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A 22% surge in US coronavirus deaths is hitting unvaccinated people hardest. Experts worry about the long-term effects for vaccinated people, too.

Disease experts worry about breakthrough cases in the elderly or immunocompromised, or the virus mutating into a more dangerous strain. ...
us 500,000 covid-19 deaths
El Paso County Medical Examiner's Office staff roll bodies in bags labeled "COVID" from refrigerated trailers into the morgue office in El Paso, Texas, on November 23, 2020.

  • The US's daily coronavirus deaths surged 22% in the last week – mostly among unvaccinated Americans.
  • Still, disease experts worry about breakthrough cases in the elderly or immunocompromised.
  • Increased transmission could also allow the virus to mutate into a more dangerous strain.
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The US is far removed from the deadliest point in its coronavirus outbreak: The country reported more than 3,000 daily coronavirus deaths in January, compared with less than 275 daily deaths, on average, in the last week.

But average daily deaths have surged 22% in the last seven days, following a record low of just 30 deaths on July 11. In the last two weeks, average daily deaths have risen 33%.

The vast majority these deaths are among unvaccinated Americans: Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told NBC earlier this month that unvaccinated people represented more than 99% of recent coronavirus deaths. The Centers for Disease Control and Prevention also reported Friday that more than 97% of people entering hospitals with symptomatic COVID-19 haven't received their shots.

The US is now dealing with a "pandemic of the unvaccinated," CDC Director Rochelle Walensky said at a press briefing.

"We are seeing outbreaks of cases in parts of the country that have low vaccination coverage because unvaccinated people are at risk, and communities that are fully vaccinated are generally faring well," Walensky said.

But disease experts worry that allowing the virus to spread among unvaccinated people could give it more opportunities to mutate. That could pose a long-term risk for vaccinated people, too. Already, the Delta variant – now the dominant strain in the US – appears to be more transmissible than any version of virus detected so far.

"The worst-case scenario is if Delta mutates into something completely different, a completely different animal, and then our current vaccines are even less effective or ineffective," Vivek Cherian, an internal-medicine physician in Baltimore, told Insider in June.

Experts also worry that increased transmission could result in more severe breakthrough infections – cases of COVID-19 diagnosed at least two weeks after someone is fully vaccinated – among the elderly or immunocompromised, since vaccines may already be less effective among these groups.

People over age 65 currently represent around 75% of breakthrough cases that result in hospitalization or death, according to the CDC.

The UK offers a crystal ball of what to expect in the US

london UK reopening
Outdoor dining in Soho, London, on April 18, 2021.

Disease experts worry that the US could soon follow in the footsteps of the UK, where average deaths have more than doubled in the last two weeks, from 17 to 40 per day. The UK's average hospitalizations have also increased around 60% during that time, from around 380 to 615 per day.

That's despite the fact that nearly 70% of UK residents have received at least one vaccine dose.

In the US, by contrast, around 44% of the population remains unvaccinated so far. (That includes roughly 48 million children under age 12, for whom vaccines haven't been authorized yet.)

The country is now administering as many daily vaccine doses as it was in late December, when vaccines were only available to healthcare workers and residents of long-term care facilities. Just 384,000 daily doses were given out, on average, over the last week.

Some Americans, particularly in rural counties, may still struggle to access shots, while others can't afford to take time off work to get vaccinated. But, for the most part, widespread vaccine hesitancy has slowed down vaccination rates.

Around 18% of adults surveyed in a recent YouGov poll said they didn't plan to get vaccinated, while another 11% said they were unsure. These rates were significantly higher among Republicans and people in the Midwest and South.

Most vaccine-hesitant people in the survey said they were worried about potential side effects from coronavirus shots – though studies have shown that vaccine side effects are generally mild and fleeting. The vast majority also believed that the threat of the virus was exaggerated for political reasons.

Lifting mask and social distancing mandates could delay herd immunity

US reopening concert phone picture Instagram
A couple takes a selfie at Madison Square Garden in New York City on June 20, 2021.

Despite lagging vaccination rates, most US states have lifted mask and social distancing mandates. In states like Delaware, Florida, Missouri, and South Carolina, masks are recommended, but not required, for unvaccinated people.

Some disease experts say removing these restrictions too soon could send the wrong message about the current state of the pandemic.

"The concern is if you're on the fence and then you go outside and you see, 'Hey, things are back to normal,' that may decrease the chance of you wanting to even get vaccinated," Cherian said.

For now, experts are hopeful that the US can still vaccinate at least 70% to 85% of its population – a threshold that may allow the country to reach herd immunity. But a new variant that evades protection from vaccines or prior infection could push that goal even further from view – so public-health officials remain determined to vaccinate more Americans as quickly as possible.

"If you get to that situation, then you essentially get us back to a level that [we were in] pre-March of 2020," Cherian said. "That's just not a place that you want to be."

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