After more than a year of pandemic, after months of an aggressive vaccination campaign, the United States should finally be better positioned to protect itself against the coronavirus. Nearly all of our long-term-care residents are vaccinated. Tens of millions of other people have been vaccinated, and tens of millions more have some level of immunity from previous infection. With more people protected, a new surge could behave differently, but early signals from the states with rising case numbers suggest that this will not universally be the case.
Just look at Michigan, the leading edge of this new surge. Cases are going up quickly, and hospitalizations are moving in lockstep—just as they have in past surges. This is a bit of a surprise. Given that so many older, more vulnerable people have been vaccinated, one might expect a divergence in the number of cases and hospitalizations. For the immunized, this disease is essentially harmless. Washington State, for example, has reported just 100 cases and as few as eight hospitalizations among its 1.2 million fully vaccinated people. But for the vulnerable and unvaccinated, COVID-19 is as devastating as it has always been.
The United States is entering a new phase of the pandemic. Although we’ve previously described the most devastating periods as “waves” and “surges,” the more proper metaphor now is a tornado: Some communities won’t see the storm, others will be well fortified against disaster, and the most at-risk places will be crushed. The virus has never hit all places equally, but the remarkable protection of the vaccines, combined with the new attributes of the variants, has created a situation where the pandemic will disappear, but only in some places. The pandemic is or will soon be over for a lot of people in well-resourced, heavily vaccinated communities. In places where vaccination rates are low and risk remains high, more people will join the 550,000 who have already died.