

Begg also noted that as the efficacy of vaccines administered at the start of last year begins to wear off in unknown degrees, residents may be at increased risk to contract a breakthrough case.

Many of the safety precautions of a year ago are a thing of the past – such as mandatory masks while inside most indoor public places and social distancing – leaving the unvaccinated population more vulnerable during gatherings or while holiday shopping, and as colder temperatures force more activity indoors.

However, “we do not anticipate we’re going to have the surge we saw a year ago,” Begg said, an opinion shared by Dr. Donald Chen, epidemiologist for MidHudson Regional Hospital and Westchester Medical Center.

“There is potential for cases to increase as families and friends gather for the holidays,” Chen said. “With a portion of the population fully vaccinated, if we do see an increase in COVID-19 cases, it is unlikely to be the large surge we saw last year.”

The holiday season arrives at a time of optimism in the ongoing pandemic. Dutchess County’s active COVID cases this week dropped below 400 for the first time since the first week in August, and the county began the month of November with several days of fewer than 20 residents hospitalized with the illness.

And, as the rollout of vaccines continues, children ages 5-11 were approved to receive doses for the first time.

Andrew Evans, director of public health and disease prevention for the county Department of Behavior and Community Health, said “multiple unknowns” make it difficult to predict how the holiday season will go. “However, with boosters, vaccination availability to those that are (5-11) and the continuance of other mitigations, the numbers are likely to continue to decline as current data and trends suggests.”

How to stay safe

Mitigating risk, all agree, is key.

Begg and Chen both encouraged anyone who is not vaccinated, or is eligible for a booster shot, to seek the readily available inoculations.

Begg said fully vaccinated people should feel safe gathering this season with friends or family members who are vaccinated, have not been exposed to high-risk situations and are not feeling symptoms.

“The conservative approach is to consider a mask,” he said, “but we do recognize that if two people are vaccinated and they are in close quarters together, the chances of them having COVID are significantly less.”

Begg added they should consider wearing a mask at such a gathering if it is indoors, they do not know the vaccination status of other guests and if six-foot distancing cannot be maintained.

Chen said U.S. Centers for Disease Control and Prevention guidelines are still a good rule of thumb. As the agency still characterizes Dutchess as an area of “high” spread, vaccinated individuals are encouraged to wear a mask whenever in an indoor public place.

That includes while holiday shopping.

“You are in close quarters with a multitude of people. You have no idea their vaccination status,” Begg said. “All you have to be is in line with one (infected) person for two to three minutes.”

How to keep others safe

Begg noted, “public health is looking at the greater good. While you may not get sick with COVID or have a severe infection, you may give it to someone who is immunocompromised. … That’s the concern that is out there.”

Vaccination, Chen said, “does provide significant protection against acute COVID-19 infection while also reducing the chances of virus transmission to others.”

Vaccinations for all those who are attending a party – including the youngest participants eligible – is the safest way to protect everyone. However, vaccinations have proven a divisive topic for all ages, and parents’ feelings on giving a shot to their 5-year-old is no exception.

As of Thursday, the Dutchess health department was in the process of distributing doses of the Pfizer pediatric vaccine to local providers. The rollout will be different from those in the past and not available at the county’s other points of distribution and pop-up sites. They’ll be available through individual pediatrician’s offices – a more private place for the young recipients – as well as through many pharmacies.

Boosters are another topic for vaccinated individuals to consider. Chen said anyone over the age of 65; over the age of 50 with underlying medical conditions or are a resident of a long-term care facility; or originally received the one-dose Johnson & Johnson vaccine, should prioritize receiving one.

But, many residents over the age of 18 who received their second Pfizer or Moderna vaccine dose at least six months ago are also eligible if they have to a qualifying condition ranging from a compromised immune system to being overweight, which makes them more at-risk for serious illness. Evans suggested anyone meeting those standards should discuss the option with their health provider.

Begg said there would be value in any eligible recipient receiving a booster and suggested it may be needed each year.

“We’ve accepted that as a society for the flu shots,” he said. “We have to treat the COVID booster the same way.”

This article originally appeared on Poughkeepsie Journal: Holiday season COVID safety: What to expect in Dutchess