Jerry Leonardson, a coronavirus disease (COVID-19) positive patient, sits in his isolation room at Madison Memorial Hospital in Rexburg, Idaho, USA, October 28, 2021.
Shannon Stapleton | Reuters
After weeks of falling Covid-19 cases in the United States, the decline in infections has stalled.
New infections have dropped to an average of more than 74,000 per day over the past week, a 57% decrease from the Delta Wave’s peak of 172,500 new infections per day on September 13.
That’s certainly good news, but the downward trend has flattened out in recent weeks, jumping between 70,000 and 75,000 new cases per day for almost three weeks, according to Johns Hopkins University. Covid hotspots in the US have now relocated from large parts of the south.
According to Johns Hopkins, the daily death toll is still up, with more than 1,200 deaths per day in the past week, a 1% increase from the previous week.
Cases have declined most in the south, where the delta wave was earliest and strongest in summer, with average daily infections in the region declining and continuing to decline by about 84% from the peak. The decline was so sharp that Florida, where hospitals were overrun when it battled one of the nation’s worst Covid outbreaks this summer, is now the state with the fewest average daily new cases on a population-adjusted basis.
Other southern states that had significant delta wave peaks, including Georgia, Louisiana, and Mississippi, also rank in the bottom 10 states in terms of daily new cases per capita.
Hospital stays and deaths are also falling in the south. The region’s seven-day average of 112 Covid patients per 1 million population is the lowest in the country, according to a CNBC analysis of data from the Department of Health.
“We were coming from a very high point, so we had our climb a little earlier,” said Dr. Sonja Rasmussen, Professor in the Departments of Pediatrics and Epidemiology at the University of Florida College of Medicine, on the falling cases in her state. She found that the cooler fall and winter temperatures in typically tropical climates make it easier for Floridians to spend time outdoors, where the virus does not spread as easily as it does indoors.
“I think we really see a certain seasonality – maybe not winter-spring like with the flu, but more when people are more indoors than outdoors,” she said. “In Florida, we were more indoors in the hot summer time, and now we have the opportunity to be more outdoors.”
Outside of the US South, things are going in the opposite direction. In the past two weeks, cases have increased by 25% in the Midwest, 18% in the Northeast, and 4% in the West. Hospital stays that lag behind reported infections have declined 9% in the Northeast over the same period, but largely unchanged in the Midwest and West.
The Midwest is now the region with the highest rate of daily new cases per capita, with the recent surge being driven by states like Nebraska, Minnesota and Wisconsin. Minnesota’s current caseload, averaging around 3,000 a day, is among the highest we’ve seen so far in 2021, according to a tweet from the state’s Department of Health on Tuesday. “Unfortunately, the pandemic is far from over,” said the tweet.
Population-adjusted cases are second highest in the west, where New Mexico, Colorado, and Arizona have all seen increases of 15% or more in the past 14 days.
According to Dr. Jonathan Samet, the dean of the university’s public health school and head of the Covid modeling group, was at the University of Colorado Hospital last week because of a combination of the disease and “all the reasons people go to” overwhelmed hospitals. “
“When I talk to my clinical colleagues, things are full, the emergency rooms are full,” said Samet. Emergency orders from Colorado Governor Jared Polis allow hospitals to move patients to other facilities if needed, he said, “but hospital reserves or beds are lower than they were during our big surge a year ago.”
Polis issued an executive order on October 31 that allows the state’s Department of Public Health and Environment to require hospitals at or near capacity to re-admit patients and move patients to other medical centers. State health authorities can now also instruct hospitals to accept patient transfers.
According to HHS data, about 85% of staffed intensive care beds in Colorado are in use in the state, the seventh highest of any state. Around 36% of these beds are used for Covid patients, who come in fourth.
Samet said a combination of colder weather and low vaccination rates in parts of the state helped fuel the recent flare-up.
“As in many states, vaccination is a patchwork,” he said. “Our rural areas tend to have lower vaccination rates and currently have the highest case and hospitalization rates.”
However, Samet could not say exactly why Colorado was going through a particularly bad increase in Covid compared to other states. Population-adjusted cases are nearly twice as high in Colorado as in neighboring Kansas, though other neighboring states like Wyoming, Utah, and New Mexico have unusually bad outbreaks as well.
“The unvaccinated are the drivers, like in many other places, but we are no different from other states in that we have a significant proportion of people who are still unvaccinated and are spreading the epidemic,” said Samet. “We know the unvaccinated are critical, but that doesn’t lead us to why Colorado is at this particular moment.”
Rasmussen, the University of Florida doctor, also cited low vaccination rates as a reason to believe Florida and nearby states like Mississippi, Louisiana, and Alabama are still at risk for future outbreaks – despite the immunity given by the residents Have built up summer delta rise.
“Their vaccination rates aren’t high enough to make me feel like we won’t see sustained outbreaks when people get together, especially in areas where vaccination rates are lower,” she said.
Florida’s 60.2% of fully vaccinated residents are a few percentage points higher than the country’s overall rate, though Rasmussen mentioned that there are many counties with lower rates. Alabama, Mississippi, and Louisiana are in the bottom 10 states after full vaccination rates at 45.2%, 46.2%, and 48%, respectively, according to the Centers for Disease Control and Prevention.
Further advances in treatments and vaccinations could help Covid become an “endemic” virus, which experts call “endemic”.
The advent of new antiviral Covid pills from Merck and Pfizer, for example, could help prevent infections resulting in hospitalizations or deaths. Pfizer’s new treatment is not a substitute for vaccinations, said Dr. Scott Gottlieb, a Pfizer board member and former FDA commissioner, told CNBC’s “Squawk Box” on Friday.
“If you have therapeutics that are so effective, it can be a support to people who vaccines don’t work on, people who have breakthrough infections – that is the environment in which pills are being studied,” said Gottlieb. “It really is a backing against death and illness from this infection.”
Pfizer released data on Friday on a Covid pill that reduced the risk of hospitalization and death in high-risk adults by 89% by combining the drug with an HIV drug to make it work longer in the body. Merck and Ridgeback Therapeutics announced in October that their antiviral drug had reduced the likelihood of hospitalization and death in patients with mild or moderate Covid cases by 50%.
U.S. vaccination rates could also rise with the advent of President Joe Biden’s workplace vaccination mandates enforced by the Occupational Safety and Health Administration. All companies with at least 100 employees must ensure that their staff are fully vaccinated against Covid by January 4, and any employee who refuses to comply must wear a mask and get tested regularly.
OSHA’s mandate will affect around 84 million private sector workers, although the new rules are already facing opposition in court.
Covid vaccines have also recently been approved for children ages 5-11. CDC director Dr. Rochelle Walensky approved Pfizer’s vaccine last week, paving the way for shots in the arms of younger children.