January 27, 2022 - Two Covid Americas

Two Covid Americas

January 27, 2022

The United States clearly has reached an inflection point in its Omicron surge. 33 states (plus D.C.) have experienced double-digit declines in reported cases over the last 7 days, and cases have dropped 21% nationwide over the same period. Hospitalizations have also dropped, but less steeply - only 8% over the last 7 days. 16 states (plus D.C.) have seen double-digit declines in patients during that time period.

In Alabama, cases are down but hospitalizations are up. Since my last letter on January 23, the State has reported 37,639 cases, a 21% decline compared to the same 4 days last week. If you look back over 7 days, the decline is just 15% compared to the prior week. However, just as the ink dried on my last letter, we saw a sharp increase in the number of Covid-related patients in Alabama hospitals. Today, there are 3,228 statewide patients (according to the U.S. Dept of Health & Human Services), exceeding the highest level during the Delta surge (3,116) and 96% as high as the record total on January 4, 2021 (3,355).

West Virginia, Alabama and Nevada have the highest per capita hospitalization rates in the nation (69, 66 and 66 per 100K population, respectively), with Kentucky not far behind (63 per 100K). Alabama’s rate of hospitalization growth has slowed modestly (up 6% this week). Given our poor vaccination rate (49% of the population), our hospitalizations will likely continue to rise.

“Two Covid Americas” is the title of a column written by David Leonhardt, senior writer for the New York Times, based on his analysis of a series of recent polls examining Americans’ attitudes toward pandemic risks. Leonhardt’s analysis gave me greater insight into Alabama’s current risk profile. According to the polls, there is significant uniformity in the way Americans of every demographic group view their level of concern about Covid. Young and old, men and women, rich and poor and middle class - they all have broadly similar attitudes about Covid risk.

The only demographic that makes a difference - and the gap is huge - is political affiliation. 65% of Democrats say they have made changes to their daily lives to prioritize public health (91% of Democrats are vaccinated), while 30% of Republicans have said the same thing (only 60% of Republicans are vaccinated). Then, there is this startling statistic: 68% of vaccinated + boosted Americans are reportedly either very or somewhat worried about getting sick from Covid, compared to only 39% of unvaccinated Americans who report being very or somewhat worried.

That is an astounding disconnect between perception and reality - not only for unvaccinated Republicans, but also for vaccinated + boosted Democrats. I don’t know what more to say to those who are still unvaccinated. But for those of you who are both vaccinated + boosted, listen up! Even if you are over the age of 65, the Omicron variant’s relative mildness, together with the effectiveness of the booster, means that Covid likely presents less danger to you than mild to average flu. That is not to say you should disregard the risk, but you should not live in mortal fear of it either. Unless you are immunocompromised, or care for someone else who is, you may face less risk from Omicron than you do by getting into a car every day.

One area of agreement in the polls among Democrats and Republicans is their concern for children’s health. Three medical groups, including the American Academy of Pediatrics, recently declared a national state of emergency in children’s mental health. Children need to be in school even if it requires masks to keep the school running. According to these medical groups, there is a high cost to children’s mental and emotional well-being posed by excessive remote learning and home-schooling. There is little evidence that children suffer adverse effects by wearing masks in school.

To be crystal clear, for the unvaccinated, Covid is worse than any other common virus. In fact, in the weeks before vaccines became widely available, it was the country’s No. 1 cause of death, above even cancer and heart disease. But, that was before vaccines. If you respect science, then you should trust vaccines to do their job. They may not be impenetrable but they generally leave you with a case you can manage at home. I have a bumper sticker for you: “Get Vaccinated and Live Responsibly”. The totals:

1/13 - 14,517

1/14 - Not reporting

1/15 - Not reporting

1/16 - 37,339 (accounting for 3 days)

1/17 - 8,058

1/18 - 6,728

1/19 - 17,106

1/20 - 15,984

1/21 - 16,525

1/22 - 17,031

1/23 - 9,087

1/24 - 5,955

1/25 - 8,808

1/26 - 10,703

1/27 - 12,173