At the moment, there are two stories in the news when it comes to COVID-19. One is the well-deserved concern over the rising tide of cases. Over the last three weeks, the nation has seen cases rise steadily, erasing months of progress and putting the national total back to where it was in March. While cases are up in all 50 states, the surge is far from uniform. Over that period, the Ozark region of Missouri and Arkansas formed the epicenter of a pulse that has spread out extremely unevenly across the nation. A dozen states are currently sitting at over 100 new cases per 100,000 population over the last seven days. Another dozen are at less than 25.

That the national average is currently sitting at nearly 80 is being driven not so much by a national surge, as by numbers in just three states that exceed 240—Missouri, Arkansas, Louisiana, and Florida. Florida in particular has come into its own as by far the most populous state to be swept up into a new surge of cases, The state is currently sitting at numbers that match those of the February spike, and is going up more steeply than in previous surges. Cases in Florida doubled in a single week, after doubling the previous week. Across the state, the majority of counties saw hospitalizations increase by more than 25% in the last week.

The other story in the news this week is vaccine breakthroughs. In the halls of the White House, at the Olympic village in Japan, and in the pages of every paper there have been stories of people who have tested positive for COVID-19 even though they are fully vaccinated. Combined with (deservedly) dire warnings about the effects of the delta variant, and a pivot in some right-wing media sources toward “see, vaccines aren’t working,” it would be easy to assume that vaccine breakthroughs are to blame for some significant portion of the rising tide.

They’re not. As everyone from Anthony Fauci to President Joe Biden has made clear, what we’re seeing now is a pandemic of the unvaccinated. Breakthrough cases, while they are happening, are barely a blip on the overall picture.

There are two charts that show the changing nature of the the Pandemic of the Unvaccinated (PU) vs. the plain-old P. The first is a chart of new cases each day as reported by the Centers for Disease Control.

Daily cases of COVID-19 in the United States

The second is a graph of COVID-19 related deaths in the United States, also from the CDC.

Daily deaths resulting from COVID-19 in the United States.

This second graph shows an uptick over the last week, and deaths always necessarily trail new cases. But the increase in deaths is both smaller, and more lagging, that it was in previous waves of cases. For example, back in November, when cases went up by 68% in the first two weeks of the month, deaths went up by an almost identical percentage. But in July, with cases up over 250%, deaths are up by 30%. Losing over 250 Americans a day to COVID-19 is certainly nothing to brag about. However, this is a reflection of how Americans over 65 are 80% vaccinated, robbing the disease of those most vulnerable to severe illness. The delta variant appears to be more virulent when it comes to children and younger adults when compared to pervious iterations of the SARS-CoV-2 virus, but not enough to make up the difference gained by taking the older population off the table.

What’s happening in the U.K. is an even more dramatic demonstration of this effect. In spite of a tremendous surge in new cases, the increase in deaths has been much lower. 

So, 97% of new hospitalizations are among the unvaccinated. And 99.5% of deaths are among the unvaccinated. But thankfully, so far at least, those deaths don’t come close to matching the levels seen when COVID-19 had the full run of the population. That dramatic graph in the U.K. comes in spite of the most common vaccine there being the AstraZeneca/Oxford version, which is thought to be less effective than either Pfizer/BioNTech or Moderna. 

As The Washington Post points out, the rate of new cases in states like Missouri is actually as high as it ever was back at the January peak … except that the vaccinated are not participating. That rate is still increasing. The unvaccinated are not just catching COVID-19 as readily as they did in January, with the delta variant now accounting for 83% of all cases, they’re catching it faster. As the Post reports, “The country’s summer of freedom from covid-19 is turning savage for the half of the nation that is still not fully vaccinated.”

Applying that same adjustment to the nation, the rate of new COVID-19 cases among unvaccinated people is already at “surge” levels, and is still rising. “The national adjusted hospitalization rate has climbed to a point last seen in April, and the death rate is comparable to May’s unadjusted figures.”

When the numbers show over 6,000 breakthrough cases that have been hospitalized, it sounds like a lot. But what it means is that half the population—including 80% of the most vulnerable population—contributed just 3%. Breakthrough cases are very uncommon. And when those cases do occur, multiple studies have shown that vaccinated people support a lower viral load in their nasal passages than do unvaccinated people. It’s not a guarantee, but it’s a good indicator that the vaccinated are much less likely to pass the disease along, either to the vaccinated or the unvaccinated.

Here’s another look at the U.K. data comparing this huge new wave of cases to the nation’s previous high, this time broken down by age range.

That’s amazing. That’s just grand. That’s exactly what good vaccine news should look like.

Now, we only have to badger, cajole, threaten, or shame the other half of the population into taking the vaccine. Because while the number of deaths might be down:

Both the U.S. and the U.K. are seeing enormous health care costs from this new wave of disease.
Long-term effects of COVID-19 remain unknown, but it’s already clear that many people will have lingering disabilities that could last for years.
The longer we keep having huge levels of cases, the better the chance that there will be new and more evasive variants.
Kids can’t get vaccinated, and kids don’t deserve to get sick just because adults are jackasses.

And remember—support the export of existing vaccine stocks as well as the relax of intellectual property laws around these vaccines. We can’t stop this in the United States unless we stop it around the world.

Thursday, Jul 22, 2021 · 7:46:22 PM +00:00 · Mark Sumner

Fingers crossed … 

Thursday, Jul 22, 2021 · 9:28:42 PM +00:00 · Mark Sumner