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Intensive care admissions are increasing at a slower rate, because of improvements in care, though 40 people have already died of the virus in November, bringing the total coronavirus fatalities in the county to 788 people.

In an encouraging sign, Erie County’s infection rate has leveled off at around 7 percent in the last few days, indicating that some restrictions are having an effect. As the message has gotten through, there are now lines to get coronavirus testing, and masking in public places is generally good, residents said, although there has been some pushback regarding current virus restrictions.

“I do believe the vast majority of people in my community are taking it seriously, whether they live in the city of Buffalo or they’re in a rural community,” Mr. Poloncarz, a Democrat, said in an interview. “But there are some folks who are not. And unfortunately, those individuals put at risk the entire community for further shutdowns.”

How Western New York got here is not clear cut. Local epidemiologists and officials say that there was no large outbreak that triggered this second wave. Multigenerational households in Buffalo’s poorer neighborhoods, which suffered disproportionately early in the spring — when more than 500 people died in the county — have not been the hardest hit this time.

Rather, said Mr. Poloncarz, it seems that the November surge started in the wealthier, more conservative suburbs, where people appeared to be not taking enough precautions in private gatherings, bars or restaurants. The spike also began in the days after Halloween, leading some epidemiologists to believe that parties played a part.

But transmission at this point is so widespread in the county that irresponsible behavior is not required to get sick, said Dr. Thomas A. Russo, the chief of infectious disease at the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo. In what he calls the “innocent bystander effect,” many infections now are being spread among family members in private homes, brought in by people who are asymptomatic.

Coupled with the small, but significant, minority resisting masking and other restrictions, the virus is finding enough hosts to fuel the ongoing community transmission, he said. Even 20 percent of people not complying is enough, he added.



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