County-level community transmission map from the August 12 Community Profile Report. The vast majority of the country is in the red zone.
In the past week (August 7 through 13), the U.S. reported about 800,000 new cases, according to the CDC. This amounts to:
An average of 114,000 new cases each day
244 total new cases for every 100,000 Americans
18%more new cases than last week (July 31-August 6)
Last week, America also saw:
71,000 new COVID-19 patients admitted to hospitals (21.5 for every 100,000 people)
3,400 new COVID-19 deaths (1.1 for every 100,000 people)
97% of new cases now Delta-caused (as of August 7)
An average of 740,000 vaccinations per day (per Bloomberg)
COVID-19 cases in the U.S. are now solidly over 100,000 new cases a day, a benchmark not hit since early February. And, per the latest CDC estimates, 97% of those cases are Delta.
It cannot be overstated how dire the COVID-19 situation has become in southern hotspots. If one is to calculate the cases per capita in all U.S. states and countries of the world, three states make the top five: Louisiana, Florida, and Mississippi.
Top 5 cases/capita in the world in any country or state with population >1 million 1. Louisiana 121/100,000 2. Georgia (country) 100/100,000 3. Florida 99/100,000 4. Mississippi 96/100,000 5. Botswana 96/100,000 Fully vaccinated in Georgia and Botswana 6%
In these states, hospitals are filling to a degree not seen since New York City at the beginning of the pandemic. For example, in Brevard County, Florida, local officials are asking residents to avoid calling 911 unless the situation is truly dire. “Leave emergency room and ambulance trips for those with life-threatening or serious emergencies,” the county’s fire chief told CBS News.
Florida as a whole now has about 14,000 patients in state hospitals, per HHS data. During the winter surge, the state peaked at under 8,000. And more than half of patients in state ICUs are sick with COVID-19. Florida and Texas combined account for over 40% of COVID-19 hospitalizations in the country.
As this Delta surge progresses, one major challenge may be that not enough Americans are getting tested—especially those who are vaccinated. While the vaccines are very good at protecting against severe disease and death, including from Delta, breakthrough infections have become more common; if these cases are not caught, they can fuel coronavirus spread among the unvaccinated. Overall test positivity in the U.S. has been about 10% for the past two weeks, per HHS data, indicating that we’re missing a lot of those infections. In some southern counties, it’s well above 20%.
This surge’s silver lining continues: vaccinations are still going up. Almost one million new doses were reported in a single day on Saturday. But vaccination alone is not enough to completely stop COVID-19’s spread, especially when a variant as contagious as Delta has taken the reins.
Daily vaccinations in Florida are rising as the state’s hospitals become overwhelmed with COVID-19 patients. Source: CDC Vaccination Trends.
In the past week (July 31 through August 6), the U.S. reported about 630,000 new cases, according to the CDC. This amounts to:
An average of 90,000 new cases each day
192 total new cases for every 100,000 Americans
34%more new cases than last week (July 24-30)
Last week, America also saw:
54,000 new COVID-19 patients admitted to hospitals (16.4 for every 100,000 people)
2,600 new COVID-19 deaths (0.8 for every 100,000 people)
93% of new cases now Delta-caused (as of July 31)
An average of 700,000 vaccinations per day (per Bloomberg)
Delta continues to dominate COVID-19 cases in the U.S. The CDC updated its variant estimates this week, reporting that Delta made up 93% of U.S. cases at the end of July.
This variant has now solidly beat out pretty much every other COVID-19 strain—even the Gamma (or P.1) variant is now down to just 1.3%—reflecting its highly contagious properties. If you missed it, I highly recommend checking out last week’s CDD rundown of key Delta facts and figures.
COVID-19 hospitalizations and deaths are taking a serious toll on under-vaccinated hotspots in the south. Seven states—Florida, Texas, Missouri, Arkansas, Louisiana, Alabama, and Mississippi—make up about half of recent U.S. cases and hospitalizations, even though they reflect less than a quarter of the country’s total population, White House COVID-19 coordinator Jeff Zients said at a briefing on Thursday. Many hospitals in these states are turning away patients and canceling elective surgeries, as though we’re back in spring 2020.
Still, there’s some good news in this crisis. As we noted last week, vaccination numbers are rising again, with the states hardest hit by Delta leading the pack. In Florida, for example, average daily vaccinations are up from 40,000 on July 7 to 70,000 on August 7. CVS and Walgreens are reporting vaccination upticks as well. And, as of Friday, over half of the U.S. population is now fully vaccinated.
