The status of the pandemic in the U.S. on January 20, 2021

Today I look at where the pandemic is on Inauguration Day in the U.S. There is a real mix of disconcerting and hopeful signs.

U.S. total deaths from COVID-19 have exceeded 400,000. This number is close to the worst case scenario from many of the public health models. At this point almost everyone knows someone who has died from COVID-19, and most know a person who was not elderly and who died unexpectedly from COVID-19. This is the most difficult aspect of this pandemic.

New cases of COVID-19 and new deaths remain at very high levels, suggesting the virus is endemic in the U.S. population. Most of us have a relative or close friend who has been infected, and new cases hover about 200,000 per day.

Despite this, as is shown above, the trends in new cases and deaths are downward. As one looks at the U.S. map, most of the country has seen reduced numbers of new COVID-19 infections over the past seven days.

We also are far enough out from the year end holidays to believe that the surge in infections due to travel at those times has ended. This would suggest that these downward numbers could be better sustained with social distancing.

So what do we do next? Do everything we can to keep infections low while vaccinating as aggressively (with two doses) as possible. The fewer infections, the less chance for mutations in SARS-CoV-2 that could prove harmful. Three to six months should do it.

Following the infection numbers and calculated R values (degree of transmission) will tell us when we are suppressing the pandemic. That is a crucial assessment for the CDC.

In addition, however, we also need to start sequencing viral isolates to determine mutation rates in SARS-CoV-2. This will give us an idea of changes in the virus and mutations that potentially could evade vaccine protection.

Fortunately, none of these types of mutations has yet occurred. Since we can modify the RNA vaccines in as short as six weeks, having a heads up on this information will make us able to continue to protect individuals regardless of what the virus does.

We need to do better with vaccinations, but if trends continue and vaccinations do pick up, we could be in a much better and more normal place by the end of next summer.