US faces pivotal moment in COVID-19 fight

The U.S. is facing a pivotal moment in the fight against COVID-19, as a new rise in cases poses a threat even as vaccinations make progress.

Cases are up about 12 percent nationally compared to the previous week, averaging around 62,000 cases per day, according to the Centers for Disease Control and Prevention (CDC). The figures come as CDC Director Rochelle Walensky issued a dire warning this week of “impending doom” in the nation’s coronavirus battle.

Still, the country is in a markedly different place from previous COVID-19 surges, due in large part to the hope on the horizon from vaccine availability. The vaccination campaign is moving at a solid pace, often exceeding 3 million shots per day.

The vaccines hold promise for the summer returning to something close to normal, but experts are urging the public to remain vigilant with precautions for a little while longer until more of the population is vaccinated.

“We have lots of good news and reason for hope, but we also have some trends that are concerning and giving us a little bit of pause,” said Helen Boucher, chief of infectious diseases at Tufts Medical Center in Massachusetts.

In short, the U.S. is in a precarious situation. There is a hope of making great strides toward normalcy in the next couple of months, but in the short-term there is still significant risk for the millions of Americans who remain unvaccinated, particularly given reopenings and the rise of more contagious variants of the virus.

“If you’d asked me a month ago, I was really optimistic about where we are headed,” said Preeti Malani, an infectious disease expert at the University of Michigan. But right now, she said, “Michigan’s numbers look terrible.”

Michigan has the highest per capita rate of new cases in the country, and has seen hospitalizations spike from around 900 statewide at the beginning of March to almost 2,000 by the end of the month, according to data from the Covid Act Now tracking site.

Many northeastern states are also seeing a spike in cases, and hospitalizations are starting to tick up in Connecticut, New Jersey and New York. While deaths have fallen from their peaks, there are still more than 900 people dying from the virus in the U.S. every day.

The surges are coming as more governors, even in Democratic-led states, are easing coronavirus restrictions, despite the Biden administration recommending otherwise.

Michigan, New York City and New Jersey increased indoor dining capacity to 50 percent in March, for example, while Connecticut lifted all capacity limits on restaurants.

Coronavirus War Room, a project of the Democratic-aligned group Protect Our Care, took the rare step this week of publicly calling out Democratic governors in those states, along with Republican governors, for reopening despite the CDC’s warnings.

The group issued a release saying: “CDC Director Warns of ‘Impending Doom’ As States Scrap Safety Measures and Rush to Reopen.”

The Biden administration, while generally urging governors not to lift restrictions, has for the most part refrained from naming and shaming states. In a speech Tuesday, President Biden called on governors who have lifted mask mandates to reimpose them, but did not make the same call for indoor dining restrictions or other limits on businesses.

Asked on Wednesday why the CDC has not issued guidance to states for reopening indoor dining and other gathering points, Walensky pointed to the agency’s urging of people to take precautions on an individual level.

“We continue to articulate in these press conferences and others the importance of masking, distancing, not traveling, and decreasing crowds,” she said.

William Hanage, an epidemiologist at the Harvard T.H. Chan School of Public Health, called states reopening a “bad idea,” and said they should “at the very least be pausing things.”

Business restrictions often mean lost revenue, though, and many people are simply tired of following precautions, a challenge that public health experts acknowledge.

“I know we’re all so tired of the pandemic,” Boucher said. “If we can just hang in there a little bit longer.”

The summer is widely expected to be much better and closer to normal, given that by then a large share of the population should be vaccinated.

Boucher noted that variants of the virus are a bit of a “wild card,” but the vaccines have shown promising results against them.

The more immediate threat is from a variant first identified in the United Kingdom, called B.1.1.7, which responds well to the vaccines but is also more transmissible, posing a threat in the short term while vaccinations are still underway.

The situation is also not equally bad in all parts of the U.S. Outside the Northeast and Midwest, the pandemic is somewhat better at the moment, even though many Southern states have been looser with their COVID-19 restrictions.

Boucher noted that in Florida, where there have been images of crowded spring break gatherings, “their numbers aren’t great, but they’re not as bad as places like Michigan or Massachusetts.”

She said variations in weather or in the strains of the virus that are present could help explain those differences, but there could be some unexplained factors as well.

Despite the current danger, vaccinations have made important progress. According to the CDC, about 74 percent of people 65 and older have received at least one dose, as have 38 percent of adults overall. Still, the flip side is 26 percent of seniors and 62 percent of all adults remain unvaccinated.

The vaccination gains among the elderly are likely to blunt somewhat the hospitalizations and deaths in the recent rise in cases, without entirely eliminating them, given that some people remain unvaccinated, experts say. The vaccines have been shown to provide very strong protections against hospitalizations and deaths for people who are fully vaccinated.

As Monica Gandhi, an infectious diseases expert at the University of California-San Francisco, put it: “If there were no vaccines and we didn’t have this incredible intervention, I would be sweating bullets.”