Friday just in: +821K doses reported administered, including 565K newly vaccinated. 7-day average of newly vaccinated is up 11% from last week and 44% over past 2 weeks. 50% of Americans (all ages) are now fully vaccinated. Keep going! 🇺🇸
— Dr. Cyrus Shahpar Archived (@cyrusshahpar46) August 6, 2021
According to new polling data from KFF’s COVID-19 Vaccine Monitor, Delta is indeed a vaccination motivator. About one in five unvaccinated adults surveyed in KFF’s July poll said that COVID-19 variant news “has made them more likely to get vaccinated for COVID-19.” Still, many more people need convincing: the poll found that over half of vaccinated adults erroneously believe a COVID-19 vaccine poses a higher health risk than the virus itself.
It’s tragic that thousands more would need to die for many Americans to finally get their shots. But every vaccination may potentially be a life saved.
It should be no surprise, at this point in the summer, that Delta (B.1.617.2) is bad news. From the moment it was identified in India, this variant has been linked to rapid transmission and rapid case increases, even in areas where the vaccination rates are high.
This week, however, the CDC’s changed mask guidance—combined with new reports on breakthrough cases associated with Delta—has triggered widespread conversation about precisely how much damage this variant can do. “I’ve not seen this level of anxiety from everyone since the beginning of the pandemic,” Dr. Katelyn Jetelina wrote in her newsletter Friday.
In the CDD today, I’m unpacking six key statements that you’ve likely seen in recent headlines, including where the statistics came from and what they mean for you.
1. Delta causes a viral load 1,000 times higher than the original coronavirus strain.
This number comes from a recent study in Guangzhou, China that was published as a preprint earlier in July. The researchers looked at viral load, a measurement of how much virus DNA is present in patients’ test samples; a higher viral load generally means the patient can infect more people, though it’s not a one-to-one relationship (more on that below).
Based on measurements from 62 people infected with Delta, the researchers concluded that Delta patients have about 1,000 times more virus in their bodies compared to patients infected with the original coronavirus strain in early 2020. This paper has not yet been peer-reviewed, but outside experts have cited it as evidence behind Delta’s super-spreading ability.
2. Delta causes similar viral loads in vaccinated and unvaccinated people who get infected.
This finding comes from a highly anticipated CDC report published Friday in the agency’s Morbidity and Mortality Weekly Report (MMWR). CDC researchers measured viral loads—remember, a reflection of how much virus DNA is in a patient’s body—in vaccinated and unvaccinated people who got infected during an outbreak in Provincetown, Massachusetts. They found that the two groups had similar measurements, on average. Test samples in this outbreak were also sequenced; 90% of cases in the outbreak were definitively caused by Delta.
It’s important to be precise when we talk about this CDC report, because viral load is just one specific measurement. While the viral load can reflect how capable someone is of transmitting the coronavirus, the CDC’s data do not definitively tell us that vaccinated and unvaccinated people are equally capable of transmitting Delta.
Experts commenting on the CDC’s findings have said that other factors, such as length of infection and virus presence in a patient’s nose and mouth, also play into coronavirus transmission.For example, here’s a quote from a Science News story discussing the CDC’s findings:
The result “just gives you an indication of how much viral RNA is in the sample, it tells you nothing about infectiousness,” says Susan Butler-Wu, a clinical microbiologist at the University of Southern California. These data “are a cause for concern, but this is not a definitive answer on transmissibility” from vaccinated people, she says.
And here’s a Twitter thread from a vaccine scientist discussing how the CDC has conflated viral load measurements with actual transmission:
In other words: vaccinated people are not capable of spreading Delta to the same degree as the unvaccinated. The infection and transmission risks for vaccinated people are still much lower. Here’s one reason why…
3. A breakthrough infection will be over faster than a non-breakthrough infection.
This finding comes from a study out of Singapore, published yesterday as a preprint. Researchers looked at viral loads over time for patients infected with Delta, comparing numbers for those patients who had and had not been vaccinated. They found that the viral load decreased more quickly in those vaccinated patients who had a breakthrough case, signifying that vaccinated patients both recover more quickly and lose their ability to get someone else infected more quickly.
