You would not know it by following the news from the United States, where daily COVID-19 cases have dropped by 80 percent over the past ten weeks – and where they are still falling.
You would also not know it by following the news from the UK. Daily business declined by 90 percent in the same period.
And you would certainly not know it by following the news from Israel, where normal life has almost resumed.
But despite the rosy views of a few select countries, the total number of COVID-19 cases worldwide is now increasing. In fact, after peaking on January 11 and halving the following month – the first overall decline of the entire pandemic – global affairs turned around in mid-February and began to bounce back.
Since then, new daily cases have climbed nearly 20 percent overall. In France, they are more than 30 percent higher. In Brazil, they are more than 50 percent higher. In Italy, they are more than 80 percent higher. In India, they rose more than 110 percent.
The dreaded ‘fourth wave’, in other words, has arrived – even if it has not arrived in the US
These divergent trajectories provide a disturbing preview of the next phase of the pandemic, and it should make it difficult for everyone, including residents of countries such as the US, UK and Israel, where the virus eventually wants to withdraw.
Why? Because the biggest difference between these recovering countries and the rest of the world is immunity – both the kind obtained from previous infection and in the future the kind obtained through vaccination. As more dangerous variants take over, countries hit hard with higher vaccinations (mostly) resist the onslaught. Severely affected countries with lower vaccination rates are (mostly) not. This suggests that until vaccination has increased everywhere, the virus will continue to spread, develop and threaten to evade our defenses.
And it’s not just anyone else’s problem. The more vaccines rich countries buy up – and the slower some of them vaccinate their own population, the greater the chance that poorer, less protected countries will serve as a breeding ground for varieties, which will extend the risk to everyone.
Consider the data. To date, more than 56 percent of Israel’s population has received at least one vaccine dose. No other big country comes close. According to all the information, Israeli researchers now estimate that more than 90 percent of the residents older than 60 have some degree of immunity, through vaccination or prior infection.
As a result, new hospitalizations among older Israelis have dropped by nearly 80 percent in the past two months – even if the more contagious and deadly British variant, known as B.1.1.7, replaced all other tribes in the country. The fact that hospitalizations did not decrease as much among younger residents just prove the point: less of it has been vaccinated. That should change soon.
Meanwhile, Israel’s latest exclusion ended a month ago, and the economy reopened fully last week. At a similar time after the previous exclusion of the country, the average number of people infected by one infectious person was already at 1.1 and rising, indicating exponential spread. (Anything over 1.0 means an outbreak is growing.) Today it’s at 0.68.
Neither the US nor the UK has vaccinated such a large portion of the population. But they do much better than most countries, and it shows. Nearly 38 per cent of UK residents have received at least one dose so far, including more than 80 per cent of those over 60. (UK delays booster shots up to 12 weeks to get vaccination in as many people as possible as soon as possible The death toll from COVID-19 among the elderly in England fell by an average of 63 per cent between 19 February and 5 March, compared with 53 per cent among non-minors – a sign that vaccination is starting to print figures, independently of other factors, such as the country’s recent exclusion.
At the same time, at least 73.7 million Americans received one dose of vaccine, or more than 22 percent of the population; more than two-thirds of the elderly began vaccination. Low the top of America’s current base of natural immunity – experts estimate that about 35 percent of the population is already infected – and that the virus will find it harder to find new hosts. This largely explains why U.S. cases have fallen by 15 percent in the past two weeks and hospitalizations have continued to fall by 23 percent, even though B.1.1.7 is spreading rapidly and is expected to account for more than half of all U.S. cases. infections. at the end of the month – even if the reopening accelerates.
This is not to say that the US has overcome its variants. In recent days, nationwide affairs have placed about 55,000 plateaus; while the cases in most states continue to fall, they begin to flatten or even creep into much of the Northeast and Mid-Atlantic Oceans and parts of the Upper Midwest.
Michigan is perhaps the most disturbing example. Cases have increased by an average of 84 percent over the past two weeks; hospitalizations rose 31 percent. Perhaps not coincidentally, the Great Lakes State ranks second in Florida in the number of B.1.1.7 cases detected among residents – without the hot weather (yet) that makes outdoor gatherings so much easier in the US capital of the spring break.
Similarly, the average rate of seven days of positive test results in New York in months did not fall below 6 percent – the likely result, officials said this week, of a local variant responsible for a growing share of the new affairs in the city. In general, new cases per capita in New York and New Jersey are currently at least double the national average, and plateau rates in nearby Rhode Island, Massachusetts and Connecticut are a cause for concern.
Ultimately, however, experts expect the downward pressure of America’s accelerated vaccination effort – which began to expand ahead of schedule, beyond the initial priority groups, even if it protects vulnerable elderly people from hospitalization and death, and protects frontline workers from infection and transmission – to temper and eventually suppresses most upward pressure attributed to variants. In short, the US may see it decline during the final descent from the pandemic. But with each day of vaccination – now averaging 2.5 million doses every 24 hours – a full-fledged fourth wave seems less and less likely.
Unfortunately, this is not the case elsewhere.
As B.1.1.7 spread across the European Union, business has increased by 52 percent over the past month. In many countries – Estonia, Hungary, Poland, Sweden, France, Italy, Austria, even Germany – the curve sloping steeply upwards. Yet none of these countries have managed to administer at least one dose to more than 15 percent of its population, and most of them perform much worse, with Austria at 9.3 percent, Sweden at 8.3 percent, Germany at 8.2 percent, Italy at 8.2 percent, France at 8.2 percent, the EU as a whole at 8.1 percent and Poland at 7.9 percent.
Hans Kluge, regional director of the World Health Organization for Europe, told reporters on Thursday that the level of vaccination in Europe was too low to delay transmission. In Central Europe, the Balkans and the Baltic states, he added, new cases, hospitalizations and deaths are now one of the highest in the world. The recent suspension of the AstraZeneca vaccine – and the hesitation it may provoke even now that the European drug regulator has considered it safe and effective – will not help.
Most of the rest of the world lags even further behind. In Brazil, where cases have increased by more than 50 percent in the past month, only 5.1 percent of the population received at least one vaccine dose. In India, where cases have climbed more than 110 percent, only 2.2 percent of the population received one dose. Morocco is the only African country to have fired more than 5 percent of its population at least one shot, and no country in Asia or Oceania has even reached that number.
Vaccination, of course, is not the only reason COVID-19 is hitting some places harder now than others. But this is the main reason, coupled with the natural immunity, why some places are unlikely to experience a true fourth wave of infection – and why even a fourth wave in other places may not be the last.
The contours of a new world division between vaccines and unnecessary things are already taking shape. For some, life is as normal on the horizon; for others, the crisis will continue, with all its disruptions and dangers. Meanwhile, the virus will continue to mutate as long as it can spread somewhere.
By the end of May, the US had received about 500 million doses of vaccine – enough to fully immunize every adult in the country. The White House has already reserved more than 1.2 billion doses, enough to vaccinate the entire U.S. population twice, and then some. Predictably, most rich countries have placed similar orders. Most developing countries do not. And so Europe does not just owe a more efficient implementation. It also owes the world – with a fairer distribution of doses to be followed. Until then, the waves will continue, and for most, the pandemic will not end.
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