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The pandemic is not over, even if we are above
I write weekly for Medium about my experiences as an emergency doctor during the Covid-19 pandemic. You can read my previous articles on vaccine inequities, the return to “normal” life, and more, here.
A A month ago, I wrote that the next phase of the pandemic depends on the vaccines, the variants, and how we follow the necessary public health measures to control Covid-19. Since then, it has become increasingly clear that this summer will be amazing (albeit a little weird). What is less clear is how this spring will shake up compared to Covid in the United States
So let’s take a look at what we’ve been up to since my last story and what probably lies ahead. Spoiler alert: there are good, bad and ugly.
If one aspect of this pandemic deserves unbridled optimism, it is the current state of vaccine deployment.
When I was vaccinated against Covid last December, there were more new cases of Covid than people vaccinated against it every day. At first, vaccine deployment was slow and ineffective, not entirely unexpected for a massive national campaign to get gunfire.
When then-president-elect Biden pledged in January 2021 to get 100 million vaccines in his first 100 days as president, even among his advisers, he feared his pledge might be made. failure due to logistical challenges and unforeseen disruptions in the vaccine supply chain.
If the trajectory of the pandemic in the United States were determined solely by vaccinations, we would be in great shape. But this is not the case.
However, we achieved the goal of 100 million shots in 58 days. And recently, the president doubled his commitment to 200 million vaccines within 100 days.
The steadily increasing supply of vaccines is responsible for much of the recent improvement in deployment. Moderna has already delivered 100 million doses of its vaccine and will deliver 100 million more by the end of May. Johnson & Johnson’s production capacity is increasing, now putting it on track to deliver 20 million doses of its single-injection vaccine by the end of March.
Greater supply means more doses are being shipped to states. This week alone, 33 million doses are available to vaccinators, a substantial increase from 27 million the week before (itself a 20% increase from the previous week).
After being dispatched, these doses quickly go into the arms. The United States currently performs an average of more than 2.7 million vaccines per day. For many days, more than 3 million Americans get vaccinated, or nearly 1% of the total population of the United States.
And with more supply available, more states can get vaccinated, in line with President Biden’s goal of ensuring that every adult American is eligible for a vaccine by May 1 and enough vaccines available to them by the end of May.
If the trajectory of the pandemic in the United States were determined solely by vaccinations, we would be in great shape. But this is not the case.
Variants of the virus that causes Covid-19 are planting what should be a happy spring festival. This is because in the race between vaccinations and variants, the variants win.
After weeks of declining cases, the daily number of new Covid-19 infections began to level off at the end of February. In mid-March, the 7-day average of new cases fell to 52,000 per day, the lowest since October 2020. But now cases have started climbing again. 36 states are reporting an increase in cases, and nationally, the United States is averaging 65,000 new infections per day, which is comparable to the highs seen in July 2020 during the summer surge. Of course, this is a lot less than the 250,000 / day we saw just a few months ago, but it still means that there are a lot of viruses circulating in our communities.
This increase is due to multiple factors, including pandemic fatigue and the relaxation of restrictions. But the variants are also definitely to blame.
Many variants currently circulating in the United States, including B.1.1.7 (first discovered in the United Kingdom), B.1.351 (South Africa) and P.1 (Brazil), have recently fueled outbreaks in the world.
Here in the United States, variant B.1.1.7 is currently the most worrying and the most prevalent. This variant is known to be 30-50% more transmissible and possibly more fatal too. It has now been identified in all US states and accounts for almost a third of all cases in the United States. This is likely contributing to recent spikes in cases and hospitalizations in places like Michigan and the Northeast.
Even more alarming, younger age groups are driving the rise in hospitalizations. Over the past month, hospitalizations among adults aged 40 to 49 increased by nearly 800% in Michigan.
In their race against vaccinations, Variants are getting help from our varying adherence to public health measures and politicians who are relaxing restrictions across the country.
There have been blatantly egregious examples of people claiming we are still not in a pandemic, such as maskless revelers in Miami whose bacchanal forced the city to enforce a spring break curfew. Most importantly, what we have seen is a gradual removal of restrictions on masks and other protective measures.
Last month, I noted how a few states had recently lifted their mask mandates and others will follow soon. A few days later, Texas and Mississippi did just that.
And despite President Biden’s call for everyone to wear a mask for 100 days, other states have followed suit. This week, hours after the president pleaded with “every governor, mayor and local leader to maintain and restore the mask’s mandate,” Arizona and Arkansas went the other way and repealed theirs.
Over the past few weeks, Covid has provided a timely and important reminder: the pandemic is not over, although many of us are overcoming it.
Interstate travel is also mixed: Even though Biden’s mask mandate is not respected in all places, one of the first actions of his administration was to pass an executive order requiring masks to be worn on air travel and trains in accordance with CDC guidelines. .
This has the potential to be very impactful, given the surge in travel recently. Over the past three weeks, the Transportation Security Administration (TSA) has screened more than one million passengers every day, the highest number since the start of the pandemic, including waves of travel around Thanksgiving and the holidays. winter.
And American Airlines recently announced that travel bookings have reached 90 percent prepandemic levels. Many of these passengers are vaccinated against Covid-19. But there is no doubt that many are not and bring the virus with them on the plane and at their destination.
Many describe this uneven public health response as a political issue between the Red and Blue states. The narrative is often simplified by stating that Republican-led states slack off too quickly, while Democratic-led states slack off too slowly. Even the state mask mandate map covers the 2020 electoral map fairly well. The problem, however, is that this simple narrative is wrong.
In the strongly democratic northeast, states are opening up quickly despite the highest rates of new Covid cases in the country. In New York, dining room is back at 75% (50% in New York). Cinemas, professional sports games and even indoor gymnasiums are open (although with limited capacity). Even though mask warrants are still in place, many other restrictions on indoor events and other high-risk activities are also being removed in neighboring states, although cases continue to rise.
So where are we now in this delicate dance of vaccines, variants and compliance with public health measures? And what does the future hold for us?
Well, I have a lot of hope for the long term, but also some concerns for the short term. Over the past few weeks, Covid has provided a timely and important reminder: the pandemic is not over, although many of us are overcoming it.
A fourth wave seems inevitable. It’s only a matter of grandeur at this point.
Again, new cases of Covid are on the rise in the United States (and around the world). Hospitalizations and deaths are also on the rise. Since the start of the pandemic, this combination has invariably preceded a strong outbreak of the virus across the country.
While the vaccine rollout has been remarkable, it is not over yet. To date, only 16% of Americans are fully immunized. Among people 65 and over, the population most vulnerable to the most severe effects of Covid, only half are fully vaccinated. This means that a large part of the country is still susceptible to Covid. The virus still has plenty of room to spread.
And even as vaccination accelerates, the threat of variants is also accelerating. When accompanied by a relaxation of public health measures nationwide, the threat of a new surge is real. A fourth wave seems inevitable. It’s only a matter of grandeur at this point.
This is exactly why CDC director Dr Rochelle Walensky recently released the script during a public briefing for beg the nation to “please wait a little longer.”
With all the optimism and improvement in the injections in the arms, it was easy to believe that the vaccines will overtake the variants. And as this pandemic continues, it’s understandable that many are fed up with wearing a mask and following the public health measures needed to slow the spread.
But as Dr Walensky noted, we have to hold out a little longer. We know it’s going to be a great summer. But spring doesn’t have to be horrible.
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