In the middle of a harsh winter, Dr. Diane Griffin began to feel something in the past few weeks that had been absent for much of the previous year: optimism.
Griffin, an infectious disease specialist at the Johns Hopkins University School of Medicine in Baltimore, said the recent declines in hospitalizations, daily deaths and confirmed new infections fuel the hope that the U.S. has reached a turning point in the path of the pandemic. of the coronavirus.
“What we are seeing is incremental and encouraging,” said Griffin, “but we are not yet out of danger.”
After more than a year of the pandemic, developments that seem to diverge have made it difficult to analyze exactly where the United States and the world are.
Griffin’s optimism is tempered by the fact that, although the case numbers have steadily declined, they are still much greater than during the first wave, which dominated parts of the country in the spring and last summer. And hanging over all recent progress is the threat of more contagious variants of the coronavirus that are already spreading rapidly in the United States – along with concerns that the variants could pose problems for the current round of vaccines.
Scientists say that while it is encouraging to see declines after some of the most deadly and challenging months of the pandemic, it may be too early to know whether the United States is experiencing a temporary delay or whether it is finally starting to control the pandemic.
And while some optimism is guaranteed, the psychological challenges of the pandemic – where human behavior and collective responsibility remain crucial to keeping outbreaks under control – mean that communities must remain vigilant.
“We are seeing a drop right now, but I don’t think it changes the thought that we should be very careful in the coming weeks,” said Dr. Bruce Y. Lee, professor of health policy and management at New York University. “Whether this is a momentary drop or if we peaked and now things are falling – that is not entirely clear.”
Clouding the predictions further, there are questions about how known variants of the coronavirus, including a more transmissible strain believed to have emerged in the UK, can alter the course of the pandemic.
Some research suggests that there is already cause for concern.
A recent study published on the prepress server medRxiv, but not yet peer-reviewed, found that cases of the UK variant are doubling in the US every 10 days. The findings appear to confirm a report by the Centers for Disease Control and Prevention released last month, which projects that the UK variant could become the dominant strain in the country in March.
Lee said the number of cases is expected to increase again as the UK variant becomes more widespread and other strains that were first reported in South Africa and Brazil circulate in the United States. But it is possible that other forces – including rising vaccination rates across the country, the expectation that people will spend more time outdoors in the spring and other changes in behavior – will help to counteract a new wave and prevent another wave of uncontrolled outbreaks.
“January and February were expected to be difficult months, because of the winter and because of the holidays, but in March or April, we can start to see things improve,” said Lee.
On the one hand, spring will bring warmer temperatures to much of the country, making it easier to spend time outdoors, where the risk of infection is less.
And improvements are expected to continue as more Americans are vaccinated, said Griffin.
Israel’s first results, where more than a third of the population received at least the first of two doses of the vaccine, provide the first real-time signs that efforts to administer injections quickly and widely appear to be working. Preliminary analyzes show that vaccines appear to be contributing to the sharp decline in infections and diseases, particularly in people over 60, who were the first to get the vaccines.
Israel administered more than 60 doses of the Moderna or Pfizer-BioNTech vaccine for every 100 residents, far surpassing all other countries. (Israel’s vaccination strategy has been criticized for excluding Palestinians.)
Figures released last week by the Israeli Ministry of Health indicated that of nearly 750,000 people over 60 who were fully vaccinated, only 0.07 percent, or 531 people, tested positive for the virus. Of that group, 38 people were hospitalized for moderate or severe illness.
Griffin said the first results of Israel’s vaccine program were “very encouraging”, adding that vaccines can at least prevent serious illnesses and deaths in the United States, even if the variants cause a general increase in cases.
Vaccine distribution in the United States was hampered from the start by supply constraints and a lack of general strategy during the Trump administration. Since then, the federal government under President Joe Biden has tried to alleviate bottlenecks in manufacturing and distribution and is expanding how and where vaccines can be administered. The efforts are part of Biden’s goal of firing at least 100 million shots in his first 100 days in office. As of Sunday, the United States had administered 40 million doses, according to the CDC.
Experts say the United States is in a race against time to vaccinate as many people as possible before more problematic variants arise, but there are ways to mitigate outbreaks, even as people wait to become eligible for vaccines, said Carl Bergstrom, professor of biology. at the University of Washington.
“Over the course of the pandemic, one of the most important factors has been changes in our collective behavior,” said Bergstrom. “This is what makes modeling the long-term trajectory of the pandemic so extraordinarily difficult.”
“Over the course of the pandemic, one of the most important drivers has been the change in our collective behavior.”
Carl Bergstrom, professor of biology at the University of Washington
In fact, behavioral changes were sometimes associated with both peak cases, as people adopted more relaxed attitudes and states reversing restrictions, and vouchers, as new measures were implemented and people became more vigilant.
The dynamics were largely responsible for the alarming increase in cases, hospitalizations and deaths in Los Angeles County, California, in December and January.
To avoid another spike in the spring, the United States has to remain aggressive with vaccinations and mitigation tactics, such as wearing a mask and social detachment, Bergstrom said. These strategies are even more crucial in combating the most transmissible variants of the coronavirus, he said. The UK strain has been reported in more than half of the states, but, as in the UK, the numbers can rise rapidly.
“This is how exponential growth works,” said Bergstrom. “It comes on a low frequency and in the first duplications you don’t really realize why you’re overwhelmed by what you’re seeing with regular tension. But when it changes, it changes suddenly, and then you really see it take off.”
This perspective is the reason why many experts approach recent falls with cautious optimism. Also worrying is the possibility that progress can be stopped if a strain emerges that avoids current vaccines. Some initial research has already shown that the Moderna and Pfizer-BioNTech vaccines are less effective against the South African variant, although neutralizing antibody levels are still expected to be protective.
It is also possible, said Bergstrom, that other problematic variants are already circulating in the United States undetected.
All of these factors combine to make it difficult to assess the US position and predict how the next few months may unfold, he said.
“There are so many moving parts and it’s so complicated,” said Bergstrom, “but all we can do to stay aggressive, the more people we can get vaccinated and the longer we can take it, the more we can avoid a huge spring spike.”