In Boston, plans to bring children back to school have been halted as cases of the coronavirus climbed precariously. New virus clusters are emerging in Rhode Island, Connecticut, Maryland and Pennsylvania. In New York City, the number of new cases each day now averages more than 500 for the first time since June.
The Northeast, devastated by the coronavirus in the spring and then held up as a model of infection control by summer, is now seeing the first inklings of what might become a second wave of the virus, an ominous prospect for the region and a sharp warning to the rest of the country.
The rise in new cases has prompted state and local officials to reverse course, tightening restrictions on businesses, schools and outdoor spaces.
In New Jersey, where hospitalizations are on the rise and the rate of infection has almost doubled to nearly eight cases per 100,000 people, towns have closed public parks and picnic areas to discourage people from gathering. Gov. Gina Raimondo of Rhode Island extended restaurant capacity limitations for another month, concerned about the state’s uptick in confirmed cases.
On Thursday, several mayors from across New York State rushed to quarantine after appearing at a news conference with another mayor who only later discovered that he was infected with the coronavirus.
Michael Osterholm, an infectious-diseases expert at the University of Minnesota, said that early in the nation’s outbreak, New York and much of the Northeast had successfully tamped down transmission of the virus with physical distancing and masking, as much of Europe had done.
“The point is, once you let up on the brake, then eventually, slowly, it comes back,” Dr. Osterholm said.
By many measures, the Northeast continues to do quite well, particularly compared to current hot spots for the virus, including the Midwest and Great Plains.
Since the spring, case numbers in the Northeast have plummeted over all. The region, which runs from Maine to Pennsylvania, is averaging about 60 deaths per day, the lowest in the nation, according to the Covid Tracking Project. Some 2,800 people are in a hospital in the region, accounting for 8 percent of the hospitalizations nationwide. Those figures are tiny compared with the spring, when tens of thousands of people in the Northeast were hospitalized on any given day, and morgues were running out of body bags.
Still, the number of people in hospitals — a clear measure of those most seriously affected by an outbreak — is starting to trend slightly upward again in the Northeast. About 1,000 more people are in hospitals than last month, and daily reports of new cases have started climbing once again, leading to fears about what the winter might bring.
“Places like New York and other states in the Northeast could have more of the classic second wave phenomenon,” said Dr. Larry Chang, an infectious-disease expert at Johns Hopkins University School of Medicine, who said he was bracing for more outbreaks this fall. “Pretty much everybody expects things to get somewhat worse.”
There may be a number of reasons for the upward trend in cases. The air turned suddenly chilly in the past few weeks, forcing people who had been lounging in sunny parks indoors. Students returned to schools and college campuses. And Northeasterners, who were among the first to take the virus seriously, may simply be growing weary after months of social distancing and wearing masks, even to walk outside.
“We’re all kind of exhausted with it,” said Danielle Ompad, an infectious-disease epidemiologist at New York University. “We have to acknowledge that this is not easy.”
The first glimpse of a resurgence has troubled public health experts and the region’s many coronavirus survivors alike.
“I’m still coming around from this,” said Laura Gross, 72, of Fort Lee, N.J., who contracted the virus in March and is still seeing doctors and struggling with significant fatigue. With cases on the rise, she fears what might happen to her next. Most people who get the virus develop antibodies, although it is unclear how long immunity lasts.
“I have a fair amount of antibodies, but what does it mean?” she said. “I’m really concerned. I don’t go out of the house except to go to the doctor. I wear a mask. I don’t go to food stores.”
In New York City, the rate of positive tests among all the tests taken remains low, about 1.5 percent, but recent outbreaks in Orthodox Jewish neighborhoods offer a new warning about how quickly the virus can spread.
City epidemiologists have tied many new cases to an outbreak in a corner of Brooklyn called Borough Park, home to tightly knit Hasidic groups where distrust of secular authorities runs deep and few people wore masks or practiced social distancing. A few cases traced back to a large wedding, the authorities said, but by late August, what had begun as a localized outbreak was spreading: Other neighborhoods in Brooklyn and Queens began to see rising case counts.
By early October, the number of new cases across the city was averaging twice what it had been at the low point two months earlier. Brooklyn alone now had more than 200 new cases some days. Gov. Andrew M. Cuomo announced an array of new rules that would shut down schools, restaurants, bars and gyms in areas where the virus was surging.
While New York may offer the clearest example of a potential second wave, the coronavirus is also reaching other parts of the Northeast that had not previously seen a major surge.
In Pennsylvania, Daryl Miller watched this spring as the coronavirus tore through Philadelphia and other parts of the state, while his mostly rural community was largely spared. “It was single-digit — one, two, three cases a day,” said Mr. Miller, a commissioner in Bradford County, an area with a population of 60,000, northwest of Scranton. “Now, we’re in the dozens.”
Part of the rise comes from the Bradford County Manor, a nursing home where dozens of residents and employees have contracted the virus in the past few weeks. But more worrisome, he said, is that the virus seems to have inexplicably spread all around the county.
“It’s something we don’t have the answers to ourselves,” Mr. Miller said. “Yes, the numbers are going up, but as far as pinpointing any particular reason, nobody seems to have any answers.”
There is one clear pattern in Pennsylvania and elsewhere: college campuses, which have been the sites of more than 178,000 cases around the country. Centre County, home to Penn State University, is leading the state in cases per capita. In Rhode Island, the governor recently blamed upticks on outbreaks connected to Providence College and the University of Rhode Island. Dr. Deborah L. Birx, the White House’s coronavirus response coordinator, visited a campus of the University of Connecticut on Thursday, as part of a series of recent visits to colleges.
As cases have risen across the Northeast, several school systems have had to pause their reopening plans or even consider closing schools again.
The mayor of Boston, Marty Walsh, announced this week that Boston Public Schools would delay bringing preschoolers and kindergartners into school buildings because the city’s positive test rate had risen above 4 percent.
In Hartford, Conn., where the seven-day positivity rate recently increased to 2.6 percent, officials said the city might also have to roll back its reopening of schools.
And in New York City, Mayor Bill de Blasio went back-and-forth with the governor in recent days over how to shut down schools in troubled areas, developments that represent a setback for a city that has the largest school district in the country.
It remains to be seen whether the new restrictions in the Northeast will slow the spread of the virus, but some people were already preparing for the worst.
“I’m not surprised,” said Jen Singer, 53, of Monmouth County, N.J., a recent hot spot. After catching the virus this spring and being hospitalized for heart failure, she said she recently rode her bike past crowds of people socializing “like any other Shore Saturday night.” They were lined up to sit outdoors at a bar, across the street from the hospital where she had to get a pacemaker.
In response to the new cases, she has begun to further limit the number of people she sees, and she said she has had flashbacks to her time spent on the hospital’s coronavirus floor, where nurses wore head-to-toe jumpsuits and she lay in her room, scared and alone.
“I don’t want to do that again,” she said.
Joseph Goldstein, Kate Taylor and Mitch Smith contributed reporting.