In other words, when a vaccinated person has a breakthrough case, their immune system is more prepared to face the coronavirus. That prepped immune system will help the person avoid severe disease, while also getting the virus out of the body more quickly than the immune system would be able to without a vaccine’s help.
This study is not yet peer-reviewed, but it aligns with other research showing that vaccinated people with breakthrough cases tend to have mild symptoms and spend less time being contagious.
If you have breakthrough, yes, Ct value may be similar initially
But data suggests you clear virus faster
Thus spend less time contagious
Finally, I've yet to see data that vaccinated folks spread when asymptomatic
So
Ignore the misinformation
Vaccines really slow spread
— Ashish K. Jha, MD, MPH (@ashishkjha) July 31, 2021
4. An interaction of one second is enough time for Delta to spread from one person to another.
In spring 2020, public health leaders agreed on a rule of thumb for COVID-19 risk: if you were indoors with someone, unmasked, for at least 15 minutes, that person qualified as a “close contact” who could give you the coronavirus, or vice versa. Now, with Delta, the equivalent of that 15-minute close contact is one second. I first saw this statistic in a STAT Newsinterview with epidemiologist Dr. Céline Gounder, but it’s been reported in other publications as well.
Let me emphasize here, though, that this one-second rule applies to indoor transmission. We don’t yet know how much Delta increases the risk of outdoor transmission, which was almost entirely negligible for past variants.
5. The average person with Delta infects at least twice as many others as the average person with the original coronavirus strain.
In spring 2020, the average person who got sick with COVID-19 would infect a couple of others, while a select few would cause superspreading events. Now, we’re learning that the average person who gets Delta can infect more. An internal CDC report leaked by the Washington Post says that Delta may infect eight or nine people on average and spreads “as easily as chickenpox.”
While this comparison is obviously pretty concerning, outside experts have been skeptical of the CDC’s generalization of data from that one Massachusetts outbreak. Plus, the CDC’s estimate of Delta’s capacity for infection is higher than estimates we’ve seen from other sources. Studies out of England suggest that the variant infects five to seven people on average—still high, but not quite chickenpox levels.
6. Hospitalizations are rising in undervaccinated areas, while well-vaccinated areas are on the alert.
Florida has been setting COVID-19 records recently. The state now has more people in the hospital with COVID-19 than at any other time during the pandemic, including the winter surge.
Meanwhile, hospitalizations in Texas are up more than 300% from lows in late June. Austin is running out of ICU beds. Louisiana, Arkansas, and Nevada have all seen more than 10 new COVID-19 patients for every 100,000 residents in the past week. And the healthcare workers treating these patients are burnt out from over a year of pandemic work.
In well-vaccinated areas, hospitalizations are low for now; even with Delta, the vaccines do a great job of protecting people against severe disease and death. But hospitals in these cities are still on high alert, ready to treat unvaccinated patients and those seniors, immunocompromised patients, and others for whom the vaccines may not be as effective.
For example, see this thread from University of California San Francisco medical professor Bob Wachter. (San Francisco has the highest vaccination rate of any city in America.)
When I began my tweets 494d ago, it was before we had reliable local, US, or world data. So I focused on data from @UCSFHospitals. Today, we’re awash in data, yet I find my hospital's data still provides a unique lens into our situation. (1/20)
The TL;DR here is: Delta is way more contagious than any variant we’ve seen before. For unvaccinated people, any indoor, unmasked interaction with someone who has Delta—even a very short interaction—is enough for you to get infected. For vaccinated people, the risk of getting and spreading Delta is elevated compared to past coronavirus strains, but it is still far lower than the risk for unvaccinated people.
So, when the CDC suggests that vaccinated people go back to mask-wearing (if you ever stopped), the agency is saying, wear a mask on behalf of the unvaccinated people around you. Those who are vaccinated are at more risk now than they were in May or June, but vaccination is still the best protection we have against infection, transmission, and—most importantly—severe COVID-19 disease.
Or, to quote WNYC health and science editor Nsikan Akpan: “The vaccines will keep you from dying. Masks will keep away infections. Otherwise, the COVID odds are against you.”
In the past week (July 24 through 30), the U.S. reported about 466,000 new cases, according to the CDC. This amounts to:
An average of 66,600 new cases each day
142 total new cases for every 100,000 Americans
64%more new cases than last week (July 17-23)
Last week, America also saw:
38,300 new COVID-19 patients admitted to hospitals (11.7 for every 100,000 people)
2,100 new COVID-19 deaths (0.6 for every 100,000 people)
82% of new cases now Delta-caused (as of July 17)
An average of 660,000 vaccinations per day (per Bloomberg)
Not only is the Delta variant driving a case rise, it’s driving an exponential case rise. This week, about 466,000 new COVID-19 cases were reported; that number is more than five times higher than what we saw during the week ending July 2.
