Are we plateauing too high for winter?

And, why boosters are important


After a much needed decline in cases, hospitalizations, and deaths, the US is again seeing increases in cases and positivity rates. We have plateaued at around 80,000 cases per day - which is really high. Look at the graph above at the curve inching back up again. Now compare that to where we were last year at the same time. The take home message - we are starting this winter-2021-curve higher than the one last year in October. This curve is due the Delta wave - which is worrisome because Delta is more infections than the other previous variants.

Now, let’s look at Europe. Since the beginning of the pandemic, Europe has reliably served as a sign of what’s to come in the US in a few weeks. Usually what happens in Europe happens in the US a few weeks later. Before we look at cases, let’s compare vaccination status between the US and UK.

The UK has a higher proportion of the population fully vaccinated than the US. Yikes. So, the surge we are seeing in the UK is not adequately protected with their vaccination rates - this should be a strong signal to us in the US to double down on mitigation efforts, roll out vaccines even more, and get boosters to people that need them. Dr. Eric Topol, one of the leading trusted voices during this pandemic, talked about this in a Guardian article:

In fact, it has been projected for Delta that any country needs to achieve 90-95% of its total population fully vaccinated (or with recent Covid) in order to have population-level immunity that covers, providing relative protection, for the others.

Key among the unvaccinated are teenagers and children. For European countries, the UK was slower in starting their vaccination program for teens and that has been suggested as one of the reasons their cases started rising again. There is compelling data from both the UK and United States that children and teens have been a key driver of spread in recent months.

Now let’s compare the rise in cases and deaths between the UK and US.

Notice the swift increase in the UK case curve with the US following behind by about 2 weeks after our decrease. Also notice that deaths in the US are already higher than the UK. Going into the winter season and with LOWER vaccinations rates than the UK, this is not good.

Test positive rates are also higher now in the US than the UK. We are inching up to the 10% level very quickly. Remember test positivity rates are an indication that we are not testing enough to catch infections in the community.

What to do?

  1. Don't delay on getting your boosters. Get your booster if you can. So far, only 13% of those eligible for a booster have received it. We know that vaccine protection wanes over time and that boosting will give a major “boost” to your protection against Delta - both in regard to symptomatic disease and severe disease. I got my mRNA booster last week after I got J&J in March. Remember that it takes around 2 weeks for full protection to occur. So, get it now before the holidays and before the winter surge takes off.

  2. If you are in an area with low vaccination rates and high spread, definitely get your booster, wear your masks, and limit indoor activities. Pull back your activities a bit more with the start of this new wave.

  3. Be careful about Thanksgiving. IF everyone is vaccinated (including kids), I feel comfortable in meeting. IF everyone is not vaccinated, they need to be tested prior to coming for the holidays - this includes children too young to get vaccinated. This uptick in cases we are seeing right now is worrisome. Please take that into account when you’re thinking about gathering for the holidays - especially if you will have high-risk people coming.

Stay safe, friends. Vaccinate, boost, mask, and distance. This pandemic is not over at all. We are all weary - I get that! So do what you have to during this winter to take care of yourself. I would recommend limiting social media, news intake, certain friends if you need to, and increasing walks outside, puppies, and silly cat videos. =)


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