As BA.2 spreads, Pa. and N.J. COVID cases are rising again heading into a holiday weekend

Fueled by the BA.2 subvariant, coronavirus cases are again rising in Pennsylvania, Philadelphia, and New Jersey, returning to February’s levels as a holiday weekend kicks off.

The increased spread of the virus could pose a risk of transmission during Easter, Passover, and Ramadan. The Philadelphia health department said residents should wear masks at indoor services and that anyone speaking or singing to a crowd while unmasked should take a COVID-19 test beforehand.

People should also stay home if they have any symptoms of illness, doctors said. Holiday celebrations generally fuel bumps in case numbers, particularly when transmission is already rising.

“Anytime we see an uptick in cases, we worry,” said Montgomery County medical director Richard Lorraine, a physician. “[BA.2] does appear to be a little bit more contagious … but it doesn’t seem like there’s going to be an increase in the severity.”

In Pennsylvania and New Jersey, the average daily numbers of new COVID cases have increased by more than 80% over the past two weeks, as BA.2 has spread faster in the Northeast than in the rest of the country, according to New York Times data. The renewed spread triggered Philadelphia to reinstate an indoor mask mandate that takes effect Monday, the first major U.S. city to do so post-omicron surge.

Though public health experts are watching the trends closely, many say it’s likely BA.2 — which now accounts for 85% of COVID cases nationwide, according to the Centers for Disease Control and Prevention — will cause an increase but not a major surge. They cite the number of people with immunity due to recent omicron infections and the fact that BA.2 doesn’t appear to cause more severe illness. They are likewise hopeful hospitalizations won’t become unmanageable, though medical personnel and health experts said it’s too soon to be certain.

“I think cautious optimism is the right approach here,” Drexel University epidemiologist Michael LeVasseur said.

Pennsylvania’s daily average number of new cases was 1,067 Thursday, the first time in six weeks that number exceeded 1,000 daily cases after hitting a low of 592 on March 28.

In New Jersey, the daily average number of new cases was about 1,850, also similar to mid-February. It had gotten as low as 738 on March 17.

New Jersey has seen a higher spike than its neighbor, with the seven-day average more than doubling over the last month in New Jersey and rising by about a third in Pennsylvania, according to an Inquirer analysis of the Times data.

As usual, the virus’ trajectory is difficult to predict. Some health officials in the area said they weren’t worried about a coming surge in hospitalizations, while others noted small increases.

» READ MORE: Will BA.2 cause a big surge in the U.S.?

City health officials have said cases could be in decline again in less than a month, and hospitals are not expecting nearly as many sick people as they saw in January — though a health department spokesperson also noted that citywide hospitalizations increased from 44 on Monday to 75 on Thursday.

“I think we’re a couple weeks too early to know if hospitalization numbers are going to increase locally,” said University of Delaware epidemiologist Jennifer Horney.

At Main Line Health’s four acute-care hospitals in the city’s suburbs, about a dozen people were hospitalized with COVID — a number that’s been fluctuating for weeks, said chief medical officer Jonathan Stallkamp. Einstein Medical Center had six people hospitalized with COVID on Friday.

“At the height of the omicron surge, we had probably close to 200 patients,” said Eric Sachinwalla, Einstein Medical Center’s medical director for infection prevention and control. “I don’t expect to get anywhere near that degree.”

Pennsylvania health officials have been anticipating the rise in BA.2 cases, a spokesperson said. The Department of Health did not directly answer questions about whether state officials were concerned about the uptick, saying residents “can make personal choices and undertake preventive measures” to protect themselves from COVID.

» READ MORE: Philadelphia is first U.S. big city to reimpose indoor mask rules as COVID rates rise

The current case tallies are almost certainly significantly undercounted, public health experts say, largely because of the increased reliance on at-home rapid tests, the results of which are rarely reported to health agencies. In addition, some mild cases are never detected.

“The real number is likely considerably higher,” said Philadelphia health department spokesperson Matthew Rankin. “How much higher is extremely hard to tell.”

Though the data shows the trends, scientists don’t know how many cases might be missing.

“What is the gap between the surge that we’re seeing and what the surge actually is?” said Horney. “It gives us a lot less insight into what is really happening in terms of cases.”

At least, said experts, the conditions now don’t point to another devastating COVID wave.

“Between recent infections, vaccines, boosters, masking, better weather,” said Sachinwalla, “I’m cautiously optimistic, let’s say.”

The city’s mask mandate doesn’t take effect until Monday, and officials didn’t recommend against holiday gatherings this weekend, though Rankin said people should take COVID tests before visiting vulnerable relatives.

“We would also recommend that service leaders and choir members who opt to sing or lead services unmasked consider doing a COVID test before doing so to avoid unintentionally spreading the virus to their communities,” he said.

Lorraine said there could be a modest increase in cases after holiday gatherings and urged anyone who has symptoms of illness to stay home.

“That is, I think, probably the main issue in terms of transmission at these holiday gatherings — somebody is not feeling all that well but still wants to go,” he said.

He said he often sees patients who test positive for COVID but thought they had something else, like allergies, a sinus infection, or a stomach bug.

“With just about any type of symptom, it can be COVID,” he said. “If you don’t feel well, stay home.”