U.S. COVID DEATH TOLL HIGHER THAN LAST YEAR

Despite vaccines, CDC records more than 386,000 deaths in 2021

This was supposed to be the year vaccines brought the pandemic under control. Instead, more people in the United States have died from COVID-19 this year than died last year, before vaccines were available.

As of Tuesday, the Centers for Disease Control and Prevention had recorded 386,233 deaths involving COVID-19 in 2021, compared with 385,343 in 2020. The final number for this year will be higher, not only because there is more than a month left but because it takes time for local agencies to report deaths to the CDC.

COVID-19 has also accounted for a higher percentage of U.S. deaths this year than it did last year: about 13 percent compared with 11 percent.

Experts say the higher death toll is a result of a confluence of factors: most crucially lowerthan-needed vaccination rates, but also the relaxation of everyday precautions, like masks and social distancing, and the rise of the highly contagious Delta variant.

Essentially, public health experts said, many Americans are behaving as if COVID-19 is now a manageable, endemic disease rather than a crisis — a transition that will happen eventually but has not happened yet.

Yet many are also refusing to get vaccinated in the numbers required to make that transition to what scientists call “endemicity,” which would mean the virus would still circulate at a lower level with periodic increases and decreases but not spike in the devastating cycles that have characterized the pandemic. Just 59 percent of Americans are fully vaccinated, the lowest rate of any Group of 7 major industrialized nation.

“We have the very unfortunate situation of not a high level of vac

cine coverage and basically, in most places, a return to normal behaviors that put people at greater risk of coming in contact with the virus,” said Jennifer Nuzzo, a public health researcher and senior scholar at Johns Hopkins Center for Health Security. “If you take no protections whatsoever, you have a virus that is capable of moving faster and you have dangerous gaps in immunity, that adds up to, unfortunately, a lot of continued serious illness and deaths.”

After steadily dropping over the last months, the seven-day national average in new coronavirus cases has increased by 18 percent, the Centers for Disease Control and Prevention said this week.

Cases are surging in the frigid Upper Midwest, with hospitals in Michigan — where infections have increased by 67 percent in the last two weeks — nearing capacity. In New England, where vaccination rates beat the national average, outbreaks are appearing in Maine, New Hampshire and Vermont as immunity wanes. In New Mexico, Santa Fe Public Schools went back to remote learning on Tuesday after an uptick in coronavirus cases. And California is urging residents to not let their guard down despite the state having one of the lowest infection rates in the country.

Dr. Celine Gounder, an infectious disease specialist at Bellevue Hospital Center, estimated that roughly 15 percent of the U.S. population might have immunity from prior infection, which is not as strong or durable as immunity from vaccines.

Many of those people

have also been vaccinated, but even assuming the two groups didn’t overlap and so 74 percent of Americans had some level of immunity, that still would not be enough to end the pandemic, said Gounder. It would probably take an 85 percent to 90 percent vaccination rate to make the coronavirus endemic, she said.

“When vaccines rolled out, people in their minds said, ‘COVID is over,’” Gounder said. “And so even if not enough people are vaccinated, their behavior returned — at least for some people — to more normal, and with that changing behavior you have an increase in transmission.”

Even in California, where COVID-19 infection rates are low at a 1.9 percent positivity rate, there’s caution. Visiting a San Francisco vaccination clinic this week, Gov. Gavin Newsom suggested that the state could once again see wide infections and hospitalizations if residents acted without vigilance.

“States are struggling because people are taking down their guard or claiming ‘mission accomplished.’ I don’t want to see that happen here in California,” Newsom said.

Meanwhile, pediatricians are reporting that coronavirus cases in children in the United States have risen 32 percent from about two weeks ago, a spike that comes as the country rushes to inoculate children before the holiday season.

More than 140,000 children tested positive for the coronavirus from Nov. 11-18, up from 107,000 in the week ending Nov. 4, according to a statement from the American Academy of Pediatrics and the Children’s Hospital Association.

These cases accounted for about a quarter of the

country’s caseload for the

week, the statement said. Children younger than 18 make up about 22 percent of the U.S. population.

“Is there cause for concern? Absolutely,” said Dr. Sean O’Leary, the vice chair of the academy’s infectious diseases committee. “What’s driving the increase in kids is there is an increase in cases overall.”

Children have accounted for a greater percentage of overall cases since the vaccines became widely available to adults, said O’Leary, who is also a professor of pediatrics at the University of Colorado School of Medicine and Children’s Hospital Colorado.

Although children are less likely to develop severe illness from COVID than adults, they are still at risk and can also spread the virus to adults. Experts have warned that children should be vaccinated to protect against possible longCOVID symptoms, multisystem inflammatory syndrome and hospitalization.

At the end of October, about 8,300 American children ages 5-11 have been hospitalized with COVID and at least 172 have died, out of more than 3.2 million hospitalizations and 740,000 deaths overall, according to the Centers for Disease Control and Prevention.

At a news conference Friday, Dr. Janet Woodcock, acting commissioner of the Food and Drug Administration, said hospitalizations and deaths among 5- to 11year-olds were “really startling.”

O’Leary said it did not help that many schools had softened their safety protocols in the past few months.

“So any protection that might be happening in schools is not there,” he said.

Vaccinations of younger children are likely to help keep schools open. Virus outbreaks forced about 2,300 schools to close between early August and October, affecting more than 1.2 million students, according to data presented at a CDC meeting Nov. 2.

O’Leary said he was especially concerned about case increases in children during the holiday season.

With the pace of inoculations stagnating among adults, states are rushing to encourage vaccinations for children 5-11, who became eligible this month after the CDC authorized the PfizerBioNTech vaccine for that age group. In May, the federal government recommended

making the PfizerBioNTech vaccine available to children ages 12-15. Teenagers 16 and older became eligible in most states a month earlier.

All of the data so far indicates that the vaccines are far safer than a bout of COVID, even for children.

Still, about 3 in 10 parents

say they will definitely not get the vaccine for their 5- to 11-year-old child, according to a recent poll by the Kaiser Family Foundation. About 3 in 10 parents said they would immunize their child “right away.”

“When vaccines rolled out, people in their minds said, ‘COVID is over.’” Dr. Celine Gounder • infectious disease specialist