U.S. hospitalizations for COVID-19 are averaging nearly 35,000, a whopping 46% increase over the prior reporting week but far below the pandemic peak in early January.
The nation is reporting over 300 deaths per day, on average, from the disease. That’s a sharp increase from an average of 170 on July 10 but far below 2,000 daily deaths during the spring 2020 crisis and 3,000 at the winter apex, according to the Centers for Disease Control and Prevention.
Although the situation is better than in 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 Fourth victory lap seem premature.
“I don’t think we’re going to 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. Scientists say some vaccinated people can spread the virus as easily as unvaccinated people, raising fears about more outbreaks and salvaging 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 virus will be detected in more people as society reopens, making the pressing question of whether the shots still protect against severe illness, hospitalization, and death and the extent to which the virus penetrates that shield or finds the virus unvaccinated.
The CDC made waves last week by saying unvaccinated and vaccinated people should wear masks inside public spaces in counties with “high” or “substantial” levels of transmission. The guidance, a reversal from advice in May, was based on studies showing that vaccinated people with “breakthrough infections” from the delta variant may be able to spread the pathogen as efficiently as unvaccinated people.
National Institutes of Health Director Francis Collins said Sunday that 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 twenty-five-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’ “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 have chosen to remain unvaccinated yet are filling hospitals in parts of the country, children younger than 12 who aren’t eligible for the vaccines, and the immunocompromised, who are unable to benefit from vaccines by mounting a sufficient antibody response.
Dr. Fauci said 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 a variant so dangerous that it can elude the protection provided by existing vaccines.
Doctors say vaccinated people, especially those who are older or immunocompromised, are sometimes hospitalized 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, the mix of poor vaccination rates in parts of the country and rapid transmission of the delta variant is proving to be toxic.
“The spread is exponential,” said Dr. Catherine O’Neal, an assistant professor 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, 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 about the best approach to virus management. Gov. Ron DeSantis, a Republican, said it is best to allow personal choice rather than imposing 2020-style mandates, especially now that vaccination is an option.
Nevada, Arkansas, Missouri and Louisiana have the next highest rates of hospitalization per population. All trail the nationwide rate of full vaccination at 49%. Louisiana’s vaccination rate is only 37%.
Dr. O’Neal said about half of her patients in Louisiana are younger than 50. All of them are unvaccinated, she told CNN.
Elderly patients, especially those older than 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 deal with a flood of patients. He said the good news is more people seem to be looking for vaccines because of renewed fears.
The U.S. was administering an average of 650,000 doses per day by the end of the past week, up from about 500,000 on July 20.
Ohio Gov. Mike DeWine, a Republican, said he is seeing an uptick in vaccinations in some rural counties of his state, in part because of fears about 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.
The share of patients who die from COVID-19 after testing positive, or case-fatality rate, in the U.S. is 1.8%, according to a Johns Hopkins tracker.
That is the same rate measured in December when the vaccine rollout began. Experts say some high-risk people remain unvaccinated and are probably driving up the rate even though immunization and new therapies are available.
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 statistic 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 death is 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 less deadly than even the best official statistics can say.
Also, comparing nations can be difficult because the mortality rate declines if a country has rampant spread and a big denominator of cases.
The U.S. has lost 186 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) and South Korea (only four) but better than Britain (194) and far better than Brazil (162) and Peru (603).