Dr. Walensky’s concerns.

First, I would like to state that I greatly appreciate new CDC Director Rochelle Walensky. She is very articulate and, unlike her predecessor, appropriately tries to get ahead of issues. It is a very pleasant change!

Rochelle Walensky expressing her concerns yesterday.

Therefore, I was extremely concerned when yesterday, Monday, she issued an urgent plea to Americans.  She commented that she has begun experiencing a “recurring” feeling of “impending doom.” She continued by saying, “We have so much to look forward to, so much promise and potential of where we are, and so much reason for hope, but right now I’m scared.”

Her plea was basically that people should continue following public health measures. It was prompted by news that positive Covid-19 cases have increased this week by 10.6%, compared to the previous seven-day period. Hospitalizations and deaths, which usually trail positive tests, also rose over the last seven days, by 4.2% and 2.6%, respectively.

Daily cases of COVID-19 in the US since the start of the pandemic. Note the slight uptick over the past week. Red lines are the 7 day averages.

New cases in the U.S. have shown slight increases. In contrast, the overall numbers remain low compared to earlier points during peaks of infection, but they remain plateaued.

In the past, increases like this led to additional waves of infection leading to Dr. Walensky’s concern. While I share Dr. Walensky’s concern, the current picture is a bit more complex.

Looking at rates of positive tests there are only 11 states responsible for this increase.

Rates of positive coronavirus tests in the 50 states. Notice only 11 states show elevated positive tests.

Most of the new cases come from a few states, predominantly in the north east and Michigan, where restrictions have been eased. Importantly, these states also were very slow on their vaccine rollouts. Of interest, Texas, which has totally removed state-enforced restrictions has not seen as high an increase as Michigan or New Jersey, that retain restrictions. Florida is one big party with spring break

New patient hospital admissions have plateaued despite increases in infections.

Despite this, new hospital admissions or overall hospitalizations have not increased. While this may be trailing the increase in infections, which is Dr. Walensky’s concern, it may actually be due to vaccinations in the elderly in the U.S. This has markedly suppressed hospitalizations in the most vulnerable age groups suppressing overall numbers. In many states the new hospitalizations are coming from younger individuals.

Hospitalizations in the over 65 population (red line) and 50-64 year olds (dark blue line) have dropped precipitously since vaccinations began.

So is Dr. Walensky correct in being concerned that numbers are going to take off? It is disconcerting that in states that kept their populations highly protected, many released restrictions before most people were vaccinated. This raises the possibility of a “catch up” of new infections in young, COVID-19 naive individuals that is responsible for this new wave of infection. This may be the real cause of the rise we are currently seeing.

One thing for sure, states like Michigan that practiced more deliberate restrictions should have facilitated the vaccination of their entire population before they released restrictions.

Published by jbakerjrblog

Immunologist, former Army MD, former head of allergy and clinical immunology at University of Michigan, vaccine developer and opinionated guy.

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