As US surpasses 900,000 COVID-19 deaths, the trajectory of the pandemic remains uncertain
The USA has surpassed 900,000 coronavirus deaths amid positive data indicating the worst could be in the rearview mirror even as statistical warning lights flash on the pandemic dashboard.
The omicron variant surge that pushed daily infection numbers to new heights appears to be easing. Daily infections and hospitalizations are edging lower. The respite, however, could be short-lived.
"We are guaranteed to have another variant surge," Melissa Nolan, an assistant professor of epidemiology and biostatistics at the University of South Carolina Arnold School of Public Health, told Paste BN. "While the current vaccines and boosters worked for omicron, they are less likely to work against future variants."
Every time the virus infects someone, it mutates a very small amount. These tiny changes also occur in breakthrough infections among the vaccinated. And millions of breakthrough infections are adding up, Nolan said.
Vaccinations remain crucial
The recurring theme of public health officials remains vaccination. An average of more than 2,000 Americans die daily, according to data from the Centers for Disease Control and Prevention. Mutations and varied vaccination status blur the data somewhat, but Dr. Robert Lahita, author of "Immunity Strong," said the likelihood of dying from COVID-19 is about 20 times greater if you're unvaccinated.
The unvaccinated also are more likely to get long COVID-19, persistent symptoms that can cause mobility issues, heart damage and tachycardia, lung damage and shortness of breath, loss of taste and smell and more. These issues can last six months or longer, or they could be permanent, said Lahita, director of the Institute for Autoimmune and Rheumatic Disease at Saint Joseph Health in New Jersey.
"It's very dangerous to remain unvaccinated against this virus," Lahita said.
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The United States reported as many cases of COVID-19 last month, driven by the omicron variant, as it did in all of 2020. The wildly contagious omicron put record numbers of people into hospitals in January, even though on a per-case basis, infections are milder.
Dr. Matthew Heinz, an internist in Tucson, Arizona, said he is "terrified" lax vaccination efforts are setting the world up for a variant that is highly transmissible like omicron but has a higher death rate. At the current rate, the nation will surpass 1 million fatalities in less than two months – about how long the coronavirus took to claim the past 100,000 American lives.
Whether it takes two, three, four or six months, the USA will absolutely exceed the threshold, Heinz said. Too many people, he said, choose to ignore science, public health and what is best for their community.
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In Arizona in November, unvaccinated people were more than 30 times more likely to die from COVID-19 infection than fully vaccinated people, Heinz said.
"We really need to make this a slogan that almost everyone knows – like Geico has accomplished with their catchy gecko commercials," Heinz said. "The mind-blowing number should be enough to sell everyone on getting the shots and convincing reticent loved ones to do the same."
Initial vaccinations have leveled off, and less than two-thirds of Americans are fully vaccinated despite widely available access. Wyoming, Idaho, Mississippi and Alabama have vaccination rates below 50%.
Interest in booster shots is waning: 42% of fully vaccinated Americans have received a booster dose, according to the CDC. The average number of booster shots dispensed per day declined from 1 million two months ago to less than half that.
Did breakthrough cases shift perception of vaccines?
Dr. Lucy McBride, an internist in Washington and author of a weekly COVID-19 newsletter, told Paste BN she believes people lost faith in vaccines when omicron fueled so many breakthrough cases. A mild version of COVID-19 after vaccination isn't a vaccine failure, she said – it's a success story if you're not in the hospital.
"If you look at the most recent CDC data, they report that in October and November, the average weekly chance of a boosted person dying from COVID-19 was about 1 in a million," McBride said.
Those odds have increased because of the transmissibility of omicron, but "the risk of getting seriously ill or dying from COVID-19 is very small after you've had a booster," McBride said.
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When will we hug again?
Experts provided mixed reviews on the path the pandemic will take in the next few years. Lahita is bullish on a return to normalcy by 2023. There will always be COVID-19, just like there will always be the flu, but people will adjust, he said.
"No more masks, no more travel restrictions, mass infections, overflowing hospitals," he said.
Annual vaccinations are likely, and Lahita said it's good that Americans appreciate the importance of sanitizing and washing their hands.
"But they will feel comfortable hugging again, definitely, assuming the person they're about to hug is not coughing everywhere," Lahita said.
Heinz is less optimistic, not expecting conditions to be much different in two years. Human behavior will continue to have a tremendous impact, he said, including whether people travel during the holidays or spring breaks and whether they will wear masks when directed to by public health authorities.
There will be surges throughout the world governed by regional vaccination level and willingness of the public to follow mitigation efforts imposed by authorities, he said.
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"I continue to be dumbfounded by the number of willfully unvaccinated individuals, especially after we have seen so many millions of Americans receive this safe and highly effective vaccination," Heinz said.
Ogbonnaya Omenka, an assistant professor and director of diversity at the Butler University College of Pharmacy and Health Sciences, said it's difficult to forecast the future of the pandemic and the relationship between an infectious disease and its host – people – because it's impossible to predict what each will do next.
"The trajectory of the pandemic will always be driven by the nature of the virus, the response of humans and the role of environmental factors," Omenka said.
And people who suffer from it "might unfortunately not recover," he said.
Pandemic a jumble
Globally, the news is mixed. New cases and deaths reported in the African region have fallen for at least three consecutive weeks after a five-week rise. Britain is easing its restrictions; Finland and Denmark are dropping all of them.
"Tonight we can start lowering our shoulders and find our smiles again," Danish Prime Minister Mette Frederiksen said. "We dare to believe that we are through the critical phase."
Russia's daily infection curve is shooting almost straight up. Tokyo launched a mass booster inoculation drive to counter surging infections, and Canadian Prime Minister Justin Trudeau tested positive for the coronavirus.
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Ending the "acute phase" of the pandemic will require high vaccination rates, equitable health care and more research, said World Health Organization Director-General Tedros Adhanom Ghebreyesus.
“We are concerned that a narrative has taken hold in some countries that because of vaccines and because of omicron’s high transmissibility and lower severity, preventing transmission is no longer possible and no longer necessary,” Tedros said. “Nothing could be further from the truth.”
Control, not eradication, is key
The goal, experts said, is to control COVID-19, not eradicate it. A CDC map of U.S. counties dealing with high transmission shows all but a handful of counties in the top level.
"Vaccines and boosters are our best option to get out of the pandemic," Nolan said. "If we can reach 70% vaccination nationally, we will have a chance to start seeing a transmission reversal."
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It's important to remember that hundreds of health care workers sacrificed their lives by showing up to work when there was no vaccine and no effective therapeutics for COVID-19, Heinz said.
"Willfully unvaccinated people are spitting on their graves," Heinz said. "It’s beyond comprehension to me how this is still being tolerated."