COVID-19 this week: Cases, deaths decline, but vigilance still needed

A Johns Hopkins University epidemiologist said Friday that declining COVID-19 cases and hospitalizations in the United States are "great to see," but that a new surge after the holidays is possible if people abandon masking and fail to get vaccinated.

The nearly 531,000 U.S. cases reported this week represents a 13.2% decline from last week, according to an analysis of data from the Johns Hopkins Coronavirus Resource Center. The average daily case count of 76,000 was the lowest since late July but still far higher than the lowest daily average of 11,000 in mid-June. Hospitalizations this week declined nearly 9% over the same period, with intensive care cases falling by 6.7%. The 11,571 deaths reported this week was down by less than 4% from last week.

"I never want to call anything an 'end,' but I certainly welcome the sustained declines in cases we're seeing across the U.S.," said Jennifer Nuzzo, the epidemiology lead for the Coronavirus Resource Center, during the website's expert briefing on Friday. "We're headed in a good direction."

But, Nuzzo added, "If we change our behaviors, if we do things differently, if we don't sustain the progress we've been making in terms of increasing immunizations, then we could see case increases again, in particular after the holidays when people travel and gather. We could see a rise in cases later in the winter.

"I'm hopeful it won't be nearly as bad as the surge of cases we saw last year after the holidays," added Nuzzo, senior scholar for the Center for Health Security in the Bloomberg School of Public Health. "I very much don't want us to get complacent, particularly when case numbers we're seeing nationally are still far beyond what they were at our lowest point in mid-June."

U.S. cases, hospitalizations, and deaths accelerated after the holidays last year just as vaccinations were being rolled out across the nation. On Nov. 1, 2020, U.S. cases stood at 610,000 cases and increased 178% to 1.7 million cases by Jan. 10, 2021. Deaths jumped from approximately 6,100 on Nov. 1, 2020, to nearly 23,500 on Jan. 17, 2021.

State testing capacity remains a significant concern for Nuzzo because many states are still reporting test positivity rates above the 5% threshold established by the Centers for Disease Control and Prevention. Higher rates indicate that states are not testing enough to find cases.

"There is nothing inherent about case decreases that suggest they will continue to decrease," Nuzzo said.

Brian Garibaldi, the CRC's clinical lead, said Johns Hopkins Hospital is, like the rest of Maryland and most other states, "seeing a slow and steady decline of patients with COVID-19."

"We are seeing a decline for those who need intensive care," added Garibaldi, medical director for the Johns Hopkins Biocontainment Unit. "The patients who do require an intensive level of care or require a respirator are patients who are unvaccinated or who have a health condition that makes them higher risk. ... So this is still, in terms of what we're seeing in the hospital, an epidemic of unvaccinated individuals."