By Donald Gilpin

As new case numbers of COVID-19 continue to rise locally, statewide, and across the country, health department officials are struggling to gain perspective on the resurgent pandemic and to devise strategies to combat its frequently changing manifestations.

As of Monday, August 2, the Princeton Health Department reported an increase in new COVID-19 cases to 10 in the past seven days, 14 in the past 14 days in Princeton. On Tuesday, the state of New Jersey reported an additional 1,173 COVID-19 cases, with a seven-day average of 977 new cases, more than four times the average a month ago.

“We are beginning to witness how COVID-19 will affect our lives long-term,” wrote Princeton Health Officer Jeff Grosser in an August 3 email. “Variants are likely to continue to emerge, and with each new strain new precautions, or existing precautions, may be put back into place to curb new disease transmissions.”

Grosser pointed out that Princeton is dealing with problems similar to those throughout the state, with an uptick in infections and the Delta variant now accounting for about 86 percent of new infections in New Jersey.

He described some of the challenges facing his department. “A major role of epidemiology is to provide a clue to changes that take place over time in the health problems we are experiencing as a community,” he wrote. “With a novel virus it’s likely that what worked last month may or may not work this month. What works in one city for disease prevention may not work in another.”

Emphasizing the unpredictable nature of the Delta variant, he added, “We need to draw up another play in the playbook depending on how we expect a disease to interact with the community next.”

He continued, “Our focus has been and will continue to be identifying subgroups within the population who are at high risk for disease. We need to remember that the COVID-19 vaccine’s main purpose is to reduce hospitalization and death, which it has.”

The Princeton Health Department continues to monitor COVID-19 community transmission levels, the Delta variant, and vaccination coverage levels. Princeton’s overall vaccination rate of those 12 years and older is 76 percent, and 94 percent for the group of those over 65, who are most susceptible to severe COVID-19. At this point experts estimate that COVID-19 requires a vaccination rate of 70-90 percent to achieve herd immunity.

Grosser stated that vaccinations continue to be of paramount importance in the battle against COVID-19. “We often look at determinants of disease outbreaks as a balancing act between immunity and susceptibility,” he said. “Although we are experiencing breakthrough cases, infections among people previously fully vaccinated, we are still minimizing hospitalizations.”

Grosser stated that the majority of Princeton’s new cases are breakthrough cases, none of which were hospitalized. “The only health symptoms experienced were cold-like symptoms that mimicked what some would say feel like seasonal allergies,” he said.

He emphasized the importance of the health department’s vaccination outreach efforts.  “We can best meet the challenge of vaccinating Princeton’s remaining quarter of the population by being present in the community in areas identified as low vaccination rate communities and collaborating with our trusted community groups to assist our efforts in getting shots into people’s arms,” he added.

Looking ahead to the fall and the start of the school year, Grosser focused on the Delta variant, which is twice as contagious as the regular strain and is creating new challenges for this phase of pandemic response. “It’s likely that mask wearing will be recommended, perhaps required for individuals going into public places well into the foreseeable future unless disease transmission begins to decrease. We are working closely with Princeton schools, Princeton University, and the Theological Seminary in order to be as prepared for the fall as possible.”

The Centers for Disease Control (CDC) has recently released new guidance for vaccinated individuals, recommending that they wear masks in public indoor settings and areas with high transmission rates, including crowded indoor settings, indoor settings involving close contact with others who may be unvaccinated or vaccine status may be unknown, and where immunocompromised or at-risk individuals are present.

The Princeton Health Department advises following the CDC’s recommendations due to the high volume of visitors to town and summertime travel. The CDC continues to recommend that policies be based on local transmission rates.

Monday’s Princeton municipal newsletter noted, “Vaccination is our best path to ending the COVID-19 pandemic. The vaccines work. New data are showing that a small number of vaccinated people can get the Delta variant and may be contagious, but these cases represent a very small amount of transmission occurring around the country.”

The Health Department has scheduled COVID-19 vaccine clinics for Thursday, August 5 at the Princeton United Methodist Church from 5-8 p.m. and August 27 at Hinds Plaza from 5-9 p.m.