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Another Winter of COVID | New Yorker

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The coronavirus pandemic in the United States seems to be retreating so far. Since the beginning of September, daily cases have decreased by a third and daily hospitalizations have decreased by more than a quarter. COVID Deaths, which are generally weeks late for infection, are now beginning to decline from their peak. There are still regions of the country that are struggling. In Alaska, where only half of the population is fully vaccinated, hospitals have reached capacity and doctors have had to distribute intensive care. But nationwide, delta waves are declining. The question now is what to keep in winter.

Illustration by Joan Fazenda

There are optimistic reasons. Currently, 78% of adults in the United States receive at least one dose. COVID Vaccines, and recent obligations, are pushing this number higher. Millions of vulnerable Americans have taken booster shots, and Halloween Pfizer may allow the BioNTech vaccine to be used by children aged 5 to 11 years.Earlier this month, Merck announced that its antiviral drug molnupiravir almost halves the chances of mild or moderate people. COVID You will be hospitalized or die. The method can change dramatically because the drug is given orally rather than infused or injected like a monoclonal antibody. COVID Because they are treated outside the hospital, fewer people will eventually enter the hospital. On the other hand, rapid antigen testing, which helps open schools and workplaces more safely, is about to be widely used. This advance has evolved against the epidemiological background that at least one-third of Americans are infected with the virus and have some degree of innate immunity.

However, there are some less promising scenarios. The United States has the lowest immunization rate of any wealthy democracy and is currently lagging behind many poorer countries such as Uruguay, Cambodia and Mongolia. The anti-vaccine movement remains a powerful force.Protesters last Monday COVID New York City test site. According to the Kaiser Family Foundation, one in six adults nationwide is categorically opposed to vaccination. Only one-third of parents say they plan to vaccinate their children shortly after the vaccine is approved, and one-quarter say they will not “absolutely” vaccinate. In the UK, 97% of people over the age of 65 are fully vaccinated. During the delta waves there, daily cases reached record levels of 80%, but daily deaths were only 11%. Only 84% of older Americans are fully vaccinated, and cases and deaths are more closely linked. Both recently reached about two-thirds of last winter’s level. “Will this winter be as terrible as last winter?” Asked Ashish Jha, Dean of the Faculty of Public Health at Brown University. “I think we can definitely say no. But what people don’t rate about Delta is to find pockets of unvaccinated people and just prey on them. If you are an elderly person living in this country and have not been vaccinated, it will be a very bad winter. “

Over the past year and a half, the virus has repeatedly surprised us, prompting public health revisions, reversals, and meaculpas. It is not clear why the virus soars in one place and not in another, why it declines when it soars, and how it evolves next. A number of factors can lead to uncertainty in our predictions, each of which can push “normal” beyond yet another horizon. Still, it’s possible to worry about some of the biggest problems. One is direct contact. When society is open, infection rates increase in most cases. In the United States, most business closures and strict capacity limits have ended. Face-to-face instruction at schools and universities has resumed. The weather is cold and we are spending more time indoors. This all means more chances of the virus spreading.

The consequences of its spread depend, in part, on how many people remain sensitive and how weakened their immunity is. The passage of time can be particularly problematic for communities with previously high prevalence and low current vaccination levels. A recent CDC study in Kentucky found that people who were previously infected but never vaccinated were more than twice as likely to be re-infected after being infected with the virus. .. Breakthrough infections are not nervous among vaccinated people, but are rare and generally mild with the use of delta mutants, but breakthroughs occur, especially as the elderly’s immunity weakens. The chances of developing a serious illness appear to increase over time. Our herd immunity goes up and down with booster shots, repeated infections, and some combination of time. “It’s like drawing the Golden Gate Bridge,” said Robert Wachter, director of medicine at the University of California, San Francisco. “The moment you complete it, you have to start over.” Complicating all this is that new coronavirus variants can destabilize the equilibrium we have reached. ..

In low-income countries, only 2 percent of people receive a single dose. COVID vaccination. This is both a moral and public health failure. Every week, thousands of people around the world die vaccine-preventably, and as the virus continues to circulate unchecked, the potential for more dangerous variants increases. In June, the daily number of coronavirus infections in the United States was one-tenth that of today, the lowest since the pandemic began.Then Delta came and nearly 100,000 Americans came. COVID Deaths (number. “What happens next depends largely on whether the virus evolves into a worse strain,” said Eric Topol, director of the Scripps Research Translational Institute. Does not contain this globally. By the way, it is not included here. So far, the United States was not home to major new variants. Alpha, Beta, Gamma, Delta- They all came from other parts of the world, but we are so much of a source that we could be the founders of the Greek character in the future. “

Individuals have very little control over the viral threats they face this winter. But whether our immune system is ready depends on the choices we make today. The gap of a few percentage points in vaccination rates can be very important, especially if the low rates are concentrated in a particular community or high-risk group. Perhaps the safest prediction is that resumption, variants, and immunity will be combined in different ways, depending on age, health status, risk tolerance, and neighbor decisions. We all set foot together in this pandemic. But we leave it at different speeds and at different times. ♦

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