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New cases of COVID-19 are now falling across most of the country, and experts predict the U.S. pandemic may finally start to wind down.
While the virus may never go away completely, it is expected to become endemic – just another less dangerous and disruptive threat that humans coexist with.
“Barring something unexpected,” former Food and Drug Administration commissioner Scott Gottlieb told the New York Times earlier this week, “I am of the opinion that this is the last big wave of ‘infection.”
Experts, of course, have already been wrong about COVID; even now, few are ready to rule out another major winter wave. The Times’ David Leonhardt noted that the virus appears to follow a cycle: surge for two months, decline for two months. The United States has just passed 700,000 deaths, testifying to the continued lethality of COVID.
But the latest trends are particularly encouraging, and the dynamics of immunity and infection suggest they could foreshadow the end of the COVID emergency in the United States.
Consider the data. Exactly three weeks ago, the US summer wave – fueled by slowing vaccination rates and the hypercontagious Delta variant – peaked at nearly 176,000 cases per day on average. That average number of daily cases has since fallen by 41%, to around 104,000. The number of COVID patients in hospitals, a lagging indicator, has been declining for a month; it has fallen 25% since September 4. And COVID deaths, which are even further behind, are now declining as well.
Overall, fewer and fewer COVID tests nationwide have come back positive: less than 6.5% currently, compared to more than 10% at the end of August.
For weeks, the cautious response to these improvements has been to remind people of what happened last year. That summer, the virus also rose and calmed down – before it came back roaring in October. Three excruciating months later, it peaked at 250,000 horrific cases and 3,300 deaths per day.
Why suppose we’ll be spared another wave, say the skeptics – especially now that Americans are taking less precautions than ever before as the cooler weather pushes them indoors again and another holiday season is just around the corner?
The skeptics are right. But so do optimists like Gottlieb, who believe this winter will be much better than last winter, and that the delta’s surge this summer could be the virus’s last big gasp.
There are two main differences between 2020 and 2021 that give optimists hope. The first is vaccination. October 5, 2020 no The Americans had been vaccinated. Now, exactly one year later, 64% of them have received a dose of the vaccine. In adults, that number is 77 percent.
Granted, people who have been vaccinated can still test positive for Delta and pass it on to others – but not as frequently or as easily as people who are not vaccinated. Meanwhile, the largest remaining block of unvaccinated Americans, 28 million children aged 5 to 11, are expected to be eligible for vaccines before Thanksgiving. And while data from Israel and elsewhere has shown that vaccine effectiveness against mild and moderate infections declines over time, and in the face of Delta – especially for early Pfizer beneficiaries – the most vulnerable Americans receive already recalls, and the rest of the country cannot be far behind.
The vaccination, in other words, gives the United States a huge lead over the virus this time around. This was not the case last year.
The second difference between yesterday and today is Delta itself. The main reason the variant has sickened so many Americans and escaped at least some vaccine protection is that it is about twice as transmissible as the strain that was spreading. in the United States a year ago. This is the bad news. The “good” news (if you can call it that) is that a variant as infectious as Delta effectively crowds out other disturbing variants while quickly generating a lot of infection-induced immunity in its wake.
Vaccination is a much safer and more effective way to acquire immunity than infection, of course. But if more unvaccinated people contract the virus now, fewer of them will be vulnerable during the winter.
The practical implications could be enormous. One of the concerns with Delta was how it would interact with the so-called seasonality. In the summer of last year, the virus hit the southern and southwestern states harder than their counterparts in the North and Midwest, possibly because warmer temperatures pushed more people to the inside. Then the whole country, including the North and the Midwest, was crushed during the holidays.
After Delta ravaged the South this summer, some feared history would repeat itself, especially with masking and distancing on the decline and children returning to classrooms.
But this year’s model doesn’t match last year’s. Because Delta spreads much faster and more efficiently than its predecessors, the variant didn’t wait until winter to move north. Instead, it looks like it is already burning all the unprotected hosts it can, wherever they are.
Vermont is a good example. At the same time last year, Green Mountain State was recording an average of just 10 cases of COVID per day; the virus did not begin to appear there until November. Yet from July through September – the month when its curve stabilized in 2020 – Vermont actually experienced its largest increase to date, which just peaked at 219 cases per day (even though it is the most vaccinated state in the United States). The same is happening next door in Maine.
Many other states that survived the summer of 2020 relatively unscathed have seen the number of cases increase in recent weeks. Alaska, for example, is by far the worst COVID hotspot in the United States; his current wave is twice as bad as his previous fight with the virus. This earlier surge began last October and peaked last December. This started in July and seems to have peaked at the end of September.
Ohio is in the same way Now comes from a surge that was almost as big as last winter. West Virginia, Washington state, and Oregon have experienced their strongest outbreaks to date. New York, New Jersey, Pennsylvania, Delaware, Maryland – all have experienced summer virus outbreaks this year.
None of these states had to face the waves last summer.
One could interpret this information in a pessimistic way and predict that an even bigger and worse winter wave is looming. But the children have already been back to school for a month; the data seems to confirm that they are not the source of new outbreaks. At some point, enough Americans will have gained at least some immunity through vaccination or infection to slow Delta – and to make any subsequent infection considerably less dangerous. The pandemic will end; the virus will become endemic.
The question is when. Already, the number of cases is not decreasing only in the under-vaccinated South, which has led to the summer outbreak. And they’re not just falling in Alaska or West Virginia, the latest under-vaccinated hot spots. They are also dropping or peaking in other more vaccinated states that have recently experienced their own smaller and seemingly premature flare-ups.
Could it be that because Delta spreads so easily, it may have already infected – or is now infecting – most of the unvaccinated Americans it will infect, regardless of region or season? ?
Could it be that most of the wave that could have hit the United States this winter has already hit – and that with the onset of winter, Delta will have fewer and fewer unprotected Americans to infect? ?
This is the hopeful argument that Gottlieb and others make. Soon Americans will know if they are right. By now, Delta appears to have extended as far north as possible; redest counties on US hotspot map trace a wintry arc along the Canadian border from Maine to Montana before descending into the rural and under-vaccinated western mountains.
If cases continue to increase in cold areas, it could portend more widespread transmission once colder weather hits everywhere. But if the northernmost United States also starts to improve, this holiday season will likely be safer than last year. It might even signal the beginning of the end.
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