U.S. hospitalizations for COVID-19 are averaging nearly 35,000, a whopping 46% increase over the prior reporting week but still far below the pandemic peak in early January.
Likewise, the nation is reporting over 300 deaths per day, on average, from the disease — a sharp increase from an average of 170 on July 10 but far below 2,000 daily American deaths amid the spring 2020 crisis and 3,000 at the winter apex, according to the Centers for Disease Control and Prevention.
While the situation is better than the darkest days of the pandemic, it’s trending poorly as President Biden, governors and mayors try to reel in a delta variant that is making a July 4 victory lap seem premature.
“I don’t think we’re gonna see lockdowns, I think we have enough of the percentage of people in the country [vaccinated] — not enough to crush the outbreak, but I believe enough to not allow us to get into the situation we were in last winter,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told ABC’s “This Week.” “But things are going to get worse.”
He predicted “some pain and suffering in the future.”
“We’re seeing the cases go up, which is the reason why we keep saying over and over again the solution to this is, ‘Get vaccinated, and this would not be happening,’” Dr. Fauci said.
Things are worsening fast in pockets of the South and Midwest, and federal scientists say some vaccinated persons can spread the virus as easily as unvaccinated persons, raising fears about what’s around the corner and how to salvage the economic recovery.
Reported daily infections have reached an average of nearly 80,000 — the highest level since February and worse than the “Sun Belt” surge last summer.
Experts say the new normal will have the virus detected in more people as society reopens, making the pressing question whether the shots still provide protection against severe illness, hospitalization and death, and the extent to which the virus manages to penetrate that shield or find the unvaccinated.
The CDC made waves last week by saying both unvaccinated and vaccinated persons should wear masks in public indoor spaces in counties with “high” or “substantial” levels of transmission. The guidance, a reversal from advice in May, was based on studies showing vaccinated persons with “breakthrough infections” from the delta variant may be able to spread the pathogen as efficiently as unvaccinated persons.
National Institute of Health Director Francis Collins on Sunday said the mask revision is “mostly about protecting the unvaccinated.”
“That’s where the real serious risks of illness are,” Dr. Collins told CNN’s “State of the Union.” “If you’re vaccinated right now, your likelihood of getting sick is 25-fold reduced.”
“Vaccinated people are capable of getting the virus in their nose and throat and they do seem to have high enough levels of virus that they might be contagious,” Dr. Collins said. “Hence the reason if you’re in a community where this virus is spreading, which is about 75% of counties right now, it is prudent to put on a mask, even if you’re vaccinated, just in case you might be someone who is currently spreading it.”
Former Food and Drug Commissioner Scott Gottlieb, speaking to CBS’s “Face the Nation,” said “there are more people with this delta variant who have been vaccinated who are probably spreading the infection, but it’s still a very small percentage of people who are becoming infected after vaccination.”
Scientists fear the virus will spread to those who’ve chosen to remain unvaccinated, yet are filling hospitals in parts of the country; children under age 12 who aren’t eligible for the vaccines yet; and the immunocompromised, who are unable to benefit from vaccines by mounting a sufficient antibody response.
Dr. Fauci that’s what makes mask-wearing a collective responsibility.
“The fact is, if you get infected, even if you are without symptoms, you very well may infect another person who may be vulnerable,” Dr. Fauci told ABC’s “This Week.” “So in essence, you are encroaching on their individual rights.”
Experts also say capping transmission through mask-wearing, combined with a rapid expansion of vaccination, will suppress the virus enough to keep it from evolving into something so dangerous it can elude the protection provided by existing vaccines.
For now, doctors say vaccinated persons are sometimes hospitalized, especially older persons or immunocompromised people, but the overwhelming majority of patients are unvaccinated.
“It’s really about 98% are either unvaccinated completely or received one dose,” said William Schaffner, an infectious diseases specialist at Vanderbilt University. “It’s unusual for a vaccinated person to require hospitalization.”
According to the CDC, the level of hospitalization for the most recent week was 34,769 — much higher than the 23,822 reported in the prior week.
It is still 72% lower than the 123,865 reported during the peak week of Jan. 5-11, raising hopes that levels of vaccination — while disappointing — will stem the kind of nightmare that upended the country last year.
Even so, poor vaccination rates in parts of the country and rapid transmission of the delta variant are proving to be a toxic mix.
“The spread is exponential,” said Dr. Catherine O’Neal, a doctor at Louisiana State University, told CNN last week. “Last year’s variant, that we thought was bad enough, was far less contagious than this variant, and that’s resulting in just an exponential number of patients coming into the hospital.”
Florida has the most hospitalized patients of any state overall, at 8,264, and the most as a share of the population, at 38 per 100,000, according to a New York Times tracker.
That’s fueling debate around the best approach to virus management at this juncture, with Gov. Ron DeSantis saying it is best to leave it to personal choice rather than 2020-style mandates and mask rules, especially now that people are able to opt for vaccination.
Nevada, Arkansas, Missouri and Louisiana are next on the list of states with the worst rates of hospitalization per population. Their vaccination rates all trail the nationwide rate of 49%, with Louisiana only at 37%.
Dr. O’Neal said about half of her patients in Louisiana are under age 50. They are “all unvaccinated,” she told CNN.
Elderly patients, especially those over age 80, account for most of the breakthrough cases of the vaccinated who arrive in her ward.
“These are patients that we don’t expect to make great antibodies,” she said. “We don’t expect them to respond to the vaccine.”
Dr. Collins said COVID-19 is having “a pretty big party in the middle of the country” as parts of Florida, Louisiana, Arkansas and other states see a flood of patients. He said the good news is more people seem to be seeking out the shots amid renewed fears.
The U.S. was administering an average of 650,000 doses per day by the end of the past week, up from around 500,000 on July 20.
Ohio Gov. Mike DeWine, a Republican, said he’s seeing an uptick in vaccinations in some of his rural counties, in part because of fears around the delta variant.
“People are making those decisions out there based upon what they’re seeing in their county and what they’re hearing on the news,” Mr. DeWine told CNN.
In the meantime, the share of patients who succumb to the disease after testing positive, or case-fatality rate, in the U.S. is 1.8%, according to a Johns Hopkins tracker.
That’s the same rate measured in December when the vaccine rollout began. Experts say some high-risk persons remain unvaccinated and are probably driving the rate up even though immunization and new therapies are available to help patients survive.
The U.S. case-fatality rate is better than in Mexico (8.5%), Italy (3%) and Germany (2.4%) and on par with France and Spain.
However, the case-fatality rate is a quirky stat because the true number of infections in a nation is unknown — the whole population can’t be tested every day. On the other hand, every dead person gets accounted for.
Therefore the denominator, the number of infections, is certainly higher and the same number of deaths accordingly would yield a lower rate of mortality. In other words, the virus is actually less deadly than even the best official stats can say.
Also, comparing nations can be difficult because the mortality rate goes down if a country has rampant spread and a big denominator of cases.
The U.S. has lost 186 persons per 100,000 in the population from COVID-19, roughly on par with Mexico, slightly worse than France (166) and far worse than Germany (110) or South Korea (only four) but better than Britain (194) and far better than Brazil (162) and Peru (603).
