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As coronavirus cases and hospitalizations climb across the country, health officials continue to urge caution, warning that despite the accelerating pace of vaccinations, the country could face a potential fourth wave of COVID-19 infections, if Americans let their guard down too quickly.
“We need to start rethinking how COVID case data is interpreted,” said Dr. John Brownstein, director of innovation at Boston Children’s Hospital and ABC News contributor. “With the rapid spread of vaccines, the increase in cases among healthy populations will not necessarily translate into hospitalizations and deaths as seen previously during the pandemic.”
During a White House briefing earlier this week, Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention (CDC), said she feared the United States could see “another preventable surge” in COVID-19 cases if mitigation measures – such as testing, wearing masks, social distancing, hand washing and crowd avoidance – are not observed.
And on Saturday, Dr Anthony Fauci, the nation’s leading infectious disease specialist, told ABC News’ Good Morning America that he was “very concerned” that “we may start to see an upsurge. cases ”.
The daily average of cases in the United States continued to climb. After two months of steady declines, last week the national average of cases rose 12.5%, now standing at just over 60,000 cases per day, like the number of cases recorded during the summer surge.
“We are seeing an increase in cases in several parts of the world, including some US states, so a fourth wave seems possible,” Rachel Baker, an epidemiologist at Princeton University, told ABC News.
In the first wave, the United States saw a rapid increase in cases and deaths, concentrated in the Northeast, and more specifically in New York. Over the summer, the country experienced a second wave with an influx of cases, hospitalizations and deaths spreading across the country. In early fall, national COVID-19 parameters subsequently plummeted, only to be hit by a third wave in late fall and early winter months with an unprecedented surge in cases, hospitalizations and deaths.
At least 22 states saw their seven-day average cases increase by at least 10% last week, according to ABC analysis of data collected by the Department of Health and Human Services, and the number of hospital patients also appears to be in hospital. to have stopped. down, reaching a plateau around 33,000, after falling more than 70% since early January.
Although nationwide testing positivity continues to rise, testing is declining. The average number of tests fell 12.2% nationally, while the average test positivity fell from 4.2% to 4.8%.
With less testing, fewer cases are discovered, leaving the possibility that states are missing out on potential community spread.
“I’m concerned that we have reached a plateau, as we lose ground to emerging variants and increase transmission by reopening and relaxing mitigation measures, such as restrictions on indoor activities,” Neil J. Sehgal, assistant professor of health policy and management at the University of Maryland School of Public Health, told ABC News.
With more Americans getting vaccinated, why are the cases on the rise?
With more older people getting vaccinated, many health officials across the country cite rising infections among young people as the likely driver of rising rates of cases.
In Massachusetts, where cases are steadily increasing, residents 29 and under account for more than 45% of the state’s positive COVID-19 tests in the past two weeks.
Earlier this week, Chicago Public Health Commissioner Dr Allison Arwady also warned that the city’s rise in the test positivity rate was being increased by an increase in cases among young adults between the ages of 18 and 18. 29 years.
“I am worried, and I hope everyone is concerned when they look at this data,” Arwady said.
And in Michigan, children aged 10 to 19 now have the highest rate of COVID-19 cases, which “is increasing faster than other age groups,” said Dr Sarah Lyon-Callo, Director of the Office of Epidemiology and Population Health of the MDHHS. .
After a steady decline in child cases over the past two months, the American Academy of Pediatrics and the Association of Children’s Hospitals reported this week that a slight increase in cases was reported last week.
While it’s still unclear what may be behind these rising measures, experts suggest it could be linked to the emergence of more contagious strains of coronavirus.
“Increasingly, states are seeing an increasing proportion of their COVID-19 cases attributed to variants,” Walensky said Monday.
Although the United States is still sequencing very few cases of COVID-19, more than 8,300 cases of the variant first found in the United Kingdom, B.1.1.7, have now been discovered in all 50 states.
Michigan health experts also correlated the state’s increasing metrics with variants. Michigan currently ranks second in the country for the most reported cases of the B.1.1.7 variant, with less than 1,000 confirmed cases, according to the CDC.
Even with the increase in cases, dozens of states have decided to reopen, with governors easing restrictions on many businesses like restaurants and gyms.
Air travel has also reached pre-pandemic levels, and with millions of young Americans traveling for spring break, there are fears the virus will spread further and spread to other states when travelers return home. .
However, experts say that with most Americans at highest risk dosed, this potential wave may not be as deadly or significant as previous ones.
“With a large proportion of vulnerable individuals now vaccinated, this fourth wave of cases cannot translate into a fourth wave of deaths,” Baker said.
Even though a fourth wave is “likely,” Sehgal said, “I don’t think it will be near the magnitude of the wave as we saw after the winter break, nor as deadly.”
Vaccination expansion will play important role in controlling 4th wave
The expansion of vaccinations will play a key role in controlling a potential fourth wave, experts say.
According to the CDC, on Saturday, 27.6% of the total U.S. population has received at least one dose of a coronavirus vaccine and 15.1% of the population is fully vaccinated.
Forty-seven states and Washington, DC, have already extended vaccine eligibility to all residents over the age of 16 or have announced plans to do so in the coming weeks – in time for the eligibility deadline of the President Joe Biden on May 1.
“I’m encouraged by the immunization rate – even in my most optimistic times, I didn’t expect us to get on average almost 2.5 million doses per day, and protecting the most vulnerable means less new cases will lead to hospitalizations and deaths. compared to previous surges, ”Sehgal said.
However, Brownstein and Sehgal both noted that there are still vulnerable segments of the population awaiting inoculation. Not all seniors have been vaccinated, and there are Americans with pre-existing health conditions who are at risk for serious illness, but who are not yet eligible for a vaccine.
“We still have vulnerable segments of our population from all age groups who have not yet been vaccinated. While this surge will not be on the same scale, the increase in B.1.1.7 and the rapid reopening, we will contribute to preventable hospitalizations and deaths, ”Brownstein said.
“Any increase in cases means more concern for these groups,” Sehgal added.
While serious illness and death from COVID-19 remains rare among young people, they are certainly not immune to the havoc the virus can wreak on their bodies.
“Going to the hospital isn’t the only COVID outcome I’m worried about – young people can have serious consequences from SARS-CoV-2 infection, like the ‘long-term COVID’ you probably read it, ”Sehgal noted, adding that he will be nervous until vaccine eligibility is broadened.
And while these vaccines offer protection against newer variants, “for unvaccinated people this may represent a higher risk. Time and time again, we find that the risk of future outbreaks is really related to the strength of the control measures. that we have in place, “Baker says. “In areas of the United States with lower immunization coverage, withdrawing too quickly from social distancing measures will increase the likelihood of a fourth wave.”
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