For the first time in months, COVID-19 cases have begun to fall, ticking back down from a rolling average of more than 30 new cases each day to just over 20.

But, that piece of good news comes before potential repercussions of Labor Day — and ahead of cold weather, Halloween and the winter holidays.

“My fear is, we’ll see an increase [in cases] because of our behaviors over Labor Day weekend,” said Dr. James Lederer, chief medical officer at Berkshire Health Systems. “Holidays, long weekends. That’s always been our downfall.”

This summer, which began with optimism about the vaccines and few COVID-19 cases, is coming to a close with high levels of community transmission, more restrictions and even some local ire over masking regulations.

But, the arrival of autumn also finds the county in a much better place than last year: A large swath of the population, including almost all of its elderly, now are protected by vaccines.

Here is where we are.

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Cases and hospitalizations

On Wednesday, the state reported just 11 new cases in Berkshire County. It was the lowest reported daily number in almost a month. The next day, there were just 14 cases, another small piece of good news.

But, the latest data likely does not reflect the full impact, whatever it might be, of Labor Day celebrations. For Lederer, the virus trends over the next 10 days or so are crucial.

“If we don’t see a major blip, if even in the presence of Labor Day parties … we’re at a plateau or a downward turn, then maybe we’re hitting that area where [the virus] is more manageable,” Lederer said. “Where it’s not eradicated, but it’s manageable.”

Even then, the county will face the hurdles of cold weather, Halloween and the winter holidays, Lederer pointed out. Last fall, cases began to rise in October but surged in full force after Halloween parties. By the height of last winter’s surge, there were about 60 patients hospitalized, and three to four people were dying each day.

This time around, Lederer says, the county has a big advantage, because of its relatively high vaccination rates. He credits the vaccines for keeping hospital admissions at a manageable level, even with the spread of the delta variant. The vast majority of the system’s current inpatients — there were 10 as of Friday — are unvaccinated, Lederer said.

In recent weeks, about 10 percent of the admissions have been vaccinated people, and the vast majority of those have been elderly, according to the hospital system.

“Those are really frail, elderly, who might not have mounted a good immune response and are not dodging this fourth wave of COVID,” Lederer said.

Vaccinations

For more than a month this summer, the fully vaccinated rate in the Berkshires barely budged, sitting stubbornly at about 60 percent of all residents.

Then the rate started to tick up again, by almost 1 percent each week, just as the delta variant began spreading through the county.

As of Tuesday, about 64 percent of all county residents had received a full COVID-19 vaccination, according to Massachusetts Department of Public Health data. The rate among eligible residents, those 12 and older, jumps to 71 percent.

Those overarching rates, though, belie the massive differences among age groups. More than 90 percent of residents 60 and older have received at least one dose of the vaccine, according to state data. That rate falls to just 61 percent for people ages 20 to 29, the least-vaccinated group in the Berkshires.

Those rates might rise over the next few months, as more mandates go into effect, after the Biden administration’s sweeping order that could affect up to 100 million people across the country.

Regulations and restrictions

As caseloads began to increase this summer, municipal governments and private entities across the country moved to put back in place rules and advisories that had been stripped away months earlier, when vaccines became widely available.

Those decisions included masking orders for public buildings, the hospital system’s vaccine mandate and universal indoor masking recommendations.

In South County, the Tri-Town Health Department put a directive into place, asking businesses to enforce masking, after seeing clusters of cases associated with outdoor events in the area, said Jim Wilusz, the department’s executive director.

And the private sector has become involved, too, as a wide swath of restaurants and shops across the county have opted to require masks again. Also, the Massachusetts Museum of Contemporary Art mandated vaccines or negative test results for its September music festival, FreshGrass, while the North Adams music venue HiLo announced that it also would start requiring vaccination or testing for entry to shows.

But, the restrictions and recommendations have not come without blowback. In Adams, a meeting about an unenforceable masking directive — it’s similar to the Tri-Town directive — turned into a raucous gathering, as attendees spoke over each other in opposition to the directive, threatened to stop paying taxes and claimed that masks could not prevent the spread of the virus.

Lederer acknowledged that it can be challenging for researchers to study mask protection, given the many different kinds of masks and the vast array of possible infection scenarios. But, he also pointed out that evidence has shown, for more than a year, that higher masking uptake is associated with fewer COVID-19 infections on the community level.

“If you look at the number of people ill in a masked area versus the number ill in an unmasked area, the masks win,” Lederer said. “It’s hard to combat ignorance. It’s hard to combat the polarization, which is definitely part of the vaccine problem too. … For most of us who realize there’s benefit to the community, ourselves, our families — we’re going to do what we need to do.”

Francesca Paris can be reached at fparis@berkshireeagle.com and 413-447-7311, ext. 239.