COVID-19 case numbers in the U.S. are on the way down, vaccines are getting into arms and spring is coming, which last year meant a decline in cases. But two experts at Johns Hopkins University said Friday that now is not the time to take the foot off the brakes.
“Where we are today is of course much better than where we were,” Dr. Jennifer Nuzzo, senior scholar at the Center for Health Security, said in the university’s weekly online briefing. That said, “there are some concerns I see emerging in the data.”
While cases in the U.S. this week were under 400,000 — a steep drop from the more than 1.5 million cases being reported some weeks over the holidays — 25 states have seen cases go up this week from the previous one, and two have seen increases two weeks in a row, which Nuzzo said was particular cause for concern. (The good news: Nineteen states have had case decreases two weeks in a row, which, conversely, is a positive sign.)
“We have come so far in starting to turn our epidemic around,” Nuzzo said, and the rollout of vaccines has been “impressive,” but until most people are vaccinated, “We remain vulnerable,” and it’s “very premature” to repeal safety measures such as mask mandates.
“I don’t want to paint too grim a picture,” Nuzzo said, “but I have to express the importance of staying the course.”
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She was also concerned about a decrease in testing, as the focus of officials and residents turns to vaccines. Testing nationwide was down more than 20% each of the past two weeks. The decline in cases could have something to do with that — as fewer people have the virus, fewer people come into contact with people who have the virus — but this downturn “predates the decline in cases,” Nuzzo said.
Without vigilance, “We could see silent spread that could come back in a quite obvious way,” she added. While “States have a very tough job” doing both, “Now is not the time to forget about testing,” Nuzzo said.
The good news comes with regard to schools. Nuzzo said the Centers for Disease Control and Prevention would announce Friday that its official guidance recommends 3 feet of distance between children in school, down from the 6 feet that has been the standard for adults, thus eliminating a major hurdle to the reopening of schools. (The CDC later announced the change.)
She emphasized that the studies that have recommended the 3-foot zone presume that all other safety restrictions, such as masks, social distancing and cohorting (forming clusters of students and staff, thus minimizing the number of people any person in a school comes into contact with during the course of a day) are still being followed.
The change, she said, “will help school districts bring students back into the classroom.”
Vaccinations
Dr. Bill Moss, executive director of the International Vaccine Access Center, had positive numbers on vaccinations: More than 115 million people have had at least one dose of a COVID-19 vaccine — that’s 15.9% of Americans age 18 and older.
Two-thirds of those older than 65 have had at least one dose, and more than one-third have been fully vaccinated — and that’s particularly important, since that age group has made up about 80% of Americans who have died of the virus.
And while demand for the vaccine still outstrips supply, Moss said, the gap is closing. In a few months, he predicted, “we’ll have the inverse of that.”
There are still a lot of disparities in who gets vaccinated, Moss said — both among traditionally disadvantaged communities as well as among people who see the vaccine through a political lens.
He cited a recent poll that found 41% of Republicans (including nearly 50% of Republican men) and 31% of independents would refuse to get vaccinated, whereas only 11% of Democrats said they would refuse. The Biden administration is spending $1.5 billion on an information campaign about vaccination, and, “A lot of work needs to be done in … correcting misinformation and disinformation,” Moss said.
He also recommended “A Shot In the Arm!” a recent Don Brown graphic nonfiction book on the history of vaccines, to help “understand the great progress that we’ve made” in immunization that made the fast development of COVID-19 vaccines possible.
Taking a question from the viewing audience, Moss said people who have had COVID-19 should still get the vaccine. While having the virus provides immunity, it can vary, he said. “The immune response to the natural infection is highly variable, but we know that the vaccines are highly protective.”
Moss added that studies are starting to show that some COVID-19 patients have a strong immune response after only a single dose of the two-shot vaccines from Pfizer and Moderna. We may see recommendations that people who have had the virus only need on dose, Moss said, but at the moment that’s unknown.
While the one-shot Johnson & Johnson vaccine remains “highly protective against severe disease, hospitalization and death,” Moss said, a study is looking into whether two shots may eventually be recommended.
He added that the variants, particularly the best known ones — those that were first reported as coming from the UK and South Africa — may put a dent into vaccine effectiveness, but they still work well. The Johnson & Johnson shot was studied in South Africa while that variant was circulating, and there was a bit less effectiveness — 64% versus 72% in the U.S.
The Moderna and Pfizer vaccines were developed before the variants were discovered, so there aren’t any large-scale studies, Moss said, but lab tests have found that they may be less effective against the South African variant but “still thought to be effective.” All three current vaccines seem highly effective against the UK variant, he said.
Third wave?
Nuzzo pointed to a so-called third wave of the coronavirus in Europe, and said such a development “remains a possibility for certain” in the U.S., although there are two differences — one positive, one negative.
The negative reason we aren’t likely to have a third surge is because the U.S. has had more cases already, so more people have developed natural immunity. The positive reason is because the U.S. is doing a better job distributing vaccines.
Still, she said, “We are by no means guaranteed to be spared.”
