Vaccines making holiday easier, but hot spots remain
The U.S. is facing its second Thanksgiving of the pandemic in better shape than the first time around, thanks to the vaccine, though some regions are seeing surges of COVID-19 cases that could get worse as families travel the country for gatherings that were impossible a year ago.
Nearly 200 million Americans are fully vaccinated. That leaves tens of millions who have yet to get a shot in the arm, some of them out of defiance. Hospitals in the cold Upper Midwest, especially Michigan and Minne- sota, are filled with COVID19 patients who are mostly unvaccinated.
Michigan hospitals reported about 3,800 coronavirus patients at the start of the week, with 20% in intensive care units, numbers that approach the bleak- est days of the pandemic’s 2020 start. The state had a seven-day new-case rate of 616 per 100,000 people Monday, highest in the nation.
In the West, New Mexico, Arizona, Colorado, Utah and Montana also ranked high. Some Colorado communities, including Denver, are turn- ing to indoor mask orders to reduce risk, a policy that has also been adopted in the Buffalo, New York, area and Santa Cruz County, California.
The statistics in Michigan are “horrible,” said Dr. Matthew Trunsky, a respiratory specialist at Beaumont Health in suburban Detroit.
“We got cold and moved indoors and have huge pock- ets of unvaccinated people,” he said. “You can’t have pockets of unvaccinated people who don’t want to be masked and not expect to get outbreaks, not expect to lose parents, not expect to lose teachers.”
During a recent office visit, he encouraged a patient who
uses oxygen to get vaccinated. The patient declined and now is in the hospital with COVID-19, desperately rely- ing on even more oxygen, Trunsky said.
He said he continues to encounter patients and their family members espousing conspiracy theories about the vaccine.
“We’ve had several people in their 40s die in the last month — 100% unvaccinated,” Trunsky said. “It’s just so incredibly sad to see a woman die with teenag- ers. Especially with that age group, it’s nearly 100% preventable.”
In Detroit, where less than 40% of eligible residents were fully vaccinated, Mayor Mike Duggan said hospitalizations have doubled since early November.
“We have far too many people in this country that we have lost because they believed some nonsense on the internet and decided not to get the vaccine,” said Dug- gan, a former hospital exec- utive.
Despite hot spots, the outlook in the U.S. overall is significantly better than it was at Thanksgiving 2020.
Without the vaccine, which became available in mid-De- cember 2020, the U.S. a year ago was averaging 169,000
cases and 1,645 deaths per day, and about 81,000 peo- ple were in the hospital with COVID-19. The U.S. now is averaging 95,000 cases, 1,115 deaths and 40,000 in the hospital.
Air p orts have been jammed. More than 2.2 million people passed through security checkpoints on Friday, the busiest day since the pandemic shut down travel early in 2020. On some recent days, the number was twice as high as Thanksgiving a year ago.
Sarene Brown and three children, all vaccinated, were flying to Atlanta from Newark, New Jersey, to see family. People close to them have died from COVID-19.
“I’m thankful that I’m here, and I’m not in heaven, and I’m thankful for my family and that God helped me survive,” said Neive Brown, 7, who got her first dose.
More than 500,000 Americans have died of COVID-19 since the last Thanksgiving, for an overall death toll of over 770,000.
“We would encourage people who gather to do so safely after they’ve been fully vaccinated, as we’ve been saying for months now,” said Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention.
On Friday, researchers working in Uganda said they found COVID-19 patients with high rates of exposure to malaria were less likely to suffer severe disease or death than people with little history of the disease.
At HARARE, ZIMBABWE — a busy market in a poor township outside Harare last week, Nyasha Ndou kept his mask in his pocket, as hundreds of other people, mostly unmasked, jostled to buy and sell fruit and vegetables displayed on wooden tables and plastic sheets. As in much of Zimbabwe, here the coronavirus is quickly being relegated to the past, as political rallies, concerts and home gatherings have returned.
“COVID-19 is gone, when did you last hear of anyone who has died of COVID-19?” Ndou said. “The mask is to protect my pocket,” he said. “The police demand bribes so I lose money if I don’t move around with a mask.”
Earlier last week, Zimbabwe recorded just 33 new COVID-19 cases and zero deaths, in line with a recent fall in the disease across the continent, where World Health Organization data show that infections have been dropping since July.
When the coronavirus first emerged last year, health offi- cials feared the pandemic would sweep across Africa, killing millions. Although it’s still unclear what COVID-19’s ultimate toll will be, that catastrophic scenario has yet to materialize in Zimbabwe or much of the continent.
Scientists emphasize that obtaining accurate COVID-19 data, particularly in African countries with patchy surveillance, is extremely difficult, and warn that declin- ing coronavirus trends could easily be reversed.
