COVID-19 cases fall, but virus isn’t done
US outlook depends on behavior, new variants
COVID-19 rates are finally falling again after a wave nearly as bad as the one last winter. Hopefully, we are through the worst of the pandemic.
But experts warn that if we start acting as if COVID-19 is over, we definitely won’t be.
Behavior has a major impact on what happens with the virus, and if people stop taking precautions, start gathering in large numbers and not getting vaccines or boosters, another wave could strike this winter.
“A lot of it depends on human behavior, and human behavior in this pandemic hasn’t served us very well,” Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, said in a recent call with reporters. “We are battling with ourselves, not with the common foe.”
The virus that causes COVID-19 thrives in cool, dry air. And when people gather indoors, especially unmasked, they are more likely to transmit it.
The holidays are coming, and travel and large gatherings serve as viral breeding grounds.
For many people, vaccinated or infected months ago, protection against the virus that causes COVID-19 may be waning.
Still, there are positive signs that America’s pandemic could get better rather than worse over the next few months.
COVID-19 infection rates fell about 12% last week compared with the week
before, and hospitalizations dropped 14%, Walensky said in a news conference.
Vaccines for kids ages 5-11 are expected to become available in the coming weeks. Although children are less likely to suffer severe consequences from the virus than older adults, they can get very sick and can pass the virus on to others. Vaccinating large numbers will help slow the virus’ spread.
In some areas, vaccination rates are so high that, combined with natural infections, it could be hard for the virus to gain a foothold among the relatively few people left unprotected.
Boosters are becoming widely available, renewing protection for the immunocompromised and those who got the Pfizer-BioNTech vaccine and who are also over 65, at high risk for serious disease or in particularly vulnerable professions. This week, federal agencies will begin the process of examining and likely authorizing boosters for the other two available vaccines.
New treatments coming online soon, including an antiviral pill, should cut down on the number of people who need hospital care and are at risk of death, easing the strain on hospitals and health care workers.
And rapid, cheap testing is finally getting ramped up, well over a year after experts began calling for wider availability of COVID-19 tests.
The pandemic “is not magically over,” said Dr. Kirsten Bibbins-Domingo, chair of the department of epidemiology at the University of California, San Francisco. But the “worst does look like it’s behind us.”
The SARS-CoV-2 virus has been unpredictable for nearly two years now, though, and it’s likely to remain part of our lives forever.
“If we proceed in the way we have in the past without additional cautions in place, that virus will eventually find the vulnerable amongst us and will wreak havoc,” Bibbins-Domingo said. “This is what this virus has shown it is very capable of doing.”
The virus has spread so far and so fast, it doesn’t seem possible anymore to eradicate it, experts say. Instead, we will eventually reach an uneasy peace, as we have with the flu and common cold, where infections might spike occasionally in certain areas, but most people will be protected from serious disease.
At least for now, COVID-19 remains far deadlier than the flu. Even in the last flu pandemic, the H1N1 pandemic of 2009-2010, about 76 out of every 1 million people who caught it died. With COVID, he said, 3,000 out of every 1 million people infected will die.
A range of forecasting models suggest things will get better going forward, said Nicholas Reich, an expert in biostatistics and infectious disease epidemiology at the University of Massachusetts, Amherst. He’s encouraged by the fact they’re all trending in the same direction.
“The general sense in the data right now and in the models, too, is one of guarded optimism,” he said. “That feels like a reasonable place to be in.”
While the nation as a whole may be through the worst of the pandemic, some unlucky pockets could still be hard-hit, said Stephen Kissler, a postdoctoral research fellow at the Harvard T.H. Chan School of Public Health.
“We’re not out of the woods, but I really don’t think especially in terms of deaths and hospitalization we’ll see the sort of thing we saw last winter,” Kissler said. With such a large percentage of people having been infected or vaccinated, “I don’t think cases will translate nearly as much into deaths this winter, thankfully.”
Kissler said he’s not as worried about variants as he was a few months ago. Delta is so contagious, he said, that it seems to have crowded out other variants, making it hard for them to gain a foothold.
“Delta has been winning out,” in competition with other variants, he said. “I’m cautiously optimistic that we’ll be dealing with delta and only delta.”
A new variant could impact areas differently, depending on how it behaves, Reich said. In Vermont, where vaccination rates are high but not many people have caught the virus, a variant that escapes the vaccine but not natural infection might chart a different path than in places like Arizona and Florida, where vaccination rates are lower but a much higher percentage of residents have been infected, he said.
Of course, what happens in the United States is only part of the story. If the virus continues to rage in other parts of the world, that will increase the chances of more infections and the emergence of new, more dangerous variants.
Said Norman Baylor, a vaccine expert and president and CEO of Biologics Consulting: “We’re not close to the endgame until the world is close to the endgame. Period. Full stop.”