Officials watch and marvel as America’s hottest coronavirus hotspot swells into two dozen counties.

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The orange spot first appeared on the national risk map in early April, marking three counties in central New York with “high” community levels of the coronavirus, the only such cluster in the country.

By mid-April, the orange had spread across 10 counties of the state, with a partial shade of yellow surrounding them. Now there are as many as two dozen Orange Counties, spanning upstate New York and flowing into Pennsylvania and Vermont.

There are now some orange and yellow counties elsewhere in the country, too, but the hotspot that started in central New York is the biggest, darkest spot on the Centers for Disease Control and Prevention’s largely pristine national map, and it could be bigger. will still be updated if the map is updated on Thursday evenings.

Health experts say people in the hotspot, including cities like Buffalo, Rochester, Syracuse and Binghamton, should increase their precautions. “These are areas where the CDC recommends that people wear masks in indoor public settings because of rising levels of serious illness and the potential for significant pressures on the health care system,” Dr. Rochelle P. Walensky, the CDC director, told reporters Tuesday.

But local officials have been reluctant to issue orders to that effect. “Mandates don’t work well, they create unrest in the community and they are unenforceable,” Ryan McMahon, the county director for Onondaga County, which also includes Syracuse, said in an interview. “What we’ve done is distribute tens of thousands of KN95 masks and Covid tests and send them to people’s homes.”

No one knows exactly why a new wave of coronavirus cases, caused by the highly contagious Omicron subvariants BA.2.12 and BA.2.12.1, first emerged in central New York.

“It’s really hard to pinpoint where this is coming from,” said Mary McFadden, the director of public health in Broome County, which includes Binghamton. “It literally comes from everywhere. It is very difficult to locate with home testing. †

Mr McMahon said it broke the pattern of previous spikes. “It didn’t make much sense,” he said. “Because we’re in the middle of the state, we see the peaks in the middle or at the end.”

He said the rise was first noticed after the school holiday week in February in some of his province’s more affluent cities, suggesting travel may have played a role. The region is also home to a large number of colleges and universities, including Syracuse University in Onondaga County and one of the largest campuses of the State University of New York, Binghamton University, in Broome County.

Onondaga, a population of 473,000, uses wastewater testing and extensive surveillance testing in its schools to detect the virus, Mr McMahon said, and has begun to see improvement in data from both in recent days. But overall test positivity rates in the county remain high, and there were 112 people with Covid-19 in hospitals as of Monday, up from 51 four weeks ago.

One of the factors the CDC assesses when assessing risk levels is the pressure on hospitals. Many of the hospitals in the hotspot region have struggled to cope with the coronavirus during the pandemic.

Some of the orange counties are sparsely populated, and in a small number of cases, per capita rates there may appear inflated, said Dr. Isaac B. Weisfuse, a medical epidemiologist at Cornell University who had a spate of new cases in March. . Cornell’s county, Tompkins, is yellow, but it is in the middle of Orange County.

“People in young adulthood seem to have higher rates than the elderly, or very young people,” he said. “An overcrowded pub with someone who is infected, you will get a lot of infections if people don’t wear mouth caps.”

Many of the region’s college campuses have higher vaccination rates than surrounding communities. Wells College, for example, has a vaccination rate of more than 90 percent, according to Chris Pollock, a spokesman, while surrounding Cayuga County is 59 percent.

Broome County, like many counties of the state, emphasizes mask wearing, physical distancing, vaccinations and booster doses as preventive measures, but all on a voluntary basis. “We still need to be diligent and vigilant in how we protect ourselves and those who are more vulnerable,” Ms McFadden said.

Some colleges in the region have taken stricter measures, with vaccine mandates for students and staff and reintroduced mask rules on campus.

As the highly contagious subvariants continue to ripple out from the original hotspot, turning more counties orange or yellow in the northeast and further afield, Mr. McMahon said he couldn’t say what made his county one of the first to be affected. .

“If you look at mask mandates, they came out at the same time” across the region, he said. “Somehow, the infectious subvariant got here first.”





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