With Pennsylvania reporting case numbers rising to April levels, and New Jersey saying its daily totals are more than double last month’s, officials on Monday reiterated that a coronavirus fall resurgence is underway and warned against yielding to restriction fatigue as the holidays approach.

“I know we are all tired of COVID-19 and all the precautions necessary to prevent the spread of disease and the restrictions we have endured,” said Judith Persichilli, the New Jersey health commissioner. "It is understandable that residents want life to go back to normal, but now is the time to double down on social distancing, wearing face coverings, and good hand hygiene.”

The splendid weather this week belies the seasonal reality that soon people will be spending more time in the great indoors, a favored habitat of viruses, said Dr. John Zurlo, division director of infectious disease at Thomas Jefferson University.

Dr. Rachel Levine, Pennsylvania’s chief health official, said every part of the state was seeing community spread, in part due to “relatively small gatherings of families and friends."

“It’s these small gatherings that we’re most concerned about,” said Zurlo. Council Rock North High School, in Bucks County, remains closed through Wednesday after learning of more coronavirus cases, some involving students seated near each other in class.

Nearly 2,400 additional confirmed cases of the coronavirus were added to the commonwealth’s total for Sunday and Monday, marking two straight weeks with more than 1,000 new positive tests per day. That prompted Gov. Tom Wolf to issue a plea to Pennsylvanians to work together to stop the spread.

In New Jersey, the daily case numbers have been coming in as high as 1,000 or more daily, said Persichilli; in mid-September, they were under 400.

Department of Health Commissioner Judy Persichilli speaks during a coronavirus briefing in Trenton in June.
Anne-Marie Caruso / AP
Department of Health Commissioner Judy Persichilli speaks during a coronavirus briefing in Trenton in June.

The recent positive-test rates — 4.3% in Pennsylvania; 3.4% in New Jersey — have increased, but remain below the World Health Organization’s 5% danger marker for community spread, although Philadelphia’s did exceed 5% one day last week, the city reported.

“I think we’re still in a reasonable range,” said Zurlo. “Obviously we are seeing more cases. It remains to be seen whether we’re going to see a major surge.” However, he said he did not think the intensity would rival the spring peaks.

Levine said that hospitalizations have doubled in about a month, from 422 to 841, but that’s about a third of the spring’s highest levels, Inquirer data show. And officials say that are now better prepared to deal with surge in hospital cases.

As elsewhere, Philadelphia officials say that are balancing public-safety imperatives against the public’s hunger for normality.

That was the logic of allowing a limited number of fans to attend the Philadelphia Eagles game on Sunday, said James Garrow, the Health Department spokesman. (In a nod to recent normality, the Eagles lost.)

“We closely watched other cities' experience with limited attendance at outdoor stadiums and didn’t see an associated rise in cases or outbreaks associated with attending the games,” he said, “so felt confident that having a limited number of people — properly spaced and masked — would be OK.”

Pennsylvania is holding back on imposing new restrictions — for now.

“It’s impossible for me to predict the future,” Levine said. Inevitably, any decision would be based on positive-test and hospitalization rates, department spokesperson Nate Wardle said.

Folks enjoying outdoor dining at Seasons 52 at the Cherry Hill Mall in June.
ELIZABETH ROBERTSON / Staff Photographer
Folks enjoying outdoor dining at Seasons 52 at the Cherry Hill Mall in June.

New Jersey restaurants will be able to extend their outdoor liquor license permits for the pandemic from the end of November through March 2021 for a small fee, Gov. Phil Murphy announced at a news conference Monday.

The licenses, through the Division of Alcoholic Beverage Control, have allowed restaurants to serve liquor to customers “beyond their normal premises,” Murphy said. The extension fee is $10.

The permits have been “meaningful and in some cases lifesaving for them, and helped them survive during these challenging times,” Murphy said of the restaurants. “Given the current uncertainty, extending these permits it the right thing to do.”

Across the United States, the reopening of state economies — no matter how gradually or geographically tailored — has been accompanied by increases in COVID-19 cases, the New York Times reopening tracker shows. In response, states including Oregon, Arkansas, and Alabama have paused the easing of restrictions or imposed new precautions, such as requiring masks in public.

Other states, notably New York, Texas, Colorado, and California, have ordered renewed shutdowns of certain businesses — especially bars and indoor dining — at least in areas where cases are spiking.

A pedestrian wearing a mask in San Francisco.
Jeff Chiu / AP
A pedestrian wearing a mask in San Francisco.

But the effectiveness of these measures in suppressing the resurgence has been literally all over the map. For examples, Colorado’s case numbers are still rising, Texas has seen a slight decline, New York’s level is stable, and California has seen a sharp decline in cases — back to the level at reopening.

While Pennsylvania officials wait to decide what’s next, Wolf urged the state’s residents to adhere to preventive protocols. He said that more half the state’s residents were wearing masks in public, which means “a lot of Pennsylvanians are not.”

Pointing to strong evidence that masks are effective in stemming transmission, the Centers for Disease Control issued guidelines Monday that would require all plane, train, and bus passengers to wear facial coverings.

Levine said that those who get sick can do their part by picking up the phone when a contact tracer calls and being honest about where they’ve been. She said that during the week of Oct. 4 to 10, when reached by contact tracers, about two-thirds of those who had tested positive refused to answer the question: Have you been to a business or mass gathering in the past 14 days?

“The trajectory of the next few months will be determined by all of us now, and in the coming weeks," said New Jersey’s Persichilli. "Our behavior will be critical in shaping how our holidays will be celebrated. Now is not the time to let your guard down. The virus has not stopped circulating so we must continue this fight.”

Inquirer staff writers Maddie Hanna, Laura McCrystal, and Marie McCullough contributed to this article.