You’ve heard it before, but it’s true: this summer in America is going to be so good. After a year of Covid-19-induced fear, the US vaccination campaign and warmer weather will give the country a much-needed respite from the coronavirus and all the horrors it has caused.
But what happens after the summer?
Last year we saw that the coronavirus spreads more easily in the fall and winter than in the warmer months. More than 330,000 Americans have died from Covid-19 in six months in the fall and winter – an unimaginable death toll, accounting for nearly nine times all car crash deaths in 2019 and more than 17 times all murders .
One of the causes was the country’s relaxed response to the coronavirus, as much of America has let down its guard and precautions. But experts also blame the seasonality of Covid-19, as lower temperatures have pushed people indoors, where the virus spreads more easily and families have gathered for the holiday season.
America is in a much better place than last fall and winter. A combination of vaccines and natural immunity against past Covid-19 infections suppresses the virus. But the country is not yet fully clear: The majority of the U.S. population is still unvaccinated, and the daily immunization rate has slowed dramatically, now standing at about half of what it was at its peak at. mid-April. .
Then there are the coronavirus variants. Vaccines do a good job of overpowering known variants, based on research, but at least some variants seem to overcome some natural immunity. So, people in the United States who are not vaccinated but have previously had Covid-19 may still be vulnerable. Some experts are also concerned that the natural immunity to a previous infection may not be long lasting – perhaps waning over time, potentially in time for a tidal wave. (Vaccines raise similar concerns, but vaccine-induced immunity has so far been shown to be better than natural immunity in research trials.)
There is also a risk that the warmer weather and the potential seasonality of the virus will in some sense give the country a false sense of security. By letting much of the United States (but not all) safely socialize outside, as Covid-19 cases and deaths continue to decline, there is a risk that people will leave the virus too quickly – and the unvaccinated people will come to believe, if they don’t already have it, that they don’t really need to be vaccinated.
All of these factors – vacations, colder weather, variants and at least some decrease in immunity – could combine to create a return of Covid-19 this fall and winter. Experts I’ve spoken to don’t believe this will be a huge nationwide push – too many will be vaccinated by the fall for this to happen. But especially in areas of the country where vaccination rates are low, there could be spikes in coronavirus at the local or state level.
“It could happen – if we really stop our immunization coverage,” Jen Kates, director of global health and HIV policy at the Kaiser Family Foundation, told me. “If we increase our vaccination coverage, it worries me less.”
This is no reason to despair. Especially if you are vaccinated you are extremely safe from Covid-19. Rather, it’s a call for more people to get vaccinated – it’s the only way the country can guarantee that another fall or winter wave never happens.
We are still not done with the pandemic
The news on Covid-19 in the United States is truly amazing right now. Almost half of the country has received at least one dose of the vaccine. New daily coronavirus cases are less than a 10th of what they were during a peak in January, and deaths are also down by more than 85% from January. Higher vaccination rates, declining cases and deaths, and warmer weather will soon allow us, if they haven’t already, to safely engage in the kind of social interactions that were dangerous. barely a year ago.
This is all really fantastic and exciting news. Personally, I am planning trips and vacations that I would have been too scared to take a year ago. I no longer wear a mask unless required by law or by the companies I operate. I will be seeing friends and family very soon that I haven’t seen for a long time. As a person who has been vaccinated, I no longer worry at all about my own risk of Covid-19 – and many experts also share this view.
But this optimism can be taken a little too far. Although things have improved, they are not yet completely back to normal. Covid-19 cases and deaths are still near or above levels considered quite high last summer. More than 60% of the country is still not fully immunized and more than half have not received at least one vaccine. In some states, vaccination rates are even lower – two-thirds of the population have yet to receive a single vaccine.
“It’s good to celebrate at this point,” Mauricio Santillana, a researcher at Harvard Medical School and Boston Children’s Hospital, told me. “But we cannot be fully convinced that this is the end.”
This large unvaccinated population means that many people remain vulnerable to the virus. We don’t know what level of vaccination is needed for herd immunity (the level of immunity that ensures infections won’t spread within a community), but experts estimate that at least 60% will be needed. of the vaccinated population and maybe as high as 85 or 90 percent, partly depending on the variants we are dealing with.
The remaining vulnerabilities could also increase. The natural immunity may wane over time or more infectious variants may appear. As fall arrives and the weather cools, people are redirecting their activities to poorly ventilated indoor environments where airborne viruses can spread more easily. People could let their guard down too much, especially if Covid-19 cases continue to decline over the summer.
“I think in the fall and winter things will be a lot better,” Ashish Jha, dean of Brown University School of Public Health, told me. “But we could very well see a bump, and we may need to put in place mild public health restrictions for short periods of time if we see an increase in cases.” He added: “We have to be ready.”
Imagine a potential scenario: cases and deaths continue to decline. Summer brings a revival of social activities. Covid-19 is starting to look like a thing of the past. The precautions related to Covid, legal and voluntary, are largely ruled out. In this environment, people who have yet to receive the vaccine decide that they may not need it – after all, the virus is no longer really a threat today. As a result, cases and deaths are falling, as are vaccination rates.
Then the fall comes. More and more people are moving indoors, traveling and gathering for the holidays. Perhaps a new variant is becoming the dominant form of the virus in the United States. At the same time, the natural immunity may be weakened. In a few parts of the country, such as the South and Midwest, a large portion of the population is still unvaccinated. Suddenly, the virus begins to grow locally, or maybe even beyond, especially if vaccination rates are low statewide. Local and state governments can be slow to respond, resistant to reinstating the restrictions they recently celebrated ending.
This scenario is not guaranteed. Maybe the vaccines are so good that it turns out that the current US vaccination rates, along with the natural immunity that may prove to be more durable than previously thought, is enough. to keep the coronavirus at bay.
But it is a risk. And that’s unnecessary since there is a good way to avoid it.
There is a solution: vaccinate more people
The vaccines are excellent. Evidence from clinical trials and the real world has shown that they almost eliminate the risk of serious illness, hospitalization and death from Covid-19. In Israel, which has the world’s most advanced vaccination campaign, a 60% vaccination rate has kept the country almost completely open and seeing daily Covid-19 deaths drop to single digits or zero – a big improvement for a country that has seen some of the world’s worst coronavirus outbreaks.
But vaccines can only do their job if more people get vaccinated. America is not at the 60% rate of Israel. And there’s a good chance the United States has to go further than that – given that reopening Israel still involves mask warrants and vaccine passports, which Americans increasingly reject.
As long as there are “pockets of people who choose not to vaccinate, you leave the door open for Covid to come back,” Santillana said. “We must remain vigilant.”
For lawmakers and other leaders, that means doing more work to get people vaccinated. Experts called for a three-tiered approach: improving access, providing incentives and imposing certain mandates if necessary. This could mean, at the state level, partnering with entertainment and transportation venues to offer on-site photos, provide financial or other rewards to those vaccinated, and push schools, including colleges, to demand vaccinations. It could also mean, on the private side, that employers offer vaccines on site, distribute bonuses to the vaccinated and require vaccination to return to the office.
For the public, this means more people are choosing to be vaccinated. One thing that might help here is for people who have been vaccinated to share their stories, given that nearly one in five people are on a wait-and-see basis with vaccines, largely on hold until the people around them walk away. get vaccinated.
America has just passed through a pandemic year with so much uncertainty. He has a chance to eradicate one of the remaining uncertainties – and the risk of another fall and winter wave – if as many people as possible get vaccinated. But it’s up to everyone to make this happen.