So far, the current surge in COVID infections that began in July shows little sign of letting up.  However, there is some modeling that suggests it may not be that far away.

Hospitalizations

US hospitalizations, after nearly tripling in July, almost doubled again in the first two weeks of August (35,000→66,000).  Daily new hospitalizations also rose at only a slightly slower rate, moving from just over 6,000 to 10,300.  These levels are a little more than half of what they were at the January peak.

The story in Texas is somewhat worse.  After increasing nearly fourfold in July, hospitalizations and ICU beds were up another 69% and 63%, respectively, during the first two weeks of August.  Both are now rapidly approaching the peaks of last January.

All of Texas’ reporting regions saw fairly similar increases with the rural areas having a somewhat higher increase on a percentage basis.  Some of that has to do with that they had reached very low levels at the beginning of the summer.

Fatalities

Fatalities have also begun to rise but not nearly at the rate of hospitalizations.   The CDC’s seven-day average has risen to 550.  Of course, fatalities are a lagging indicator so this will probably get worse before it gets better, but it is hard to imagine fatalities even approaching the highs of last winter.

Texas’ date of death analysis, which had bottomed out at about 20 per day at the end of June, has also begun to move up, now standing at about 55.  This also is still well below last winter’s peak of about 350.

The rise in fatalities has not had any noticeable effect on the CDC Excess Death Analysis.   But that analysis is based on actual date of death and so is every much a lagging indicator.  However, at about 500 daily fatalities, that would be less than 10% of what is typical for this time of year for fatalities from all causes.

Vaccines

Vaccinations have begun to pick up since their lows in July, when the daily doses administered fell to just over 400,000 per day.  Since then, the rate of vaccinations has continued to rise and now stands at around 650,000 per day.

But the percentage of the US population fully vaccinated continues to rise at an excruciatingly slow pace.  The last two weeks only moved the needle a little over 1% (49.6 %→50.9%).  The rate for seniors increased by a little over .7% (80.1%→80.8%).  The number with one shot under their belt rose a little more (90.0%→90.9%), which probably indicates that the latest wave has gotten some hesitant seniors off the fence.

Vaccinations in Texas picked up a little more.  It added 1.4% (43.9 %→45.3%), inching slightly closer to the national average.  The over-65 population moved up only slightly (76.2%→76.4%).  There was a slightly more impressive jump in the number of over-65s with one shot (86.2%), again perhaps indicating that the last surge in infections is affecting some people’s willingness to get the vaccine.  But Texas continues to lag behind the national average in all categories.  It is a particularly stunning comparison to see states like Pennsylvania, which now has gotten one shot in the arm of 99.9% of seniors.  Even Florida is well ahead of Texas at 93%.

Testing Results

Nationwide, testing has picked back up with the delta wave to nearly 1 million tests per day, up from about 700,000 at the end of July.  The CDC’s daily “new case” count increased from 72,000 at the end of July to 128,000 as of August 16.  I don’t put a lot of stock in case counts, but one slight hint that we may be nearing the peak is that the rate of increase in the seven-day average has been declining in the last few days.  The seven-day average for positivity rose from 8% to 10.5%.

Texas’ seven-day average for “new cases” now stands at about 12,000 per day.  That indicator has also shown some slight slowing in the last few days.  The positivity rate for the State’s date of specimen testing was a little over 17% at the end of July and then rose to nearly 19% before it began to ease slightly in the last few days, now at just under 18%.

Conclusion

It is clear at this point that the delta variant has moved the goal posts on herd immunity.  The data indicates that the US hit the herd immunity threshold for the previous strains sometime in late December or early January.  But with delta being more contagious, the dropping most suppression efforts, and perhaps some waning of immunity for those previously infected or vaccinated has tipped the scale back in the virus’ favor.

Of course, what we all want to know is when this wave will peak.  While there is very little in the data to give much encouragement, several of the models are projecting that it may not be far off.  The IHME model is projecting that infections actually peaked in the last week and that hospitalizations will peak in about two more weeks.  The TMC models are also showing a similar timeline. The COVID modeling has been pretty awful generally but apparently they are seeing something in the data that suggests we are nearing the peak.

The models are consistent with the experience in both the UK and India, which were exposed to the delta variant earlier.  In both cases their peaks occurred about 4-5 weeks after the delta wave took off.  India’s experience is encouraging because the wave peaked quickly even though India had a very low vaccination rate at the time.  Also, the UK’s experience is similarly encouraging because while it saw a spike in cases, there was only a small rise in fatalities because of their high vaccination rates.  But the UK is well ahead of us in vaccination rates, so we will probably not do quite as well in suppressing fatalities in this wave as they did.

BTW, this chart came from Houston Methodist’s last townhall on COVID.  That series has been excellent, and I would encourage everyone to take the time to watch the latest.  

We are now about 2-3 weeks into the delta wave.  If we see the same curve as Britain and the UK did, as the models are predicting, we should start to see some easing within the next week or two.  Let’s keep our fingers crossed that is the case.