Parts of the country with lower vaccination rates are more vulnerable to Delta, of course. Current hotspots include Louisiana, Florida, Arkansas, Mississippi, and Alabama, all of which reported at least 300 new cases for every 100,000 people in the past week and all of which have under half of their populations fully vaccinated.
But Delta is now entirely dominant—causing at least 82% of cases in the country, per the most recent (yet two weeks old) CDC estimate—and every single state is seeing case surges right now. Hospitalizations are also up, 46% higher than last week, and deaths are up 33%. About 300 Americans are dying from COVID-19 every day—and almost all of those deaths are entirely preventable.
The CDC is now recommending that vaccinated people wear masks in indoor settings, if they live in high-transmission areas, have young children, or fit other criteria. While you can use the CDC’s county-level data to find your community’s COVID-19 status, it’s important to note that everyone’s risk levels are elevated right now.
Some 70 percent of American counties are, according to the map, currently on fire; that percentage will probably tick up before it drops again. For now, I am tracking my pandemic circumstances. But my boundaries for my “community” are bigger than what the map says they are. They don’t stop at my county line, or my state line. They go as far as the virus treads—everywhere. Right now, I’m masking for as many people as I can.
All that said, there’s one silver lining to this new surge: vaccination numbers are ticking up again, with the highest daily rates now in states like Louisiana, Arkansas, and Missouri where the new COVID-19 wave is hitting the hardest. The vaccines are still our best protection against Delta and other variants; more on that later in the issue.
In the past week (July 10 through 16), the U.S. reported about 184,000 new cases, according to the CDC. This amounts to:
An average of 26,300 new cases each day
56 total new cases for every 100,000 Americans
69%more new cases than last week (July 3-9)
Last week, America also saw:
19,600 new COVID-19 patients admitted to hospitals (6.0 for every 100,000 people)
1,500 new COVID-19 deaths (0.5 for every 100,000 people)
58% of new cases now Delta-caused (as of July 3)
An average of 500,000 vaccinations per day (per Bloomberg)
Cases have been rising for a couple of weeks now, but we’re now seeing the sharpest increase since fall 2020. Between July 9 and July 16, we went from an average of 15,000 new cases a day to an average of 26,000 new cases a day.
Hospitalizations and deaths are also increasing. We’re now seeing about 26% more new COVID-19 patients in hospitals every day and 36% more new deaths—it’s the first time that deaths have increased since the winter.
“There is a clear message that is coming through: this is becoming a pandemic of the unvaccinated,” CDC Director Dr. Rochelle Walensky said at a press briefing on Friday. As I’ve continually emphasized in recent issues, states and counties with lower vaccination rates are more vulnerable to the Delta variant.
Missouri continues to be a hotspot, as does Arkansas, with other states in the Midwest and South also seeing major surges. Florida is of particular concern: one in five U.S. cases in the last week were reported in this state, and Florida has seen a 109% case increase from the first to the second week of July.
The under-vaccinated hotspots are more likely to see hospitals become overwhelmed with COVID-19 patients (see: this great data visualization by Conor Kelly). But even areas with high vaccination rates are seeing Delta take over. In New York City, Delta now causes 69% of new cases—and case numbers have doubled in the past two weeks. In San Francisco, where a full three-quarters of the eligible population is fully vaccinated, cases and test positivity rates have jumped in July.
If you're wondering how bad Delta really is, even in highly vaccinated SF (76% of >age 12 fully vaxxed) & still w/ a lot of masking (most folks in stores), we're seeing a pretty steep Covid uptick. Daily cases up 4-fold (10->42; Fig L), hospital pts doubled (9->19; R)(Thread 1/4) pic.twitter.com/6JC2UlA0Sf
Despite the clear dangers of Delta, millions of Americans still refuse to get vaccinated. As Ed Yong put it in a recent piece on Missouri’s surge: “Vaccines were meant to be the end of the pandemic. If people don’t get them, the actual end will look more like Springfield’s present: a succession of COVID-19 waves that will break unevenly across the country until everyone has either been vaccinated or infected.”
