As far as I can tell, the current context for covid-19 in the United States is constrained and becoming more constrained. Our current condition is better than I expected eight weeks ago or even two weeks ago.
Given the current status of virus mutations, reasonable projections for vaccination rates, and continued Non-Pharmaceutical Interventions, it now appears likely most of the US can avoid another deadly contagious spike. Each additional day that covid deaths and hospitalizations decline, the less risk of resurgence.
Given past behavior by the coronavirus, my concern was not misplaced — and vigilance is justified. The virus will continue to evolve and will exploit any openings we provide.
But here’s an assessment of what has happened (and not happened) since late 2020.
The variants appearing in the United States have — so far — not been as virulent as I feared. While the variants are certainly spreading, there has not (yet) been the rapid increase in disease seen in other places. There is also accumulating evidence that current vaccines are largely effective suppressing transmission of known variants. So, as the number of Americans vaccinated continues to advance, the variant risk should decline. Well into late February I was worried that the US coronavirus testing process might be too weak to recognize a variant take-over and warn us of threats to the healthcare system. But given the continued decline in hospitalizations (more), I have finally decided that — until data demonstrate otherwise — it is reasonable to give at least as much attention to optimistic options as other options.
Further, the US population has been more self-restrained than I perceived early in the New Year. In late September US mobility was about 18 percent less than pre-pandemic. Over the final three months of 2020, mobility decreased to about one-third less than pre-pandemic — despite Halloween, Thanksgiving, and Christmas comings and goings. Over the same 90-some days use of facial coverings is estimated to have increased from about 64 percent to about 76 percent. There is now evidence that as more Americans suffered confirmed cases of covid-19, related hospitalizations, and death, millions of Americans responded by reducing their circulation and increasing prophylactic behavior. Even edging into mid-March, mobility statistics appear to be holding at about one-quarter below pre-pandemic levels.
The risk persists. We absolutely should continue to look for hot spots, especially of vaccine-resistant variants. But with reduced population circulation, individual face-to-face restraint, and with each additional vaccination, the United States is giving the virus less opportunity… and improving our future opportunities.