But there is something “mysterious” going on in Africa that is puzzling scien- tists, said Wafaa El-Sadr, chair of global health at Columbia University. “Africa doesn’t have the vaccines and the resources to fight COVID19 that they have in Europe and the U.S., but somehow they seem to be doing better,” she said.
Fewer than 6% of people in Africa are vaccinated. For months, the WHO has described Africa as “one of the least affected regions in the world” in its weekly pan- demic reports.
Some researchers say the continent’s younger population — the average age is 20 versus about 43 in Western Europe — in addition to their lower rates of urbanization and tendency to spend time outdoors, may have spared it the more lethal effects of the virus so far. Several studies are probing whether there might be other explanations, including genetic reasons or past infection with parasitic diseases.
On Friday, researchers working in Uganda said they found COVID-19 patients with high rates of exposure to malaria were less likely to suffer severe disease or death than people with little history of the disease.
“We went into this project thinking we would see a higher rate of negative outcomes in people with a history of malaria infections because that’s what was seen in patients co-infected with malaria and Ebola,” said Jane Achan, a senior research advisor at the Malaria Consortium and a co-author of the study. “We were actually quite surprised to see the opposite — that malaria may have a protective effect.”
Achan said this may suggest that past infection with malaria could “blunt” the tendency of people’s immune systems to go into overdrive when they are infected with COVID-19. The research was presented Friday at a meet- ing of the American Society of Tropical Medicine and Hygiene.
Christian Happi, direc- tor of the African Center of Excellence for Genom- ics of Infectious Diseases at Redeemer’s University in Nigeria, said authorities are used to curbing outbreaks even without vaccines and
credited the extensive networks of community health workers.
“It’s not always about how much money you have or how sophisticated your hospitals are,” he said.
Devi Sridhar, chair of global public health at the University of Edinburgh, said African leaders haven’t gotten the credit they deserve for acting quickly, citing Mali’s decision to close its borders before COVID-19 even arrived.
“I think there’s a differ- ent cultural approach in Africa, where these coun- tries have approached COVID with a sense of humility because they’ve experienced things like Ebola, polio and malaria,” Sridhar said.
In past months, the coronavirus has pummeled South Africa and is estimated to have killed more than 89,000 people there, by far the most deaths on the continent. But for now, African authorities, while acknowledging that there could be gaps,
are not reporting huge numbers of unexpected fatalities that might be COVID-related. WHO data show that deaths in Africa make up just 3% of the global total. In comparison, deaths in the Americas and Europe account for 46% and 29%.
In Nigeria, Africa’s most populous country, the government has recorded nearly 3,000 deaths so far among its 200 million population. The U.S. records that many deaths every two or three days.
The low numbers have Nigerians like Opemipo Are, a 23-year-old in Abuja, feel- ing relieved. “They said there will be dead bodies on the streets, but nothing like that happened,” she said.
On Friday, Nigerian author- ities began a campaign to significantly expand the West African nation’s coronavirus immunization. Officials are aiming to inoculate half the population before February, a target they think will help them achieve herd immunity.
Oyewale Tomori, a Nigerian viro logist who sits on several WHO advisory groups, suggested Africa might not even need as many vaccines as the West. It’s an idea that, while controversial, he says is being seriously discussed among African scientists — and is remi- niscent of the proposal Brit- ish officials made last March to let COVID-19 freely infect the population to build up immunity.
That doesn’t mean, however, that vaccines aren’t needed in Africa. “We need to be vaccinating all out to prepare for the next wave,” said Salim Abdool Karim, an epidemiologist at South Africa’s University of KwaZulu-Natal, who previously advised the South African government on COVID-19.
“Looking at what’s happening in Europe, the likelihood of more cases spilling over here is very high.”
The impact of the coronavirus has also been relatively muted beyond Africa in poor countries like Afghanistan, where experts predicted outbreaks amid ongoing conflict would prove disastrous.
Hashmat Arifi, a 23-yearold student in Kabul, said he hadn’t seen anyone wearing a mask in months, including at a recent wedding he attended alongside hundreds of guests. In his university classes, more than 20 students routinely sit unmasked in close quarters.
“I haven’t seen any cases of corona lately,” Arifi said. So far, Afghanistan has recorded about 7,200 deaths among its 39 million people, although little testing was done amid the conflict and the actual numbers of cases and deaths are unknown.
Back in Zimbabwe, doctors were grateful for the respite from COVID-19, but feared it was only temporary.
“People should remain very vigilant,” warned Dr. Johannes Marisa, president of the Medical and Dental Private Practitioners of Zimbabwe Association. He fears that another coronavirus wave could hit Zimbabwe next month.
“Complacency is what is going to destroy us because we may be caught unaware.”