You wouldn’t know by following the news from the United States, where daily cases of COVID-19 have dropped 80 percent in the past 10 weeks – and where they continue to fall.
You also wouldn’t know how to follow the news from the UK. There, daily cases plunged 90% in the same period.
And you certainly wouldn’t know by following the news from Israel, where normal life has practically resumed.
But despite the optimistic outlook from selected countries, the total number of COVID-19 cases worldwide is currently increasing. In fact, after peaking on January 11 and falling in half the following month – the first general decline in the entire pandemic – the global cases reversed their course in mid-February and began to recover.
Since then, new daily cases have increased by almost 20% overall. In France, they increased by more than 30%. In Brazil, they are more than 50 percent. In Italy, they have increased by more than 80%. In India, they have increased by more than 110%.
The dreaded “fourth wave”, in other words, has arrived – even if it has not made it to the United States
These divergent trajectories offer a worrying prediction of the next phase of the pandemic and are expected to bother everyone, including residents of countries such as the United States, the United Kingdom and Israel, where the virus finally appears to be receding.
Why? Because the biggest difference between these recovering countries and the rest of the world is immunity – both the type acquired by previous infection and, from now on, the type acquired through vaccination. As more dangerous variants take over, countries hard hit with higher vaccination rates are (mostly) resisting the attack. The most affected countries with the lowest (most) vaccination rates do not. This suggests that, until vaccination grows everywhere, the virus will continue to spread, evolve and threaten to escape our defenses.
And that’s not just someone else’s problem. The more vaccines rich countries buy – and the slower some of them vaccinate their own populations – the more likely it is that the poorest and least protected countries will serve as breeding grounds for variants, prolonging the risk for everyone.
Consider the data. To date, more than 56% of Israel’s population has received at least one dose of vaccine. No other major country comes close. In all, Israeli researchers now estimate that more than 90 percent of residents over the age of 60 have some degree of immunity, due to previous vaccination or infection.
As a result, new hospitalizations among these older Israelis have dropped nearly 80 percent in the past two months – even when the most contagious and deadly UK variant, known as B.1.1.7, has replaced all other strains in the country. The fact that hospitalizations has not decreased so much among younger residents it just proves the point: fewer of them were vaccinated. That should change soon.
Meanwhile, Israel’s last blockade ended a month ago, and the economy was fully reopened last week. In a similar interval after the previous blockade of the country, the average number of people infected by an infectious individual was already 1.1 and increasing, indicating an exponential spread. (Anything above 1.0 means an outbreak is growing.) Today is at 0.68.
Neither the United States nor the United Kingdom vaccinated such a large portion of its population. But they are doing much better than most countries, and it is showing. Nearly 38 percent of UK residents have received at least one dose so far, including more than 80 percent of those over 60. (The UK is delaying booster vaccines for up to 12 weeks to start vaccination for as many people as possible as soon as possible.) On average, deaths from COVID-19 among older people in England fell 63 percent between 19 February and March 5, compared with 53 percent among non-elderly people – a sign that vaccination is starting to push the numbers down regardless of other factors, such as the country’s recent blockade.
At the same time, at least 73.7 million Americans received a dose of vaccine, or more than 22% of the population; more than two thirds of the elderly started vaccination. The top layer of America’s existing base of natural immunity – experts estimate that about 35% of the population has already been infected – and the virus is beginning to have a harder time finding new hosts. This largely explains why in the past two weeks, cases in the United States have still fallen by 15 percent and hospitalizations are still down by 23 percent, even though B.1.1.7 is spreading rapidly and should account for more than half of all cases. infections in the US before the end of the month – even with the reopening accelerating.
This is not to say that the United States has beaten its variants. In the past few days, cases across the country have stabilized at around 55,000; although cases continue to decline in most states, they are beginning to flatten or even increase in much of the Northeast and Mid-Atlantic and parts of the Upper Midwest.
Michigan may be the most unsettling example. There, cases have increased by an average of 84% in the past two weeks; hospitalizations increased by 31 percent. Perhaps not coincidentally, the Great Lakes state is second only to Florida in the number of cases B.1.1.7 detected among residents – without the warm weather (yet) that makes outdoor meetings much easier in the vacation capital. America spring day.
Likewise, the seven-day average rate of positive test results in New York City has not dropped below 6% in months – the likely result, officials said this week, of a local variant that is accounting for an increasing share new cases in the city. Overall, new cases per capita in New York and New Jersey are at least double the national average now, and stabilization rates in the vicinity of Rhode Island, Massachusetts and Connecticut are causing concern.
Ultimately, however, experts hope that downward pressure from the United States’ accelerated vaccination effort – which is beginning to expand ahead of schedule beyond initial priority groups while protecting vulnerable older adults from hospitalization and death and protects frontline workers from infection and transmission – for temperament and ultimately suppress most of the upward pressure attributed to variants. In short, the US may see some leveling off during its final fall outside the pandemic. But with each passing day of vaccination – now an average of 2.5 million doses every 24 hours – a fourth developed wave seems less and less likely.
Unfortunately, this is not the case elsewhere.
As B.1.1.7 spreads across the European Union, cases have soared 52% in the past month. In many countries – Estonia, Hungary, Poland, Sweden, France, Italy, Austria and even Germany – the curve is tilted up. However, none of these nations has managed to administer at least one dose to more than 15% of its population, and most of them are doing much worse, with Austria with 9.3%, Sweden with 8.3%, Germany with 8.2% and Italy with 8.2. %, France with 8.2%, the EU as a whole with 8.1% and Poland with 7.9%.
On Thursday, Dr. Hans Kluge, regional director of the World Health Organization for Europe, told reporters that Europe’s vaccination level is too low to delay transmission. In Central Europe, the Balkans and the Baltic States, he added, new cases, hospitalizations and deaths are now among the highest in the world. The recent suspension of the AstraZeneca vaccine – and the hesitation it may arouse even now that Europe’s drug regulator has found it safe and effective – will not help at all.
Most of the rest of the world is even further behind. In Brazil, where, again, cases increased by more than 50 percent in the last month, only 5.1 percent of the population received at least one dose of the vaccine. In India, where cases increased by more than 110%, only 2.2% of the population received a dose. Morocco is the only African country that has administered at least one injection to more than 5% of its population, and no country in Asia or Oceania has approached that number.
Vaccination, of course, is not the only reason why COVID-19 is hitting some places harder than others now. But it is the main reason, along with natural immunity, why some places are unlikely to experience a true fourth wave of infection – and because even a fourth wave elsewhere may not be the last.
The contours of a new world divided between those who have and those who do not have a vaccine are already taking shape. For some, normal life is on the horizon; for others, the crisis will continue, with all its disturbances and dangers. In the meantime, the virus will continue to mutate as long as there is somewhere to spread.
By the end of May, the United States will have received about 500 million doses of the vaccine – enough to fully immunize all adults in the country. In all, the White House has reserved more than 1.2 billion doses, enough to vaccinate the entire population of the United States twice, and a little more. Predictably, most rich countries have made similar requests. Most developing countries did not. And so Europe is not just about more efficient implementation. He owes the world too – with a more equitable dose distribution to follow. Until then, the waves will continue and, for most, the pandemic will not end.
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