It has now been almost exactly one month since I had anything noteworthy to say about the U.S. COVID-19 trend. Rather than continue to repeat the same story (average new case counts are falling, we’re still looking for any sign of a winter wave, vaccinations are flat), I’m going to stop these daily postings on COVID-19 trends.
Maybe I’ll do a weekly update, until such time as there is any material change.
Let me wrap up where things stand in the U.S. as of 10/22/2021.
In a nutshell, the entire U.S. COVID-19 scene is stagnant. Seems like we’ve reached an equilibrium, for the time being.
Our daily new case rate is stuck at a high level in many northern states. Nothing devastating, outside of a few excess deaths from lack of hospital capacity in a few areas. Not going up, but not coming down either.
Our vaccination rate is stuck, with new vaccinations having slowed to a trickle. People aren’t even getting booster shots very much now, after an initial flurry of interest.
In short, as of now, to me, this looks like the new normal. Keep your antibodies up-to-date — or not, depending on your tolerance for needless risk — and, barring bad luck, the worst you’ll get will be something like a bad case of the flu.
And what of the one-to-two percent of formally-diagnosed new cases who end up dying, the eight percent or so who end up hospitalized, and the unknown percent with long-term effects? You’ll just have to hope that’s somebody else’s problem.
I’ll keep tracking it, and if I see any material change I’ll surely post about it. But it’s a waste of everybody’s time to keep posting the same story day after day.
Cases and trend.
The U.S. as a whole continues to see declining counts of new COVID-19 cases. Currently, we’re 54% below the 9/1/2021 peak of the Delta wave.
But that’s mainly due to declines in the South and West. The Mountain states and the Northeast have more-or-less plateaued since September. That’s no longer true of the Midwest, due almost entirely to Illinois, which accounts for a large share of the population in that region and has been showing declining case counts.
In terms of a “winter wave”, as of right now, it looks more like a winter “muddle through”. We have persistently high new-case rates in a lot of northern states. But that’s it. Not “high-and-rising”, just “high”.
Impact of vaccination.
Source: Calculated from Virginia Department of Health COVID-19 dashboard.
This is now very much a pandemic of the unvaccinated, and has been for some time. So no matter what nonsense you read in the popular press or on-line, don’t let the bullshitters fool you. The press is always geared toward reporting man-bites-dog stories, and so tends to ignore the bigger picture. The bigger picture being that the vaccines are working just about exactly as they were expected to.
In Virginia, the observed efficacy of the vaccine seems to run in the neighborhood of 90%. In a typical week, the infection rate for vaccinated individuals is about 10% of the infection rate for the unvaccinated. That’s right in line with the clinical trials data, where the observed vaccine efficacy was somewhere in the high 80 percents, on average, for the first six months of vaccinated status. So both theory (controlled clinical trial) and practice (observed data as-used) tell you that the vaccines are working well.
The commonly-repeated statement that vaccines are truly exceptional at preventing deaths does not show up in the observational data from Virginia. I suspect this occurs largely because the un-vaccinated are younger individuals at low risk of death. (So these un-adjusted observational numbers confound the impact of vaccines with the fact that the unvaccinated are low-risk in the first place).
Source: Calculated from Virginia Department of Health COVID-19 dashboard and downloadable data sets.
Even with that caveat, my main takeaway is that most of the protection you get from vaccines is that they prevent you from getting infected in the first place. Vaccines further reduce your odds of death, once infected, but by a much more modest amount.
In sum, based on the un-adjusted observational data from Virginia, from vaccination you get:
- About a 10-to-1 reduction in risk of infection.
- A further further N-to-1 reduction on top of that, in terms of risk of death, where N is much smaller than 10.
Trend in vaccinations
Facts and logic aside, pretty much everybody who wants to get vaccinated has done so. Somewhere down the road, we’re slated to get an OSHA-based mandate for vaccination (or weekly testing) for a large swath of the U.S. workforce.
The piecemeal mandates that firms and local governments are imposing get a lot of press. But they aren’t material in terms of the overall rate of new vaccinations. As of today, per the U.S. CDC, the vaccination trend is down, whether measured by new persons fully-vaccinated (first graph), new persons with at least one dose (second graph), or even by total doses administered per day (third graph).
FULLY-VACCINATED:
AT LEAST ONE DOSE:
TOTAL DOSES INCLUDING BOOSTER SHOTS:
Source: CDC COVID data tracker.
That last graph is particularly telling, because even the people who got vaccinated aren’t very motivated to get booster shots. You can see a little blip as of about two weeks ago. After which total doses delivered returned to its downward trend.
You may see a flurry of activity once shots are generally available for kids age 5-12, but I wouldn’t bet much on that. We’re now five months into the period during which children 12 and up could get vaccinated. And after five months, about half have done so.
Source: CDC COVID data tracker.
For children, it’s not so much that they themselves typically face serious consequence. Hospitalization and (particularly) death from COVID-19 are exceptionally rare in that population. It’s more that they remain a vector for transmission of disease. It’s not a hugely disproportionate source of new infections. But it’s not as if that source of new infections is going to get shut down any time soon, either.
Maybe.
I guess we get what we deserve. Maybe. If we’re lucky.
We have a tool — vaccination — that is, in theory, completely capable of driving this new virus out of circulation. But we, as a tool-using species, are not quite smart enough, on average, to use it.
And so, we’ll just continue to muddle through and turn a blind eye to the cost, as long as possible. Not just the cost in morbidity and mortality, but the actual dollars-and-cent cost in health care use.
FWIW, I did a quick back-of-the-envelope on what an actuarially-fair surcharge would be, for private health insurance, for lack of COVID-19 vaccination. The idea being that the choice to remain unvaccinated raises expected future health care costs. My best guess, based solely on cost of hospitalization, at current U.S. infection rates, was 8 percent. The unvaccinated working-age population ought to be paying an 8 percent health insurance premium surcharge, based solely on the cost burden of the additional COVID-19 hospitalizations incurred within that population. That’s how much COVID-19 matters in terms of overall U.S. health care expenses right now.
But that’s never going to happen. People who choose not to get vaccinated will continue to freeload as they do now. Just as the parents of unvaccinated children can depend on their children to be protected anyway, thanks to the herd immunity created by the vaccinated children of responsible parents.
Maybe we’ll eventually have enough people infected that herd immunity will drive this particular disease out of general circulation. And that would be great, because we certainly don’t seem to be on track to achieve that via vaccination.
Barring that, looks to me like this is just the way the world works now. At the outset, we were caught by surprise. But we now have the pandemic we deserve.
