Many infectious-disease experts in the U.S. are cautiously optimistic. Covid-19 cases, hospitalizations and deaths have all sharply dropped in recent weeks as the country comes down from its deadliest surge yet, and vaccination campaigns are getting more shots into people’s arms. Warmer weather is around the corner.
Yet the hard-won progress against the coronavirus pandemic remains fragile, public-health experts say. Case counts are still high and might be plateauing; current levels of built-up immunity aren’t enough to safely drop precautions; and more dangerous variants are threatening to gain a foothold in the U.S. and exploit safety lapses.
“Things are tenuous. Now is not the time to relax restrictions,” Rochelle Walensky, director at the Centers for Disease Control and Prevention, said Friday. “We cannot get comfortable.”
Covid-19 cases in the U.S. have declined for the past several weeks, with the seven-day average dropping 74% since the Jan. 11 peak, Dr. Walensky said Monday. Average daily hospital admissions, now 6,500 a day, have dropped 60% and are at their lowest point since the fall.
Daily reported Covid-19 cases in the U.S.
Note: For all 50 states and D.C., U.S. territories and cruises. Last updated
Source: Johns Hopkins Center for Systems Science and Engineering
There is no single explanation for the declines, health authorities say, but the biggest contributor is likely changed behavior. People are likely taking more precautions, following the holiday season and a deadly winter in which the U.S. surpassed 500,000 total deaths from Covid-19. In addition, state and local authorities increased restrictions in response to the climbing numbers.
Epidemiologists also roughly estimate that at least a quarter of the population has had Covid-19, with most developing some level of immune response. That, in combination with the relatively smaller number of people who have been fully immunized, reduces the number of susceptible people in the population and helps to slow the spread. Vaccinations have also likely driven down hospitalizations and deaths, after rolling out to residents in nursing homes and long-term-care facilities.
“We’re coming down from a holiday bubble, and we’re emerging from a very dark and cold winter that might have kept people inside,” said Darlene Bhavnani, an infectious disease epidemiologist at the University of Texas at Austin. “I hope that being outdoors more and without big holidays, we’ll continue to see these declines.”
Some states and counties have started to ease up on safety measures since conditions have improved. Nearly a year into the pandemic, many people and communities are eager to get back to a more normal version of life. But public-health authorities advise caution, as another rise in cases in the spring is still on the table.
“The pressure to get back to something more normal will be immense and irresistible,” said Robert Wachter, chairman of the department of medicine at the University of California, San Francisco. “My hope is that we’re just thoughtful about it, we don’t just declare victory and open the floodgates. This virus is smart, and it will come back to bite us.”
Loosening mitigation measures too aggressively or early will likely lead to a rebound in cases—as happened last spring and summer, say Dr. Bhavnani and other health authorities.
Daily confirmed cases and hospitalizations, while down considerably from January, are at a similar level to peaks seen last summer, and the declines have stalled over the past week. Cases have increased over the past three days, compared with the week before, and the recent shift “must be taken extremely seriously,” Dr. Walensky said.
The amount of immunity built up through both infection and vaccination is still far from the estimated 70% to 80% or above necessary to stop the spread through population-level immunity alone.
Newer, more transmissible variants complicate the calculation. The variant that emerged in the U.K. can spread much more easily than previous versions of the virus and could become the dominant strain in the U.S. in March. A variant that emerged in South Africa has shown some resistance to currently available vaccines and therapies.
“I fear that once we reach a level that feels safer for society, and as people decide to loosen restrictions for communities or themselves, we’ll see this return in cases,” said Ajay Sethi, an infectious disease epidemiologist at the University of Wisconsin-Madison. “And in this case, it will be a return in the new variant that’s harder to control.”
States and cities have responded to improving numbers with a patchwork of rules and regulations based on guidance from their respective health departments, as elected officials try to navigate the ever-changing pandemic landscape. Some states, such as Iowa and North Dakota, have dropped their mask mandates.
New York state, which recently reopened indoor dining in New York City and arenas at limited capacity, is set to also expand nursing-home visiting rules, allow 25% attendance at movie theaters and expand wedding attendance. Health officials in the state are cautiously optimistic. “To date we’ve administered over 3 million shots, but everyone needs to remember that this pandemic is not over,” said Jeffrey Hammond, a spokesman at the New York State Department of Health.
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In Virginia, Democratic Gov.
said Wednesday he would remove a statewide curfew and restrictions around the number of people allowed in outdoor gatherings, beginning in March.
Lilian Peake, a state epidemiologist at the Virginia Department of Health, said vaccines provide the most hope for less infections and a return to anything resembling normal. “The vaccines we have work well and are a path forward,” Dr. Peake said.
Phoenix Mayor Kate Gallego said she would only rest after all residents and visitors coming to the city are vaccinated.
Arizona suffered a severe increase in reported coronavirus infections during the summer of 2020, only to have those new case numbers overshadowed by an even higher surge in the fall and winter. In the summer, daily confirmed cases regularly were over 5,000, while case numbers in January regularly exceeded 10,000 a day, according to data from the Arizona Department of Health Services. By contrast, this week’s daily case numbers were around 1,000.
“Like so many people, I’m encouraged to see the number of cases decline,“ said Ms. Gallego, a Democrat. “At the same time, I’m wary of celebrating too soon.”
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Source: WSJ – US News