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The United States has spent months trying to vaccinate those most at risk for serious Covid-19 disease, from health care providers and the elderly, to essential workers and those with other underlying medical conditions.
In the coming weeks, data on Covid hospitalizations and deaths will show if this strategy works.
The rises in case the figures have translated weeks later to increase hospitalizations and fatalities, a dynamic that should decrease after vaccination of the most vulnerable. While there are early signs of occurring in places like nursing homes, it remains to be seen whether it will stay with other at-risk groups and with younger people. And the moment of truth comes like infections increasing again in many states.
“It will be a test of the effectiveness of our vaccination campaigns to reach at-risk populations,” said Josh Michaud, associate director of global health policies at the Kaiser Family Foundation, an independent nonprofit organization. All states have chosen at least those 65 and older, which means “you’re eliminating something like 80% of the population most at risk of dying.”
The growing proportion of Americans who have received vaccines against Covid-19: about 26%, or more than 87 million people, have achieved at least a dose: represents a turning point in the trajectory of the pandemic and a watershed moment for the United States, where the virus has sickened at least 30 million and killed more than 547,000.
However, most people in the US are not yet protected. And there are significant obstacles to the U.S. race to stay ahead of the virus, including vaccine hesitations and barriers to access, declining testing, and the emergence of more contagious variants.
While the number of new cases, hospitalizations and deaths will remain an important indicator of the state of the pandemic, there is a blatant need for more accurate ways to measure Covid-19, according to public health experts.
“Knowing where we have a problem by community and by source is very important to control the pandemic as we move forward,” he said Ali Mokdad, a professor at the Seattle Institute of Health Metrics and Assessment, who produces influential projections of Covid-19. “Otherwise, we want the blind.”
Younger shift
At least for some groups, vaccines against Covid reach the target audience and do what they are supposed to. Among those 65 and older, an early demographic group to qualify for inoculation, approximately 71% have received at least one dose, according to the Centers for Disease Control and Prevention data.
In nursing homes, where residents were also given priority for gunfire, Covid cases among residents have dropped nearly 98 percent since mid-December and deaths by 88 percent, according to CDC data, which industry officials have linked to vaccines.
This means that new cases of Covid are likely to appear in younger age groups. This occurred in Israel, where infections recently spread despite the country’s leading vaccination program. It turned out that cases among young people were increasing, even as infections fell in people aged 50 and over.
Younger people, although believed to be less likely to have symptoms, can still spread the virus and get serious cases. In a handful of states, for example, those with underlying medical conditions still do not meet the requirements to receive shots.
Vaccines work
Residents of nursing homes watch Covid-19 infections fall, dead
Source: CDC National Health Security Network
While it’s “extraordinarily good news that our mortality rate is declining in vaccinated people, there is still a mortality rate among those over 20,” CDC director Rochelle Walensky said in a session this week. White House information. “As these cases continue to increase in this demographic, we will also see mortality rates in this demographic.”
These risks are first and foremost in West Virginia, which expanded eligibility this week in an effort to stop the transmission of the virus among young people.
“We believe this will save us more time,” said Clay Marsh, West Virginia’s Covid-19 coordinator and executive dean of health sciences at the University of West Virginia. “We would love to keep the variants at bay and try to vaccinate the rest of the population.”
In Michigan, where Covid infections are on the rise again, the proportion of hospitalizations and cases is significantly lower than in October, the last time the state experienced an increase of this magnitude. Approximately 69% of its cohort aged 65 and over, which has typically accounted for half of Covid’s hospitalizations and about 4 out of 5 deaths, now have at least one dose of vaccine.
Still, the The Michigan Health & Hospital Association has sounded the alarm this week about hospitalizations growing in younger age groups: since early March, they have risen 633% in their 30s and 800% in their 40s. Covid-19 vaccines work, but also “that adults of any age are vulnerable to complications from the disease,” the group said.
Strong tool
While expanding vaccination coverage is key to the U.S. recovery, it also threatens to further separate an already fractured national pandemic response.
Take, for example, levels of evidence, which are the way U.S. cases are identified and accounted for. In recent months, these levels have stagnated and have even recently begun to decline.
“We have completely shifted our focus to vaccines at the expense of testing,” even states have turned test facilities to administer shots, said Jennifer Nuzzo, a scholar at the Johns Hopkins Center for Health Security, who he added that “we are potentially losing some knowledge about where the virus is and where it is not, and about how quickly it is spreading.”
And while there are other ways to monitor Covid trends known as surveillance, such as doing more specific testing in places like travel centers, nursing homes, or prisons, which never started operating in the United States, he dir Nuzzo.
This is important because as vaccination coverage expands, virus outbreaks are likely to spread.
“People would be surprised to see the number of people who are not yet vaccinated, especially among vulnerable groups,” said David Rubin, physician and director of PolicyLab at Philadelphia Children’s Hospital, which has been modeling the spread of Covid -19.
CDC epidemiologist Adam MacNeil said in an interview that the agency is establishing surveillance systems to track Covid-19 reinfections and cases where people who have been immunized become infected, to accompany efforts to long duration to track and model infection levels.
Federal and state officials have made virus data available to the public at the county level, but more accurate views on who is affected are often lacking, according to Mokdad of IHME and others. Case and hospitalization data by age group and race or ethnicity, for example, are infrequently and inconsistently available at the county level, according to Rubin of PolicyLab.
“We don’t even have that, a year after the pandemic,” he said.
– With the assistance of Jonathan Levin and Jill R Shah