January 26, 2021

Is the Covid-19 peak (finally) behind us? Here's what experts say.

Daily Briefing

    The U.S. daily case rate of the novel coronavirus appears to be slowing, but public health officials say the ongoing race between rolling out Covid-19 vaccines and the quickly circulating new coronavirus variants will ultimately determine whether the nation has finally hit a turning point in its battle against the virus.

    Stay Up to Date: Why have some states been more successful than others at vaccine rollout?

    A turning point—or just a new peak?

    According to data from the New York Times, the United States' average daily number of newly reported coronavirus cases over the past week was 172,429, which is down by 31% when compared with the average from two weeks ago—and enough of a decline to spur some experts to say this could mark a downshift in America's epidemic after nearly four months of consistently increasing case numbers.

    The Times' data also showed that, as of Tuesday morning, the daily average of newly reported cases over the past seven days was "going down" in Puerto Rico; Washington D.C.; and 43 states (except Hawaii), in which all states (except Hawaii) had been seeing comparatively higher rates of coronavirus transmission. In Hawaii and Guam, meanwhile, rates of newly reported coronavirus cases were "staying low" as of Tuesday morning, the Times' data shows.

    The numbers have some experts optimistic that the nation has hit a turning point. For instance, the University of Washington's Institute for Health Metrics and Evaluation last week released a projection that the new U.S. case rate would decline regularly from here on out. "We've been saying since summer that we thought we'd see a peak in January and I think that, at the national level, we're around the peak," said Christopher Murray, director of the institute.

    Similarly, Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and the chief medical adviser for the Biden administration's Covid-19 response efforts, said with cautious optimism that the U.S. novel coronavirus outbreak "looks like it might actually be plateauing in the sense of turning around"—although he warned that the country was not out of the woods yet.

    According to the Times, the country is still averaging about 190,000 new cases per day—more than at any point of the pandemic prior to December 2020—and death totals are still "extraordinarily high." In fact, according to data from the Times, U.S. officials reported about 1,796 new deaths linked to the novel coronavirus on Monday. As of Tuesday morning, officials had reported a total of about 421,003 U.S. deaths linked to the virus since the country's epidemic began, up from about 419,207 deaths reported as of Monday morning.

    And several states have reported no significant progress at all, with Virginia consistently reporting some of its highest infection totals yet, South Carolina reporting new outbreaks, and case numbers in certain parts of Texas remaining high. Overall, as of Tuesday morning, data from the Times showed that the rates of newly reported coronavirus cases were "staying high" in six states that have had a daily average of at least 15 newly reported cases per 100,000 people over the past week.

    Hospitals remain at the brink

    Meanwhile, hospitalizations among patients with Covid-19 appear to be stabilizing. But as the Washington Post reports, "they do so from record heights," averaging more than 130,000 Covid-19 patients per day over a seven-day period this month. According to data from The Atlantic's COVID Tracking Project, there were 109,936 people hospitalized with Covid-19 as of Monday.

    As a result, hospitals remain near "the breaking point," the Associated Press reports, with more than 40% of Americans currently living in areas that have just 15% of ICU beds available. As such, hospitals are still competing for traveling nurses around the nation, reassigning corporate staff to the frontlines, crowding patient rooms, and struggling to maximize limited ICU space.

    "No one should be fooled that we are in an easy period right now," Nancy Foster, VP for quality and patient safety policy at the American Hospital Association, said. "The cold, hard data says we were on the brink in many places, many communities across the country."

    New variants threaten progress

    In addition, experts are continuing to raise concerns about several new, evidently more transmissible variants of the novel coronavirus identified in the United Kingdom, South Africa, and Brazil. Looking to the experience of those other countries, experts say the United States could be experiencing a brief lull before a new, more dangerous surge commences—especially since the variants identified in Brazil and the United Kingdom have now both been spotted in the United States.

    For instance, new data suggests that the variant first identified in Britain, B.1.1.7, which has been found to be 56% more contagious than the original version of the novel coronavirus, may also be up to 30% more fatal.

    CDC had already issued a report indicating that, based on the increased transmissibility, the variant by March may become the dominant version of the virus in the United States. But the latest findings have deepened experts' concerns. Michael Osterholm, director of the University of Minnesota's Center for Infectious Disease Research and Policy and member of President Biden's coronavirus transition team, said, "The data is mounting … that clearly supports that B.1.1.7 is causing more severe illness and increased death. Already we know this variant is has increased transmission, and so this is more very bad news."

    However, Luciana Borio, a Covid-19 advisor to the Biden administration, said it's still too early to assume the new variant is deadlier than the original virus, particularly given that an increase in the number of infected people could "degrad[e]" medical care by putting the health system "under tremendous stress."

    Still, Akiko Iwasaki, an immunologist at Yale University, said the new research should spur people to "double-down" on their efforts to self-isolate, wear masks, and get a Covid-19 vaccine as soon as feasible. "You don't want to be fear-mongering," she said, "but this is a problem."

    A race to vaccinate the country

    As a result, experts say that whether the United States has hit a turning point in the pandemic depends on how quickly the country can distribute and administer its Covid-19 vaccines compared with how fast B.1.17 and other variants spread.

    For its part, the Biden administration has pledged to organize and quicken a currently slow, uneven vaccine rollout, which so far has seen an estimated 22.7 million people receive a dose—including 3.3 million who as of Monday morning had been fully vaccinated. Still, it remains unclear how many vaccines will be made available in the coming weeks for many cities around the nation. And so far, more than half of states have administered less than 50% of the doses made available to them, the Times reports.

    Ashish Jha, dean of Brown University's School of Public Health, expressed hope that the vaccine rollout might make the latest decline permanent, especially given fewer Americans are traveling now than during the recent holidays. "If we can roll out the vaccine fast enough, we may stave off another surge," he said.

    However, Megan Ranney, an ED physician in Rhode Island, cautioned that the hope afforded by the vaccine "doesn't feel durable," given how many factors are at play in the virus' spread—including the public's willingness to abide by self-isolating and social-distancing recommendations.

    In fact, a new model published by epidemiologist Jeffery Shaman and other scientists at Columbia University predicts that because the novel coronavirus has spread so virulently in the United States for so long, that even if millions of U.S. residents are vaccinated, millions more will become infected unless people keep adhering to prevention measures, such as mask-wearing and social distancing.

    "There are people who are going to want to relax the controls we have in place," Shaman said. But "[i]f we start thinking, 'We've got a vaccine, there's a light at the end of the tunnel, we can stop in a couple of months'—that's way too soon" (Hjelmgaard/Weintraub, USA Today, 1/25; Cohen, CNN, 1/24; Bosman/McNeil, New York Times, 1/23; Conlen et al., New York Times, 1/24; New York Times, 1/22; Johnson/Forster, Associated Press, 1/24; Nirappil, Washington Post, 1/23; Chen, Axios, 1/26; Hellmann, The Hill, 1/25; New York Times, 1/26; "The COVID Tracking Project," The Atlantic, accessed 1/26; CDC data, updated 1/25).

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