COVID update: USA July 2022

We haven’t had a post on the COVID situation in some time.  Here are some current numbers:

After last winter’s Omicron wave, the seven-day moving average of deaths in the USA fell to about 325 per day by mid-April, and has stayed close to that level for three months now. (There’s a roughly parallel pattern at the international level, with international death totals from COVID falling from about 11,000 per day in early February to around 1,500 in early May, and staying around that level since then. It’s safe to say that the international numbers are massive underestimates, but at least the pattern data is probably consistent enough to be meaningful).

Note that this would represent an annual COVID death total in the USA of around 120,000 per year, i.e., about triple what used to be considered a bad flu season (Interestingly flu mortality has fallen off a cliff since the beginning of the pandemic.)

If this plateau were to continue for the rest of the calendar year, which is of course at this point extremely speculative, we would end up with about 250,000 official COVID deaths in 2022, after 460,000 and 390,000 in 2021 and 2020 respectively.  Given overall increased mortality rates, the real COVID death totals are probably in the neighborhood of 20% higher, assuming that almost all increased mortality can be accounted for by COVID deaths attributed to other causes, which at this point seems likely.

The COVID vaccines remain extraordinarily effective at preventing death and hospitalization: until very recently, the odds of dying from COVID if someone was unvaccinated were about 20 to 30 times higher on average that if someone was vaccinated and boosted.  The latest CDC data, for April, show this gap narrowing by quite a bit, down to an eight to one ratio, but that’s still an enormous difference of course.

Unfortunately the campaign to get Americans boosted has been, given these numbers, remarkably unsuccessful: As of right now only 34% of the population over 5 years old has been boosted even once.  Why this is the case I have no idea, but it appears that far less than half of the population that has gotten the COVID vaccine has gotten even a first booster, which everyone has been eligible to get for many months now.  Eligibility for second boosters seems to vary a lot across jurisdictions; anecdotally it appears that a lot of people who aren’t technically eligible for a second booster can get one with some effort.

Also unfortunately, the vaccines seem very much less effective at preventing people from getting COVID in the first place than they were prior to the Delta and Omicron waves.  This is disconcerting, given that any real understanding of either the prevalence or ultimate epidemiological significance of long COVID still seems far off. 

I’ve also noticed a lot of people making the argument that we have no idea what sorts of health effects the virus will have several years down the road on people who were infected and recovered, which of course at this point includes far more than 99% of all people who become infected.  I really don’t know what to make of this argument in pragmatic terms, as it is by definition true of any novel virus. 

What does seem clear is that local, state, and national efforts to minimize transmission of the virus have with a few exceptions largely disappeared.  The unofficial policy consensus at this point appears to be something like get boosted – again two thirds of the population hasn’t done even this – accept that you’re eventually going to get COVID if you haven’t yet, and hope that both long COVID and potential down the road post-COVID consequences of exposure to the virus don’t turn out to be too bad.

It’s a plan of a sort — and given the populace’s evident and quite understandable exhaustion with any COVID mitigation measures nearly two and a half years into this thing, it’s probably the only realistic course of action from a public health perspective.

Still, I do think it’s remarkable that nearly two-thirds of the US population hasn’t gotten boosted, and I wonder what can be done about that.