On July 4, President Biden is planning to mark “a summer of freedom,” with a large event at the White House to celebrate the resumption of American life. It will be a key moment for the administration, which has hit goal after goal on the pandemic since taking office and — of late — has been encouraging a return to normalcy. But a close look at the situation suggests this may project an excess of optimism that could make it harder to beat back another surge.
Vaccination rates are the first sign of the gap. After setting a partial vaccination target of at least 70% by July 4, Biden will have to settle for something less due to shortfalls among 18-29-year-olds. There are also massive regional disparities in vaccination rates: Vermont and Massachusetts are over 60% fully vaccinated, while Mississippi and Louisiana are hovering below 40% of the population having had a single dose. There are significant local disparities, as well, with lower-income areas and communities of color falling behind.
These lags are especially concerning due to the renewed threat from the delta variant, which has spread quickly through less vaccinated communities in the UK and is already responsible for 20% of new US cases. And there’s been significant hospitalization and death from delta variant cases — even among younger patients.
Another red flag was raised by studies on the UK outbreak showing that the two dominant vaccines there — those produced by Pfizer-BioNTech and AstraZeneca — aren’t particularly effective against the delta variant on just a single dose. The vast majority of Americans who have been vaccinated so far have received either the Pfizer vaccine or the Moderna vaccine, which is based on similar technology; others have received the Johnson & Johnson vaccine, which is similar to AstraZeneca’s. And only about 45% of Americans have been fully vaccinated to date.
Anthony Fauci, the top US infectious-disease official, has called the delta variant the “greatest threat” to defeating Covid-19 in the US Biden himself has acknowledged that it may cause significant harm in unvaccinated communities. We may already be starting to see that, with accelerating Covid transmission and hospitalization in southern states with low vaccination rates. While increased spread in that region could be driven by more people spending time indoors in the heat of summer, it’s likely that the summer weather — and the resulting opportunity to go outdoors — has been dampening transmission as well. The real test may not come until the fall.
Transmission could also increase as people reduce mask-wearing and journey far from their homes for long-awaited vacations. With offices, restaurants and retailers returning to full capacity, we may see new vectors of indoor Covid spread, as well. Hopefully, the maskless will be those who are fully vaccinated. But unfortunately, there’s not really any way to be sure who is vaccinated and who isn’t. With the scientific consensus building around airborne transmission, we now know that one infected person not wearing a mask could expose an entire room.
And as many different variants of the virus — including delta — continue to spread both in the US and in other parts of the world, there’s a possibility that new, even more dangerous variants will emerge. If one turns out to be able to escape the protection from our current vaccines, we could end up back more or less where we started — at least until we figure out the right booster shots and manage to get them distributed.
Moreover, while vaccination reduces one’s likelihood of becoming sick with Covid-19, and limits the severity even if you do get the virus, it’s still better to avoid exposure if possible. The long-run consequences of having had even a mild case of Covid-19 are not well-understood. We’re starting to identify more and more “long” Covid cases, although it may take years to get clarity on what causes them. But the evidence is certainly scary — for example, a recent paper based on brain scans showed that even some people who had mild Covid cases suffered a reduction in grey matter, especially in parts of the brain that manage smell, taste and memory.
The risks described above could push Covid deaths up even higher than the current rolling average of around 275 deaths per day — a level we've been at or (far) above for months. But even if the death rate remains exactly where it is, we’ll have more than 100,000 additional Covid deaths over the course of the next year. That’s roughly 1.6 times the estimated death toll of the worst flu season in the last decade, and almost 8 times the number of American battle casualties during the Revolutionary War. If none of the other risks come to pass — and I hope they don’t — it might still be good to get those numbers down further before declaring independence from the virus.
Bloomberg
