A month ago, Covid-19 cases had increased in some parts of New England and Mountain West. But they still fell in most of the northern parts of the United States, as well as Canada.
This pattern seemed to suggest that cold weather nationwide spikes were unlikely anytime soon. The predictive models collected by the CDC agreed: They forecast a sustained decline in US Covid cases in November.
Instead, cases have soared about 30 percent this month.
It’s an amazing development. Almost two years after Covid began to spread, it’s still there, causing fear again as Americans prepare for the holidays. Today’s newsletter will try to help you understand the surge before Thanksgiving.
The secret of Covid
The seemingly obvious explanation for the recent surge in falls is weather. As temperatures have dropped, more activity has moved indoors, where the Covid virus tends to spread. And the weather certainly plays a role in the high tide.
But I mentioned Canada above – along with the cold weather parts of the US where the case numbers didn’t rise a month ago – for a reason. If the weather were really the dominant cause, recent Covid patterns would be different. They would match the temperature patterns better.
Unsatisfactory as this is, the full explanation for the increase remains unclear. There is still a lot more scientists don’t know about the spread of this virus than they know, as Michael Osterholm, a University of Minnesota epidemiologist, has been saying for months.
Media reports and expert comments overlook this point too often. We provide decent explanations for the ups and downs of the virus – like weather, school calendars, masking habits, even sporting events – when reality is more chaotic. (Here are some detailed examples.)
The bad news about the unpredictability of the virus is that surges can sneak up on us: The absence of a spike in Covid in most parts of northern North America a month ago wasn’t as comforting as it might seem.
The good news is that the virus can also surprise in pleasant ways. This winter, falls are not guaranteed to rise any further. Remember, they peaked in early January last winter before plummeting about 75 percent in late February. In the coming weeks I encourage you to ignore most of the Covid predictions. Nobody knows what will happen next.
What should we think about the rising number of cases in the meantime?
Zero point
For most people, the vaccines remain remarkably effective in turning Covid into a treatable disease that is less dangerous than some everyday activities.
The most important dividing line is age. In Minnesota, which publishes detailed Covid data, the death rate for fully vaccinated people under 50 during the delta surge this year was 0.0 per 100,000 – meaning so few people died that the rate is spinning to zero .
Washington State is another place that publishes statistics by age and vaccination status. Washington didn’t even quote a death rate for fully vaccinated residents under 65 in its most recent report. It was too low to be meaningful.
The hospitalization rate is very low even for vaccinated people under 65 years of age. In Minnesota during the delta rise, the average weekly hospitalization rate for vaccinated residents between 18 and 49 years of age was about 1 per 100,000.
To put that in perspective, I looked up data for a few other medical problems. During a typical week in the United States, nearly 3 people in 100,000 visit an emergency room because of a bicycle accident. The number of car accidents is around 20 per 100,000.
Covid is the threat to many of our minds. But for most people under 65, this week the virus may pose less of a risk than driving to see relatives. “Vaccination changes everything, I think,” Dustin Johnston, 40, a Michigan photographer who wants to get together with his family, told The Times.
In need of protection
The situation is more frightening for the elderly, especially those in their 80s and 90s. For the oldest age groups, Covid poses a real risk even after vaccination. It seems more dangerous than typical flu and far more dangerous than time spent in a vehicle based on CDC data.
As a result, older Americans need protection during a surge. (The same goes for a small percentage of younger people with specific vulnerabilities to Covid, such as organ transplant recipients.) The most effective way to protect people at risk is to vaccinate – not just from them, but from others who infect them could.
An example are children aged 5 and over who are now eligible for vaccinations. Covid remains overwhelmingly mild for them. But vaccinated children are less likely to infect other people than unvaccinated children, and a mild case of Covid in a child can turn into a fatal case for an older grandparent.
The argument for booster shots can be similar. Most young and middle adults who have had two vaccinations for Covid remain heavily protected from serious illness (as these charts show). But vaccines seem to be dwindling enough to make people more susceptible to a mild infection that they could pass on to someone at risk. All Americans 18 and older are now entitled to a booster vaccination if they were last vaccinated at least six months ago.
When the discussion about boosters began a few months ago I was a little skeptical as the evidence of their usefulness for most people was thin. However, their collective value now seems clear. I recently got a booster vaccination mainly because I will be spending time with older relatives in the coming weeks. The case for booster shots in people over 65 is even stronger.
If you are concerned about the risks to the elderly at your Thanksgiving gathering, I would give you three pieces of advice. First, insist that everyone in your home is fully vaccinated if they are eligible. Second, encourage people to get tested – either at a testing center or with a rapid test at home – before they come. Third, as soon as the day comes, try to put your Covid fear aside and enjoy the vacation.
More about the virus:
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Whether your literary habits include science fiction, poetry, or nonfiction, the Times Book Review’s annual roundup of 100 notable books has options for you. “We put together an initial list of about 500 books,” said Gregory Cowles, who helped edit the project. It includes works by Chang-rae Lee, Sally Rooney, Kazuo Ishiguro, Colson Whitehead, Jonathan Franzen, and more:
Fiction: “Strange Beasts of China” by Yan Ge is an enchanting novel about a cryptozoologist who hunts down fabled creatures.
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