Dr Rochelle Walensky, director of the Centers for Disease Control & Prevention (CDC), warned on Monday that the country’s seven-day average COVID-19 cases reached 67,440 cases per day. That was a clear increase from a month ago – when Walensky noted, the seven-day average was “just over 53,000 a day.
“Unfortunately, the seven-day average of daily deaths is now increasing, with six consecutive days increasing, to about 695 deaths per day,” Walensky said.
The slow increase in COVID-19 cases across the country may seem illegal with another basic fact in public health: at the same time, millions more Americans have been vaccinated against the new coronavirus, which causes COVID-19. According to the CDC, more than 50 percent of U.S. adults 18 and older in the U.S. received at least the first dose of the vaccine; nearly 25 percent of the population is fully vaccinated. As Walensky noted Monday, that means more than 84 million have been fully vaccinated; and of those vaccinated, the U.S. had fewer than 6,000 “breakthrough infections” in which individuals who were fully vaccinated tested positive for COVID-19.
Given the rapid implementation of vaccinations, the news of an increase in cases may seem very peculiar. Shouldn’t things really start to decline as more people are vaccinated?
Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center, said the reasons for this were related to demographics – specifically who was vaccinated and who was not.
“If you look at the demographics of the cases that occur, it is often in the twenties to thirties age group that is largely unvaccinated,” Adalja said. “I think it’s going to take a while before the cases go down as the vaccine penetrates the population.”
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Up to this week, availability in all states was mainly based on age groups; only now are COVID-19 vaccines available to people in their twenties and thirties. And indeed, it seems that younger adults are infected. Last week, the Conway Daily Sun in New Hampshire reported that younger people are responsible for nearly half of the new COVID-19 cases in the state. It is also believed that young people in states like Michigan, where young people are admitted to the hospital, are booming.
Adalja said he thinks the U.S. will see cases drop when more of the population is vaccinated – perhaps about 40 percent, which he says could be a turning point.
“All you have to do is look at a country like Israel where they could vaccinate a large portion of their population, and once they reached about 40 percent, you saw cases fall,” Adalja said. “It is difficult to know exactly when we are going to cross that threshold, because the threshold will be exceeded by a combination of natural infection, as well as immunity caused by vaccine.”
Adalja noted that “one of the biggest obstacles will be the hesitation of vaccines.”
According to a poll conducted by Axios-Ipsos last week, 30 percent of respondents said they were “not at all likely” or “not very likely” to be vaccinated if possible. 20 percent of respondents said, “I will not get the vaccine” after the vaccine became available to them.
Monica Gandhi, an infectious physician and professor of medicine at the University of California-San Francisco, told Salon it is difficult to make comprehensive generalizations across the country across the country because the pandemic varies nationwide. “It’s like there’s almost 50 different pandemics going on across the country,” Gandhi thinks.
Gandhi noted that 50 percent of new business comes from several states: Minnesota, Michigan, New York, Florida and Pennsylvania. One measure Gandhi is monitoring is what she refers to as the “hospitalization per case”, which tracks the number of cases leading to hospitalizations.
“They started delinking, and what I mean by delink is that the same number of cases does not lead to the same number of hospitalizations as we had before,” Gandhi said. “I think it’s to vaccinate our older individuals first.” In other words, fewer COVID-19 cases lead to hospitalization, which is a good sign.
Gandhi said large numbers of younger people becoming infected would also lead to an increase in hospitalizations. Gandhi also pointed to Israel as an example of how the US could expect to reach a turning point.
The spread of highly transmissible variants may play a role in the increase in cases across the country, but Gandhi said that is probably not the only reason. The COVID-19 strain known from B.1.1.7., First identified in the UK, is thought to be 40 to 70 per cent more transmissible.
“I’m sure I’m sure in places where B.1.1.7 is in circulation, and it was also true in Israel, it seems to have more portability, and I’m sure it contributes,” Gandhi said. “However, that may not be the only reason, because there are places that have equally high percentages of variants and do not have the increases.”
Gandhi said another contributing factor to the increase in the US may be the tendency to rally people, along with the degree of natural immunity in the population of a state. But she said she could hopefully be the “turning point” where business nationwide began to decline.
“I think we are very, very close,” Gandhi said.