The Delta variant is now dominant in the U.S., but our high vaccination rates still put us in a much better position than the rest of the world—which is facing the super-contagious variant largely unprotected.
Let’s look at how the U.S.’s situation compares:
U.S.: Delta now causes 52% of new cases, according to the latest Nowcast estimate from the CDC. (This estimate is pegged to July 3, so we can assume the true number is higher now.) It has outcompeted other concerning variants here, including Alpha/B.1.1.7 (now at 29%), Gamma/P.1 (now at 9%), and the New York City and California variants (all well under 5%). And Delta has taken hold in unvaccinated parts of the country, especially the Midwest and Mountain West.
Israel and the U.K.: Both of these countries—lauded for their successful vaccination campaigns—are seeing Delta spikes. Research from Israel has shown that, while the mRNA vaccines are still very good at protecting against Delta-caused severe COVID-19, these vaccines are not as effective against Delta-caused infection. As a result, public health experts who previously said that 70% vaccination could confer herd immunity are now calling for higher goals.
The higher infectivity of Delta means the threshold for herd immunity will be higher. 70% may have been enough before, but likely isn’t high enough against Delta, as shown by case increases in places like the UK and Israel, which have high vaccination rates.
Japan: The Tokyo Olympics will no longer allow spectators after Japan declared a state of emergency. The country is seeing another spike in infections connected to the Delta variant, and just over a quarter of the population has received a dose of a COVID-19 vaccine. I argued in a recent CDD issue that, if spectators are allowed, the Olympics could turn into a superspreading event.
Australia: Several major cities are on lockdown in the face of a new, Delta-caused surge following a party where every single unvaccinated attendee was infected. Unlike other large countries that faced significant outbreaks, Australia has successfully used lockdowns to keep COVID-19 out: the country has under 1,000 deaths total. But the lockdown strategy has diminished incentives for Australians to get vaccinated; under 5% of the population has received a shot. Will lockdowns work against Delta, or does Australia need more shots now?
India: Delta was first identified in India, tied to a massive surge in the country earlier this spring. Now, India has also become the site of a Delta mutation, unofficially called “Delta Plus.” This new variant has an extra spike protein mutation; it may be even more transmissible and even better at invading people’s immune systems than the original Delta, though scientists are still investigating. India continues to see tens of thousands of new cases every day.
Africa: Across this continent, countries are seeing their highest case numbers yet; more than 20 countries are experiencing third waves. Most African countries have fewer genetic sequencing resources than the U.S. and other wealthier nations, but the data we do have are shocking: former CDC Director Dr. Tom Frieden reported that, in Uganda, Delta was detected in 97% of case samples. Meanwhile, vaccine delivery to these countries is behind schedule—Nature reports that many people in African countries and other low-income nations will not get their shots until 2023.
South America: This continent is also under-vaccinated, and is facing threats from Delta as well as Lambda, a variant detected in Peru last year. While Lambda is not as fast-spreading as other variants, it has become the dominant variant in Peru and has been identified in at least 29 other countries. Peru has the highest COVID-19 death rate in the world, and scientists are concerned that Lambda may be more fatal than other variants. Studies on this variant are currently underway.
In short: basically every region of the world right now is seeing COVID-19 spikes caused by Delta. More than 20 countries are experiencing exponential case growth, according to the WHO:
I’m struggling with how best to stress how fragile the global situation is, so I’ll be blunt:
Each week >2.6 million cases and >53,000 deaths are reported to @WHO
We’ve already seen more COVID-19 deaths worldwide so far in 2021 than in the entirety of 2020. Without more widespread vaccination, treatments, and testing, the numbers will only get worse.
COVID-19 hospitalizations by age, via the CDC. Adults between ages 18 and 49 now make up over 40% of these patients.
In the past week (July 3 through 9), the U.S. reported about 104,000 new cases, according to the CDC. This amounts to:
An average of 14,900 new cases each day
32 total new cases for every 100,000 Americans
16%more new cases than last week (June 26-July 2)
Last week, America also saw:
14,300 new COVID-19 patients admitted to hospitals (4.3 for every 100,000 people)
1,100 new COVID-19 deaths (0.3 for every 100,000 people)
52% of new cases now Delta-caused (as of July 3)
An average of 500,000 vaccinations per day (per Bloomberg)
The Delta variant is now officially causing more than half of new cases in the U.S., per the CDC’s Nowcast estimates. This super-transmissible variant has contributed to rising cases in under-vaccinated parts of the country.
