Even as Pandemic Starts to Ease, U.S. COVID Death Toll Nears 500,000

MONDAY, Feb. 22, 2021 (HealthDay News) -- While coronavirus infections in America plunge to levels not seen in months, the country prepares to mark the devastating toll of 500,000 dead so far in the pandemic.

The seven-day rolling average is now under 65,000 and the daily death toll is also dropping, with fatalities decreasing by 30 percent in the past week, the Washington Post reported. But top infectious disease expert Dr. Anthony Fauci cautioned on Sunday that masks might still be needed in 2022 and refused to predict when "normal" would return.

"I think it is possible that is the case," he told CNN when asked whether Americans will still be wearing masks next year. The level of new infections must go "way down," he added, before he could say people needn't wear face coverings.

"I want it to keep going down to a baseline that's so low there is virtually no threat," Fauci said. "If you combine getting most of the people in the country vaccinated with getting the level of virus in the community very, very low, then I believe you're going to be able to say, you know, for the most part, we don't necessarily have to wear masks."

Not only deaths and new infections are declining: The number of Americans hospitalized for COVID-19 is at its lowest since early November, The New York Times reported.

There were 56,159 people hospitalized as of Feb. 21, the lowest level since Nov. 7. The number of U.S. hospitalizations has steadily and rapidly declined since mid-January, when the seven-day average reached about 130,000, the Times reported.

Experts say several factors may explain why the country's coronavirus metrics have been improving over the past few months: more widespread mask use and social distancing, more effective public health messaging, and a growing number of people who have been vaccinated. The most vulnerable, like residents of nursing homes and other elderly people, were among the first to receive the vaccine.

The change is perhaps most evident in intensive care units: Heading into her night shift in the I.C.U. at Presbyterian Rust Medical Center in Rio Rancho, N.M., Dr. Denise Gonzales, the medical director, told the Times that she has seen a difference in her staff.

"People are smiling. They are optimistic," she said. "They're making plans for the future." During the worst of the crisis, "working in such a highly intense environment where people are so sick and are on so much support and knowing that statistically very few are going to get better — that's overwhelming."

Dr. Kyan Safavi, medical director of a group that tracks COVID-19 hospitalizations at Massachusetts General Hospital in Boston, said the number of newly admitted patients has dropped sharply. The hospital is admitting about 10 to 15 new patients daily, a decline of about 50 percent from early January, Safavi said.

"Everybody's physically exhausted — and probably a little bit mentally exhausted — but incredibly hopeful," Dr. Safavi told the Times.

Pfizer, Moderna vaccines less effective against South African variant

Two of the world's leading coronavirus vaccines don't work as well against a more contagious South African variant, though both did manage to neutralize the virus, two new studies show.

But experts pointed out that what level of neutralization is needed to actually protect against the variant is still unclear and these latest studies on the Pfizer and Moderna vaccines were done in a lab setting, and not the real world, the Post reported. Both reports were published last week in the New England Journal of Medicine.

"These are in vitro studies and we don't know if there is a threshold for neutralization that defines protection. In fact, we don't even know that there is a quantitative correlation between antibodies levels and protection," NEJM Editor-in-Chief Eric Rubin said in a podcast on the findings. "It is very concerning that we don't know the clinical significance of these findings."

The two studies used genetically engineered versions of the South African variant against blood samples from vaccinated volunteers, the Post reported. The strain has been identified in many countries, including the United States, along with a variant first identified in Britain that scientists say is also highly contagious.

Moderna's research letter in the NEJM on its COVID-19 vaccine showed a sixfold drop in antibody levels against the South Africa strain, the newspaper said. The shot's efficacy against the variant has not yet been determined.

Pfizer, in testing its vaccine against the variant in a lab, found the shot generated about a third of the antibodies that are normally mobilized with the original strain. The activity, however, appeared to be enough to neutralize the virus.

Still, Pfizer said in a statement that it was "taking the necessary steps… to develop and seek authorization" for an updated vaccine or booster shot that could better combat the variant.

As of Monday, nearly 63 million people had received at least one dose of a COVID-19 vaccine, including just over 16 million people who have received both doses, according to the U.S. Centers for Disease Control and Prevention.

New evidence that British COVID variant could be more deadly

More evidence has emerged that suggests a coronavirus variant already known to spread faster is also likely to be more deadly.

The B.1.1.7 variant, which is thought to have originated in Britain, is already firmly entrenched in America and could soon become the dominant strain, according to CDC Director Dr. Rochelle Walensky.

Speaking on CBS' "Face the Nation" last week, she said "we know now that, or we estimate now that about 4% of disease in this country is related to B.1.1.7," she said. "And we have projections that it may be the dominant strain by the end of March."

As of Monday, there were 1,661 cases of the British variant found in 44 U.S. states, according to the CDC. Florida has the most cases at 433, followed by 210 cases in Michigan and 195 cases in California.

Walensky's warning came on the heels of research released by British scientists that shows B.1.1.7 might be more likely to trigger more lethal cases of COVID-19.

"The overall picture is one of something like a 40 to 60 percent increase in hospitalization risk, and risk of death," Neil Ferguson, an epidemiologist and scientific adviser to the British government, told the Times.

Vaccines already being distributed in the United States are believed to be effective against B.1.1.7, so Walensky said it's imperative that the massive rollout already underway continues. At the same time, and in the face of other new variants, other steps are underway, she told CBS.

Pharmaceutical companies are tweaking their research to fight the B.1.1.7 variant, she said, and the CDC is monitoring how people who've already gotten the Pfizer or Moderna vaccines are faring.

"But we're not waiting for that," she said. "We're doing the science to scale up different vaccines in case we either need bivalent vaccines, that is a vaccine that has two different strains, or booster vaccines. Both are happening."

A global scourge

By Monday, the U.S. coronavirus case count passed 28.1 million while the death toll was over 498,650, according to a Times tally. On Monday, the top five states for coronavirus infections were: California with over 3.5 million cases; Texas with more than 2.6 million cases; Florida with over 1.8 million cases; New York with nearly 1.6 million cases; and Illinois with nearly 1.2 million cases.

Curbing the spread of the coronavirus in the rest of the world remains challenging.

In India, the coronavirus case count was more than 11 million by Monday, a Johns Hopkins University tally showed. Brazil had just over 10.1 million cases and more than 246,500 deaths as of Monday, the Hopkins tally showed.

Worldwide, the number of reported infections passed 111.4 million on Monday, with more than 2.4 million deaths recorded, according to the Hopkins tally.

More information

The U.S. Centers for Disease Control and Prevention has more on the new coronavirus.

SOURCES: Washington Post; The New York Times; CBS News; CNN