Infectious disease experts are concerned the summer surge of COVID-19 hospitalizations and deaths in several Southern states portends another wave this fall in Northern states unless vaccinations pick up dramatically.
“We’ll likely see a winter surge like we did last year, but it’ll be blunted by the amount of vaccination that’s been done, and the boosters will be going on right at that period of time,” said Dr. George Rutherford, an epidemiologist at the University of California San Francisco.
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Several Midwestern and mountain states will have to boost their vaccination rates to avoid major outbreaks, severe infections, and deaths like those recorded in the Midwest last fall once the summer surge in the South began to dwindle, Rutherford said.
In Indiana, for instance, roughly 45% of people have been fully vaccinated, meaning less than half of the population has completed the two-shot regimen for the Pfizer or Moderna vaccines or the single-shot Johnson & Johnson vaccine. Cases there skyrocketed in October 2020 and remained high through early January. They tapered off once the federal vaccination rollout picked up speed — but the prognosis for this fall and winter is murky.
“If there are low vaccination rates, everybody comes inside, and they’re circulating the delta virus — We’ll see outbreaks pretty much for sure,” Rutherford said.
Southern states such as Texas, Mississippi, and Florida have seen major jumps in cases and hospitalizations since the delta variant overtook alpha in the spring as the dominant strain circulating globally. The highly transmissible delta variant, in addition to low vaccine uptake in certain pockets of the region, spurred a devastating wave of severe cases requiring hospitalizations this summer. For instance, more people than ever in Florida and Mississippi are becoming so sick they need to be treated in a hospital, according to New York Times data.
Florida is contending with the worst phase of the pandemic yet, despite the fact nearly 52% of the population has been fully vaccinated. Vaccination rates vary by county, and certain age groups are also far more likely to have been fully vaccinated. About 86% of Florida seniors have gotten the shots, compared with less than 50% of people ages 20-29.
Deaths due to COVID-19 in Florida have also exceeded the summer and winter 2020 surges. Florida recorded an average of 220 COVID-19 deaths a day over the past week, compared with the previous high of 185 deaths in late January.
Experts said states in the Northeast — such as Vermont, Massachusetts, and Connecticut — have fully vaccinated a majority of their populations but could still face rising hospitalizations in the winter.
“Climate itself does not really affect the transmission that much, but it changes the behaviors of people, and that definitely has an effect on the number of cases and other outcomes,” said Dr. Oguzhan Alagoz, a professor of engineering at the University of Madison-Wisconsin’s Population Health Sciences department.
Still, allowing for gaps in vaccinations makes it easier for the coronavirus to mutate into more transmissible or virulent strains.
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The Biden administration is imploring vaccine holdouts to get the shots now that one of them, the Pfizer-BioNTech two-shot vaccine, has been granted full approval by the Food and Drug Administration. The extra vote of confidence from regulators will hopefully convince the millions of unvaccinated people in the “wait and see” crowd to finally get the shots, Dr. Anthony Fauci, chief medical adviser to President Joe Biden, said on Monday.
“This is a very wily virus,” Fauci said. “If we keep lingering without getting those people vaccinated that should be vaccinated, this thing could linger on, leading to the development of another variant, which could complicate things.”
