Is the United States Turning a Corner in the Pandemic?

Halfway through a gloomy winter, Dr. Diane Griffin has started to sense something in recent weeks that was lacking for much of the past year: optimism.

Griffin, an infectious disease expert at Johns Hopkins University School of Medicine in Baltimore, said recent declines in hospitalizations, daily deaths and new confirmed infections raised hopes that the United States has come to a crossroads. in the trajectory of the coronavirus pandemic.

“What we’re seeing is gradual and encouraging,” Griffin said, “but we’re not out of the woods yet.”

More than a year after the start of the pandemic, developments that seem to contradict each other have made it difficult to analyze the position of the United States and the world.

Griffin’s optimism is tempered by the fact that while the number of cases is steadily declining, it is still much higher than it was in the first wave, which overwhelmed parts of the country in the spring and last summer. And above all of the recent advancements is the threat of more contagious coronavirus variants that are already spreading rapidly in the United States – as well as fears that the variants could pose problems for the current round of vaccines.

Scientists say while it’s heartwarming to see declines after some of the pandemic’s deadliest and most difficult months, it may be too early to know if the United States is experiencing a temporary reprieve or whether it is are finally starting to take control of the pandemic.

And while some optimism is warranted, the psychological challenges of the pandemic – in which human behavior and collective responsibility remain essential to contain outbreaks – are forcing communities to remain vigilant.

“We’re seeing a decline right now, but I don’t think that changes the idea that we need to be very careful in the coming weeks,” said Dr Bruce Y. Lee, professor of politics and management of the health at the City of New York University. “Whether it’s a momentary dip or whether we’ve reached the top and now things are going downhill – it’s not entirely clear.”

Questions about how known variants of the coronavirus, including a more transmissible strain that is believed to have emerged in the UK, could further hurt forecasts, could alter the course of the pandemic.

Some research suggests that there is already cause for concern.

A recent study that was posted on the medRxiv pre-print server but has not yet been peer reviewed found that cases of the UK variant are doubling in the US every 10 days. The results appear to confirm a report from the Centers for Disease Control and Prevention released last month which predicted the British variant could become the predominant strain in the country by March.

Lee said the number of cases will likely rise again as the UK variant becomes more widespread and other strains that were first reported in South Africa and Brazil are circulating in the U.S. But it is possible that other forces – including rising immunization rates across the country, the anticipation that people will spend more time outdoors in the spring, and other behavioral changes – will help counteract a new wave and prevent a new wave of epidemics.

“January and February were expected to be tough months, because of the winter and the holidays, but by March or April we might start to see things improve,” Lee said.

On the one hand, spring will bring warmer temperatures to much of the country, making it easier to spend time outdoors, where the risk of infection would be lower.

And the improvements are expected to continue as more Americans get vaccinated, Griffin said.

The first results from Israel, where more than a third of the population has received at least the first of two doses of vaccine, provide the first real-time insights that efforts to deliver injections quickly and widely appear to be working. Preliminary analyzes show that vaccines appear to contribute to a sharp decline in infections and diseases, especially in people over 60, who were among the first to get vaccinated.

Israel administered more than 60 doses of the Moderna or Pfizer-BioNTech vaccine per 100 inhabitants, far surpassing all other countries. (Israel’s vaccine strategy has been criticized for excluding Palestinians.)

Figures released last week by Israel’s health ministry indicated that of nearly 750,000 people over the age of 60 who have been fully vaccinated, only 0.07%, or 531 people, have tested positive for the virus. Of this group, 38 people were hospitalized with moderate or severe illness.

Griffin said the early results from Israel’s vaccination program were “very encouraging,” adding that the vaccines could at least prevent serious illness and death in the United States, even if the variants cause an overall increase in cases.

The deployment of vaccines in the United States was hampered from the start by supply constraints and a lack of a comprehensive strategy under the Trump administration. Since then, the federal government led by President Joe Biden has attempted to reduce bottlenecks in manufacturing and distribution, and it is expanding how and where vaccinations can be administered. The efforts are part of Biden’s goal of giving at least 100 million shots in his first 100 days in office. As of Sunday, the United States had administered 40 million doses, according to the CDC.

Experts have said the United States is in a race against time to vaccinate as many people as possible before more troublesome variants emerge, but there are ways to alleviate outbreaks even while waiting to become eligible for vaccines, said Carl Bergstrom, professor of biology. at the University of Washington.

“One of the biggest drivers throughout the pandemic has been the changes in our collective behavior,” Bergstrom said. “This is what makes modeling the long-term trajectory of the pandemic so extremely difficult.”

Indeed, behavioral changes have at times been associated with both spikes in cases, when people adopted more lax attitudes and states rolled back restrictions, and with valleys, as new measures rolled out. been put in place and people have become more vigilant.

The dynamic was largely to blame for the alarming spike in cases, hospitalizations and deaths in Los Angeles County, Calif., In December and January.

To avoid another peak in the spring, the United States must remain aggressive with vaccinations and mitigation tactics, such as wearing masks and social distancing, Bergstrom said. These strategies are even more crucial in tackling more transmissible variants of the coronavirus, he said. The British strain has already been reported in more than half of the states, but like the UK the numbers could rise quickly.

“This is how exponential growth works,” Bergstrom said. “It happens at a low frequency, and the first few dubs you don’t really notice because it’s overwhelmed by what you see with the regular strain. But when that changes, it changes pretty suddenly, and then you really see it. . lift-off.”

This outlook is why many pundits approach recent declines with cautious optimism. The possibility that progress will be wiped out if a strain emerges that eludes current vaccines is also of concern. Some preliminary research has already shown that Moderna and Pfizer-BioNTech vaccines are less effective against the South African variant, although the levels of neutralizing antibodies are still expected to be protective.

It’s also possible, Bergstrom said, that other problematic variants are already circulating in the United States undetected.

All of these factors combine to make it difficult to assess the position of the United States and predict how the next few months might unfold, he said.

“There are so many moving parts, and it’s so complicated,” Bergstrom said, “but whatever we can do to stay aggressive the more we can get vaccinated and the longer we can stay in there, the more we can avoid a huge spring spike. “