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The surge in coronavirus cases in the United States shows a change in who is ill.Alaska Native Quarter

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When the number of cases of COVID-19 began to increase again in the United States this spring, it may have felt like déjà vu, a repeat of the early months of the pandemic. Currently, cases are beginning to decline in many, but not all, hotspots, but the country still sees more than 50,000 new cases per day, exceeding 70,000 in the days of mid-April. I did. US Centers for Disease Control and Prevention.. This may seem easier to manage than the more than 200,000 case days in December and January, but the latest numbers are comparable to the number of cases during the surge last summer.

However, this time around, many demographics of people who get sick are different. Depending on the state, they are usually young and unvaccinated, so they remain at risk. More contagious coronavirus variants, especially those called B.1.1.7, appear to be causing a new surge. And as businesses continue to reopen and vaccination efforts fall into low demand, public health experts are worried that the same community, which was vulnerable throughout the pandemic, could be hit again. I will.

New case with numbers

last year, Vital trends of individuals infected with COVID-19 It shows that adults over the age of 65 are more likely to die of the disease. Black residents, Hispanic / Latino residents, and other minority groups are more likely to get sick and face severe illness.But now, vaccination protects the majority of older people, but many minority communities, young adults who have not yet been vaccinated, and people under the age of 50 Remain vulnerable to infection..

And this young crowd does more than just develop asymptomatic or mild COVID-19 cases. The percentage of people currently hospitalized is younger than the total number of hospitalizations in the previous month. Nationwide, about 9,000 COVID-19 patients under the age of 50 were hospitalized in the second week of April, compared to about 6,000 in the same age group a month ago, but among patients over the age of 60. Hospitalization has remained at a certain level since late February. ..

This trend is even more pronounced in states where the number of cases is skyrocketing. For example, in Michigan, about less than 50 years of age with COVID-19 cases identified in the week leading up to April 9, compared to less than 300 patients in that age group during the first week of 2021 at peak times. 1,000 new adult patients were hospitalized. The surge in winter. These young patients accounted for only 17% of all patients in Michigan during the first week, but reached 29% three months later.

Enriquene Brett, a health behavior expert at the University of Michigan and Ann Arbor and an associate director at the Detroit Community Academic Urban Research Center, said these numbers were concerned. Through his work in Detroit, Nebrett has seen first-hand how access issues disrupt vaccination. “People on earth [community organizers in Detroit] They didn’t hesitate too much, but it was about access to vaccines, transportation, and working hours, “he says. These barriers are already common in vulnerable communities, and during this new surge, individuals living there will be more vulnerable, he says.

The vulnerability has consequences. Racial and ethnic disparities in COVID-19 hospitalization rates during the winter of 2020 Less severe Compared to the early months of the pandemic.However, Nebrett said he was worried that the lack of access to vaccines, coupled with long-standing differences in access to health care, employment and other institutional and cultural factors, caused them. Masu COVID-19 disparityIn the first place, it is possible that this pattern will be reversed in the coming months (SN: 4/10/20).

“It’s really hard to say, but if you don’t understand this, I think it’s very likely that those disparities will start to widen again,” he says.

The role of the new variant in rising cases

The COVID-19 vaccine currently used in the United States is clear Valid for B.1.1.7That is, even if you get sick with this variant, you may be protected from serious illness. However, B.1.1.7 is estimated to be 40% to 70% more contagious, so Can spread more easilyAmong those who have not yet been vaccinated (SN: 4/19/21).

Lee says the UK winter outbreak shows how B.1.1.7 cases increase in the region, even though cases caused by older variants decrease. The proliferation of Michigan in cases follows a similar pattern. From mid-March to mid-April, B.1.1.7 accounted for an estimated 70% of cases in the state and identified the first mutant case only in mid-January. And this variant is clearly influential. Michigan accounted for 10% of new COVID-19 cases nationwide during the week of April 8-14, while the state accounts for only 3% of the country’s population.Hospitals in the state Canceled selective surgery To cope with the proliferation of COVID-19 patients. Also, Michigan is not the only country with B.1.1.7 issues. The CDC reports that nearly three out of four cases in Tennessee, Minnesota, and Florida are currently due to B.1.1.7.

It takes time to do the genetic testing needed to identify these mutant cases — and the United States is still Difficult to scale up Its national surveillance efforts — therefore, these data are snapshots of mid-April. Since then, new outbreaks from B.1.1.7 and other variants may have expanded.

That said, variants are not completely blaming the surge in cases. “I don’t think there’s one factor that drives everything we see,” says Natalie Dean, a biostatistician at the University of Florida at Gainesville. According to Dean, B.1.1.7 and other new variants could accelerate the increase in cases, but other factors, such as business resumption and behavioral changes, have caused people in recent months. It’s getting closer and spurring the spread of the virus.

Still, in this latest surge, there is one important metric that remains mercilessly low: mortality.The daily average of deaths Less than 1,000 since mid-March.. This number partially suggests that vaccines protect many of the most vulnerable so far.

But that’s not enough. In order for us to control the new increase in cases, the United States will need enough vaccinated people to stop the new infection. Dean sees Michigan as a warning to other states about how quickly new outbreaks can occur, but she says that’s not a natural conclusion.

“Every day we vaccinate more people, we make it [trajectory] It’s unlikely, “she says.

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