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Forget about a second wave, this is more like the fourth wave.
As the United States again reels from another spike in Covid cases, putting pressure on health officials and hospitals and leaving the president practically begging people to get vaccinated, the fault lines of the new crisis are becoming clearer to assess.
Though there are exceptions, the new cases – a tripling over the last three weeks – are overwhelmingly among unvaccinated people. And of those cases, more than 80 per cent are of the new Delta variant of the coronavirus, which is far more contagious, and as a result has the ability to lead to more deaths.
“I think we’re in what is probably the most challenging period of the Covid pandemic,” Anthony Santella, Professor of Health Administration and Policy at the University of New Haven, tells The Independent.
He says after the dark days of last year and the first part of 2021, the arrival of widespread, easily-accessible vaccines appeared to be a tool that would spearhead the fight-back.
Yet, he and many of his colleagues believe people collectively let down their guard as a result. In May, the Centers for Disease Control and Prevention suggested it was no longer necessary to wear masks – guidance it is now changing – and Joe Biden talked of 4 July being the nation’s day to celebrate independence from Covid.
Biden’s dream of having 70 per cent of Americans vaccinated by 4 July, has fallen well short. Right now, that figure stands at just 50 per cent, and Covid is surging again among unvaccinated populations, particularly in places such as Arkansas, Alabama, Missouri and Mississippi. Many of these have some of the lowest vaccination rates, though some states were not as badly hit last year as some of the worst hotspots.
Many Americans bought into measures such as social distancing and the wearing of masks, but persuading people to get a vaccine was much tougher, Santella says.
“With the small but mighty anti-vax movement, what should be a no brainer – getting the vaccine – has become the challenge of the day,” he says.
Maps on two different websites underscore the situation.
A map hosted by the Mayo Clinic website shows daily Covid cases per 100,000 people. On it, the states of Arkansas, Florida, Missouri and Louisiana burn red, indicating the highest percentage of cases.
Another map, curated by the Centres for Disease Control (CDC), shows states by the number of vaccinations per head of population. Among those shaded in the deepest shade of blue are Washington, New Mexico, New York and New Jersey. None of these are centres of the fourth wave of cases.
“Look, the only pandemic we have is among the unvaccinated,” Biden said earlier this month.
Dr Rochelle Walensky, the director of the CDC, which has revised its guidelines to say vaccinated people should continue to wear masks indoors in certain states and certain situations, was even more forceful.
“Our biggest concern is we are going to continue to see preventable cases, hospitalisations and, sadly, deaths among the unvaccinated,” she said.
Dr Charles Hennekens, a professor and senior academic advisor at Florida Atlantic University, located in the city of Boca Raton, says after having suffered the largest number of cases and deaths in the world, the US appeared to be leading the fight back with its vaccine roll out.
He says it ran into two roadblocks, the Delta variant and those individuals who do not want to be vaccinated. “The irony is that in some places we have more people lining up at hospital for Covid medicine than we do to get vaccinated,” he says.
How would he persuade those opposed to or worried about a shot?
He says one tactic would be for the FDA to push through the full authorisation for the various vaccines available.
“The other would be to make more use of health care providers,” he says. “Among the people Americans trust the most are the person they get health care from, They don’t trust the government. Those healthcare providers need to be urging their patients to get vaccinated.”
Because he knows how sensitive the issue is, and because the most pressing danger appears to be in states that voted for Donald Trump in 2020, Biden has sought to walk a careful path.
At the moment, he has a high approval rating for his handling of the pandemic – he does not want to lose that, nor does he want to add to the more than 610,000 Americans who have lost their lives.
He fears that if the federal government plays too heavy a hand, there could be a backlash, further discouraging people already anxious. A door-to-door vaccine push met such resistance from right wing media and some politicians, that it was dropped.
Republican congresswoman Marjorie Taylor Greene claimed Biden’s administration was acting like the Nazis. Meanwhile, first term congressman Madison Cawthorn of North Carolina claimed the government could also seek to “take your guns, [or] to take your Bibles”.
Some Republican politicians have been been strikingly outspoken about the perils facing their constituents. Alabama governor Kay Ivey was asked by a reporter what more could be done to increase vaccination rates in her state, which has one of the lowest vaccine uptakes in the nation.
— thomas dobbs (@TCBPubHealth) July 19, 2021
“I don’t know. You tell me. Folks are supposed to have common sense,” she said. “It’s time to start blaming the unvaccinated folks, not the regular folks. It’s the unvaccinated folks that are letting us down.”
Pia MacDonald, an infectious disease epidemiologist at RTI International, a non-profit group focused on health research, acknowledged the full-steam-ahead efforts that had been made with the vaccine roll-out. It has now hit stagnation, she says.
She argues it is vital the nation addresses the wave of Delta cases before they get worse. She says persuading those still unvaccinated to get a jab can be done but it is difficult and costly work.
The key, she believes, is to recognise there can be many reasons for vaccine hesitancy, even within the same communities.
She adds: “Those conversations need to dealt with in a sensitive and respectful way.”