Walensky noted exactly what the numbers in so many states are showing: “a steady rise of cases.” And, as so many others have insisted, Walensky asked that Americans hold on “just a little longer” as the vaccination effort continues.
As The Washington Post reports, cases nationwide are up 12%, setting the U.S. up for a “fourth wave.” That this is happening at the same time that the nation is hitting almost daily records for rate of vaccination may seem puzzling. It looks even more so when the maps of vaccination rates are set against the locations where new cases are growing.
What’s immediately obvious in looking at these two maps together is that some of the areas with the highest rates of vaccination—such as New Jersey—still manage to be among those with the highest rates of new cases. In fact, there’s no clear pattern at all that relates the rates of vaccination and the rates of disease. The reason for this is simple enough: Even in the states with the highest rate of vaccination, the levels are barely high enough to affect the rate of COVID-19 transmission. In most of these states, any benefit that has been gained from vaccination has likely been outweighed so far by the effects of relaxing social distancing standards.
Some states that have eliminated mask mandates and opened their businesses wide, such as Texas and Mississippi, are not suffering relative to other states at this point (though both undoubtedly have more cases than they would have had restrictions remained in place). Other states, such as Florida and New York, are showing definite growth related to changes in guidelines.
However, there’s a third factor at play. As it has been since the start of the pandemic, testing rates can both reveal, and cover up, issues. New York may appear worse than Texas in the map above, but the rate of positive cases in New York is actually much lower than that in Texas. That’s made possible by the fact that New York is now testing at a rate that’s almost five times greater than in the Lone Star State. Texas is not alone in this. Even as cases leveled out and began to climb, testing rates in many states kept right on plummeting. The result is over a dozen states with rates of positive tests exceeding 6%. Overall testing in the United States is still turning up 8.52% positive results—far above the numbers that should be seen when a disease is being pushed to elimination.
It’s tempting to look at the 28.6% of Americans who have received at least one shot, according to the CDC, add that to the 9.4% of Americans who have tested positive for COVID-19, and assume that there are some areas where herd immunity can’t be so far away. Unfortunately there’s a big overlap between these groups, and it’s unclear just how many Americans have been vaccinated who had already, at some point in the pandemic, tested positive for COVID-19.
What may be most important is this chart:
As usual, the last few days are incomplete, but the rate of daily vaccine doses administered in the United States is now moving toward 3 million a day. That’s about 1% of the over-18 population being vaccinated each day. At that rate, the United States should reach a level where the spread of COVID-19 is greatly reduced by mid-May. Sooner, if the rate of vaccination increases.
The second half of May could see rates of COVID-19 finally plunging to levels that have not been seen since the first weeks of the pandemic. It’s entirely possible that, at that point, a national program of testing and case management could do what it should have done from the beginning: Help direct isolation and quarantine to take those remaining cases and push them, as much as possible, toward extinction.
But that can’t happen yet. There simply are not enough doses in enough arms at this point. Which is why social distancing and mask mandates remain critical.
At the moment, many of the cases are among younger patients. That may be bringing the number of deaths down, but the latest review of the P1 variant showed that it had almost three times the death rate among patients under 29. All variants, including the fast-spreading B.1.1.7, are capable of leaving COVID-19 patients with symptoms that may linger for months or years.
Dying, or catching a case of COVID-19 that generates possible lifelong injury, would be a tragedy at any point in the pandemic. But at this point, with a solution not only close but tantalizingly visible, that tragedy would be even greater.
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