Cases are now up 16% from last week—and there may be more cases that were delayed in reporting due to the July 4 holiday. Missouri continues to be a hotspot, with 127 cases per 100,000 people in the last week; Arkansas is close behind, at 123 cases per 100,000. Both states have under 40% of their populations fully vaccinated.
Hospitalizations are also rising. We’re up to 2,000 admissions a day; this is far from the country’s peak in January (over 16,000 admissions a day), but is concerning after months of decreases. Like cases, hospitalizations are rising more in the South and West.
Numerous studies have shown that the vast majority of COVID-19 patients now in U.S. hospitals are unvaccinated. These patients are also younger, on average, than those hospitalized in earlier stages of the pandemic. Adults between ages 18 and 49 now make up over 40% of COVID-19 hospitalizations, according to the CDC; those over 65 only make up 27% of hospitalizations.
Meanwhile, vaccinations continue to slow. The U.S. administered an average of only 500,000 shots a day last week, per Bloomberg, and surveys indicate that many remaining unvaccinated Americans are unlikely to be convinced. Two changes that might be able to turn the tide, according to the Kaiser Family Foundation: full FDA approval for a vaccine and more vaccination encouragement (or mandates) from employers.
Washington is one of the states reporting high levels of detail about breakthrough cases. Screenshot via June 23 report.
For the past few months, we’ve been watching the vaccines and variants race in real time. With every new case, the coronavirus has the opportunity to mutate—and many scientists agree that it will inevitably mutate into a viral variant capable of outsmarting our current vaccines.
How will we know when that happens? Through genomic surveillance, examining the structure of coronavirus lineages that arise in the U.S. and globally. While epidemiologists may consider any new outbreak a possible source of new variants, one key way to monitor the virus/variant race is by analyzing breakthrough cases—those infections that occur after someone has been fully vaccinated.
In May, the CDC changed how it tracks breakthrough cases: the agency now only investigates and reports those breakthrough cases that result in hospitalizations or deaths. I wrote about this in May, but a new analysis from COVID Tracking Project alums and the Rockefeller Foundation provides more detail on the situation.
A couple of highlights from this new analysis:
15 states regularly report some degree of information about vaccine breakthroughs, some including hospitalizations and deaths.
Six states report sequencing results identifying viral lineages of their breakthrough cases: Nebraska, Arkansas, Alaska, Montana, Oregon, and Washington.
Washington and Oregon are unique in providing limited demographic data about their breakthrough cases.
Several more states have reported breakthrough cases in isolated press briefings or media reports, rather than including this vital information in regular reports or on dashboards.
When the CDC stopped reporting breakthrough infections that did not result in severe disease, the number of breakthrough cases reported dropped dramatically.
We need more data collection and reporting about these cases, on both state and federal levels. Better coordination between healthcare facilities, laboratories, and public health agencies would help.
Vaccine breakthrough cases are kind-of a data black box right now. We don’t know exactly how many are happening, where they are, or—most importantly—which variants they’re tied to. The Rockefeller Foundation is working to increase global collaboration for genomic sequencing and data sharing via a new Pandemic Prevention Institute.
Luckily, there is a lot we do know from another side of the vaccine/variant race: vaccine studies have consistently brought good news about how well our current vaccines work against variants. The mRNA vaccines in particular are highly effective, especially after one has completed a two-dose regimen. If you’d like more details, watch Dr. Anthony Fauci in Thursday’s White House COVID-19 briefing, starting about 14 minutes in.
New research, out this week, confirmed that even the one-shot Johnson & Johnson vaccine works well against the Delta variant. The company reported that, after a patient receives this vaccine, blood antibody levels are high enough to beat off an infection from Delta. In other words, people who got the J&J shot do not need to rush to get a booster shot from an mRNA vaccine (a recent debate topic among some experts).
Again, we’ll need more genomic surveillance to carefully watch for the variant that inevitably does beat our vaccines. But for now, the vaccinated are safe from variants—and getting vaccinated remains the top protection for those who aren’t yet.
Cases are rising in unvaccinated areas, such as Las Vegas and parts of Texas. Chart via the July 1 Community Profile Report.
