As of Friday, the CDC indicates that over a third of adults in the United States have received at least one dose of COVID-19 vaccine. That’s a tremendous accomplishment. It’s also not enough to have more than a tiny effect on the disease’s ability to spread through the remaining population. And as the past few weeks have shown, even though vaccinations are now running at a pace of about 2.5 million per day, COVID-19 is continuing to spread.
Encouraged by a sharp drop in cases in late January and early February, many states declared that they were “moving to stage 3” or even “reopening completely.” And multiple governors cited the idea of “trends.” But trends exist only on charts. The virus is not following a script. It doesn’t have ”momentum.” At the end of February, the rate of new cases leveled off at a number that was actually above where it was just before the massive winter spike. As state after state has stripped away mask mandates, opened restaurants for indoor dining, and allowed ever-larger social gatherings, cases haven’t just remained flat, they’ve started to rise again.
While it would be nice—or at least, more satisfying—if this was limited to a few Republican governors, but while Texas’ Greg Abbott and Arizona’s Doug Ducey may be among the most visible offenders, they’re certainly not alone. Andrew Cuomo reopened indoor dining in New York City on Feb. 12, and has pushed to accelerate reopening elsewhere in the state. Six weeks later, New York is doing something that it hasn’t done since the earliest days of the pandemic—topping the charts in daily cases. Neighboring New Jersey is once again capturing the unwanted crown for the most new cases per capita. And Michigan has seen a rise in cases that is actually steeper than that seen in November.
While trends may be nothing but illusory, the number of active cases at any given time certainly sets the stage for what happens next. Those active cases—particularly patients who are in their first week of COVID-19—represent the source of additional infections. So a large number of new cases does not guarantee an increase the following day, but it provides that possibility. But no matter how they are read, the numbers coming out of Michigan are not good.
Michigan, like many northern states, largely avoided the “summer spike” in 2020 that was centered in Texas, Arizona, and Florida, but its rapid growth in the last two weeks makes it just one of several states that are greeting spring 2021 with a fresh bloom of cases. New York is plateaued at 8,000 cases a day. While New Jersey is seeing a rise, it’s not (yet) as steep as that in Michigan.
Red states are certainly not immune to this (hopefully final) surge. Florida is still seeing cases at a rate equal to that of November and has seen an upward trend for the last two weeks. The Sunshine State has also seen a return to triple-digit daily deaths after an encouraging trend earlier this month.
While it may seem that vaccinating a third of the adult population would make a significant difference in the spread of the virus, that’s not the way it works. Original calculations based around the best estimates of COVID-19’s transmissibility set a baseline of about 65% of the population before a significant herd immunity effect would set in.
But that was before new variants like B.1.1.7, which has a higher rate of transmission. The P1 variant, originally seen in Brazil, is showing up in larger amounts in North America; it appears this variant is even more contagious (and more deadly) than the B.1.1.7 variant.
All of this is to say that vaccinating a third of adults is unlikely to significantly slow the spread of the disease. Before vaccinations can make a measurable impact on the rate of transmission, it’s likely that over half the population will need to be vaccinated, and any real “herd immunity” is unlikely to be achieved until a very large number of adults, something on the order of 80%+, have been fully vaccinated.
To that end, President Joe Biden’s announcement that the U.S. intends to continue accelerating the rate of vaccination is extremely welcome. Not only is Biden doubling previous goals for his first 100 days in office, he has authorized use of $10 billion from the American Rescue Plan to both provide vaccinations directly, and improve public outreach and messaging on the vaccine.
That the government is spending $3 billion at this point to essentially “sell” the COVID-19 vaccine may seem a bit ridiculous. By now, everyone is certainly aware of the various vaccines. Pfizer, Moderna, and Johnson & Johnson have all entered the vocabulary of Americans in a way that most corporate PR firms can only envy. With both news and social media regularly reporting the frustration that many Americans feel about their inability to get the vaccine, it might seem that vaccine promotion is the last thing that is needed.
But as polling data from Civiqs shows, over 40% of Republicans are still giving a flat “no” in response to whether they will take the vaccine, and another 10% are unsure. For states that went for Donald Trump in 2020, that could mean more than a quarter of the adult population unwilling to take the vaccine. Which makes it impossible to ever reach the level of vaccination needed for herd immunity, even without factoring in children or people who can’t be vaccinated for medical reasons.
That number has to come down if the pandemic is ever going to really end.