The St. Joseph County Department of Health holds a COVID-19 vaccine clinic inside the County-City Building lobby on Thursday, Nov. 4, in South Bend. Photo by Robert Franklin.

Jeff Parrott
South Bend Tribune

SOUTH BEND – Stroll through a grocery store or attend an indoor community event and chances are you’ll see few people, other than employees, wearing masks.

Go to a movie. Eat at a restaurant. Rock out to a live band at a bar.

As such aspects of normal, in-person, pre-pandemic life have resumed over the past couple of months in the South Bend area, after nearly two years of restrictions and virtual life aimed at stemming the spread of the COVID-19 virus, one might wonder whether the pandemic is over.

The pandemic is now different. It’s becoming less deadly as more people are vaccinated. Fewer people are contracting the virus. But local public health and medical officials say it’s not over.

In fact, a new wave of infections is expected to hit Indiana next month, according to projections by the Institute for Health Metrics and Evaluation at the University of Washington. The global research center projects 7,550 new infections per day in Indiana by Jan. 25, which would be the state’s highest daily new case count since Dec. 5, 2020.

“It’s not over,” said Dr. Mark Fox, St. Joseph County’s deputy health officer. “If people aren’t motivated to go get boosters, they’re going to experience some decrease in protection from the vaccine. So if you take those factors in combination, cold weather driving people inside, family traditions of gathering for the holidays, greater length of time from vaccination, and ongoing fatigue with mask use, that’s the basis for expecting things will get worse between now and the beginning of the year.”

In St. Joseph County last week, the rolling 7-day average of new daily cases was 87, which was up 38% from the 67-case 7-day average on Oct. 23. Both of those figures are far lower than the county’s peak 7-day average of 329 new daily cases on Dec. 6, 2020.

But the number of new cases has begun increasing over the past two weeks after falling in early October, according to county health department data. The county’s number of new cases per 100,000 population over the past seven days averaged 210.8 in October, down 27% from its 288.34 average in September.

But from Oct. 15 through Wednesday, that figure increased each day. On Friday it was 241.3 after peaking, over the past two months, at 340.3 on Sept. 17.

Statewide, COVID-19 hospitalizations and deaths have been declining since late September, a trend that should continue as more people are vaccinated, said Micah Pollak, associate professor of economics at Indiana University Northwest in Gary. As vaccination rates increase, tracking daily new case counts should become less meaningful because the vaccine, while not preventing all infections, generally saves people from death or hospitalization, Pollak said.

However, that has not been the case recently at Saint Joseph Health System’s Mishawaka hospital. On Tuesday it reported treating 44 COVID-19 patients, 33 of whom were unvaccinated. That’s far fewer than a year ago but it’s up from 28 patients on Oct. 26.

“Our local region saw a downward trend in COVID-related hospitalizations over the last few weeks, but unfortunately hospitalizations are trending upwards once more,” the health system posted on its Facebook page Tuesday. “Please wear masks, keep your distance and get your COVID-19 vaccine if you’re eligible.”

Employers in tough spot

One thing that’s certainly not over with is the political turmoil surrounding vaccines. Aiming to boost the nation’s 59% vaccination rate, the U.S. Occupational Safety and Health Administration on Thursday released a draft of a proposed rule requiring companies with at least 100 employees to mandate either vaccination or weekly testing. While saying he agrees that vaccines are safe and effective, Indiana Gov. Eric Holcomb called the move a federal “overreach” and said he was directing Attorney General Todd Rokita to join nearly two dozen states in filing a lawsuit opposing the federal rule.

The area’s largest employers, such as health systems and the University of Notre Dame, already have mandated vaccines for their staff. Other local employers have been grappling with the issue all year, said Jeff Rea, president and CEO of the South Bend Regional Chamber of Commerce.

Rea said the chamber isn’t “actively working against” the rule, which would affect 167 local companies, but most of its members oppose it.

“Most employers we’ve spoke with prefer this be left up to them,” Rea said.

In March, Rea predicted many companies would mandate vaccines because they understand that vaccines work, and they would want to keep production flowing as the economy ramped back up, once the U.S. Food and Drug Administration changed the Pfizer vaccine’s authorization status from “emergency use” to full approval.

That happened August 23, for people age 16 and older, but most employers haven’t mandated vaccines locally, Rea said. Area employers had figured full FDA approval would make workers feel more comfortable with it, but they seem to have underestimated fears of the vaccines’ safety, he said.

The tight labor pool has left many companies reluctant to mandate.

“I had a lunch group who was contemplating mandating the vaccine, thinking, what if we all did it together, then we’d have less likelihood of somebody leaving and going across the street because they’re not mandating it,” Rea said.

Rea said he thinks most local employers will follow the rule. Fox agreed but noted that if many workers opt for weekly testing, the nation’s testing infrastructure won’t be able to meet the demand.

Fox said he thinks “quite a few” employers will mandate vaccines.

“I think there are a number that have been inclined to but they wanted the backing or something they could blame it on,” Fox said. “Actually having OSHA and the feds to blame it on provides cover for them to keep their employees and their customers safe.”

Will child vaccines matter?

In another sign last week that the pandemic isn’t over, the CDC announced approval of vaccines for children ages 5-11. Fox and Pollak said they did not expect the development to have much of an effect on infection rates, partly because so many parents are leery but also because children in that age group make up a relatively small share of the population.

“Unfortunately we anticipate that only about 25% of those eligible in that age range will get vaccinated initially, which still means the vast majority of students in any given classroom are likely to remain unvaccinated,” Fox said, basing his projection on national survey data and the county’s vaccination rates thus far for people age 12-16. “That is truly regrettable and avoidable.”

On Wednesday, the first day the vaccines were available for young children, a clinic at the Indianapolis Motor Speedway ran out of doses, and the St. Joseph County Department of Health saw a steady flow of parents lined up in the lobby of the County-City Building. But Fox attributed some of that to the state’s decision to release the child-sized doses only to the county health department the first two days, without also initially sending them to health systems and pharmacies.

Pollak said the ability to vaccinate young children might increase only the state’s total vaccination rate, now at about 50%, by four percentage points, which won’t likely bring a faster end to the pandemic. But he said it will give a big “psychological” boost to parents who have lacked control over school policies on COVID-19 restrictions or lack thereof.

This story was made available through the Hooser State Press Association.