In the past week (June 26 through July 2), the U.S. reported about 88,000 new cases, according to the CDC. This amounts to:
An average of 12,500 new cases each day
27 total new cases for every 100,000 Americans
9.1%more new cases than last week (June 19-25)
Last week, America also saw:
13,000 new COVID-19 patients admitted to hospitals (4.0 for every 100,000 people)
1,400 new COVID-19 deaths (0.4 for every 100,000 people)
26% of new cases now Delta-caused (as of June 19)
An average of 1.1 million vaccinations per day (per Bloomberg)
This is the first week since April that we’ve seen new COVID-19 case numbers go up in the U.S. It’s nominally a small bump—about 7,300 more cases than last week—but represents a 9% increase, and may be the beginning of a summer surge. (Even if we see a dip in the numbers this week due to the July 4 holiday.)
The culprit for this case rise is, of course, the Delta variant (B.1.617.2). According to CDC estimates, the variant makes up about 26% of new cases in the country. But, as I have explained in previous issues, the CDC data are old—that 26% estimate is as of June 19, about two weeks ago.
The Delta variant is doubling every two weeks, so we can assume that the variant now causes at least half of new cases in the U.S. Estimates from other genomic sequencing sources (which are more up-to-date than the CDC, though less comprehensive) indicate that the variant may now be causing up to 60% of new cases.
This variant poses the most danger to unvaccinated people; many of the current Delta outbreaks are happening in regions with lower vaccination rates. Nevada and Missouri, the two states with the highest new case counts last week, have about 42% and 39% of their populations fully vaccinated, respectively.
Some metropolitan areas in Missouri, Texas, and other parts of the Midwest have less than one-third of their populations fully vaccinated—and saw more than 200 new cases for every 100,000 people last week. That’s about seven times the national average for new cases.
Nationally, hospitalizations also rose very slightly this week, while deaths remained low, at about 200 new COVID-19 deaths each day. The vaccines continue to protect seniors and other more vulnerable people from severe disease. But it is likely that, in the coming weeks, these numbers will start to rise in the areas seeing Delta outbreaks. Many Midwest hospitals are already filling up.
More on vulnerable, non-vaccinated pockets later in this issue.
This week, the CDC titled its weekly COVID-19 data report, “Keep Variants at Bay. Get Vaccinated Today.” I love a good rhyme, but the report also makes a valuable point: vaccinations not only protect individuals from coronavirus variants, they also reduce community transmission—slowing down future viral mutation.
Delta, or B.1.617.2, is particularly dangerous. As I’ve written before, this variant spreads much more quickly than other strains of the coronavirus and may cause more severe illness, though scientists are still investigating that second point. Thanks to this variant, it’s now much more dangerous to be unvaccinated than it was a year ago.
The Delta variant was first linked to a surge in India, but it’s now become dominant in the U.K., Russia, Indonesia, and other countries. As Eric Topol recently pointed out on Twitter, the variant’s dominance has led to sharp rises in cases—and in deaths—for these nations.
Countries where the Delta variant has become dominant. A sharp rise in cases. In Russia and Indonesia, where vaccination rates are low, 14% and 9%, respectively, also a spike in fatalities. pic.twitter.com/8omOCq6NIY
The U.S. is somewhat distinct from the U.K., though, because we had a more diverse group of variants circulating here before Delta hit. In the U.K., Delta arrived in a coronavirus pool that was 90% Alpha (B.1.1.7); here, the Alpha variant peaked at about 70%, with several other variants of concern also circulating.
In other words: we can’t forget about Gamma. Gamma, or P.1, was first identified in Brazil late in 2020. While it’s not quite as fast-spreading as Delta, it’s also highly transmissible and may be able to more easily re-infect those who have already recovered from a past coronavirus infection.
The Gamma variant now causes an estimated 16% of cases in the U.S. while the Delta variant causes 21%, per the CDC’s most recent data (as of June 19). Both are rapidly increasing as the Alpha variant declines, now causing an estimated 53% of cases.
A recent preprint from Helix researchers suggests an even starker change in the U.S.’s variant makeup. Helix’s analysis shows that Alpha dropped from 70% of cases in April 2020 to 42% of cases, within about six weeks.
Delta will certainly dominate the U.S. in a few weeks, but Gamma will likely be a top case-causer as well. Other variants that once worried me—like those that originated in New York and California—are getting solidly outcompeted.
The TL;DR here is, get vaccinated. Don’t wait. Tell everyone you know.
COVID-19 Data Dispatch 