December 15, 2021 - Getting through it Together

Getting through it Together

December 15, 2021

Today, the United States observed an official marker that will haunt this nation for generations. More than 800,000 Americans have now died of Covid-19. Eight hundred thousand is almost certainly an undercount, yet there it is - more than the entire population of Seattle, Denver or Washington, D.C. To put that number in perspective, consider this: 38,000 Americans die in car crashes each year; between 12,000 and 52,000 die from the flu; and 150,000 suffer fatal strokes.

No group has suffered more than older Americans. One of every 100 adults age 65 and older in the United States has been killed by the virus, which is equivalent to about 600,000 deaths. A CDC analysis of “excess deaths” has found that 18% more older Americans died of all causes in 2020 than would have died in an ordinary year, challenging the notion that older virus victims were dying anyway of something else. After bearing the heaviest burden in this pandemic, it is no wonder that 87% of American seniors above the age of 65 have elected to get vaccinated (79% in Alabama). If only younger generations would follow suit ….

While the Delta strain is responsible for the current wave in the Northeast and Upper Midwest, Omicron has been detected in 35 states and is overtaking Delta as the dominant strain in some of them. In New York and New Jersey, for instance, Omicron is the cause of 13% of new cases, 4 times the national average. Although Omicron has not been sequenced in Alabama, we are surrounded on all sides by states that have detected it.

A new South African study of over 200,000 positive test results has confirmed a lot of what the preliminary data showed: (i) the risk of reinfection is substantially higher with Omicron than prior variants; (ii) 2 doses of the Pfizer vaccine provide just 33% protection against infection but 70% protection against hospitalization; (iii) more children test positive with Omicron; and (iv) most cases so far are mild with recoveries usually within three days. The most common early symptom reported was a scratchy throat, followed by nasal congestion, dry cough and myalgia, or aches, manifesting in lower back pain. There was less evidence of respiratory infections, with fewer patients requiring oxygen.

It is difficult to know what this South African study portends for the U.S. because the population in South Africa is much younger than in the United States. Since booster shots are still quite rare in South Africa, Pfizer’s lab studies - which show 75% vaccine efficacy against Omicron after a booster shot - could not be put to the test.

Here is where things stand in Alabama before Omicron’s arrival. Over the last 4 days since my previous letter, 2,085 new cases have been reported (excluding a dump of 841 positive tests between 3/20/2020 and 12/6/2021). During the same 4 days last week, there were 6% fewer cases - 1,959 to be exact. Last week, Alabama hospitals averaged 3.46 patients per reporting hospital, which is identical to the hospitalization rate today. In other words, Alabama seems to be in a holding pattern while we wait.

I don’t expect we’ll have to wait long for Omicron to make its appearance. Given our low vaccination rate, the daily case counts should begin to rise sharply soon, but it’s too early to forecast the impact on Alabama hospitals. I could be wrong, but I don’t anticipate a repeat of last winter’s wave or the horrific Delta wave in August and September. If we are fully vaccinated and boosted, and use common sense, we will get through this latest challenge together. The totals:

12/1 - 536

12/2 - 767

12/3 - 595

12/4 - 478

12/5 - 361

12/6 - 281

12/7 - 630

12/8 - 687

12/9 - 549

12/10 - 592

12/11 - 713

12/12 - 330

12/13 - 294

12/14 - 814 (excluding 841 older cases)

12/15 - 647