covid risk assessment age vaccine

I wrote my last update on the COVID-19 data near the height of the delta variant phase of the pandemic in late August. At the time, case numbers were still rising. Since then, they continued rising until September 2. And then they started an extended decline. Let’s revisit the topic of COVID-19 and see where we’re headed.

Readers looking for my full history of posts on the topic can find links here: March 2020, August 2020, January 2021, August 2021.

COVID-19 Data in the US

In short, cases began declining nationwide in early September and they continue to decline. The US moved from a height of about 170,000 cases per day to around 80,000 cases per day as of October 21. In short, our cases fell by half.

However, these days, public health experts worry less about case numbers per se and more about hospital occupancy rates and death. They see us moving gradually out of the pandemic stage and more toward a stage where COVID-19 lingers as an endemic disease – one where it’s a background concern, but not really a source of major outbreaks or public health disasters. Most experts agree that’s where we’re headed, but they don’t know how far we are along that progression.

But hospitalization and death data still tell a story very similar to case numbers. As always, they lag about 2 weeks behind cases. The US had about 1,300 deaths per day in late August, rising to about 2,000 by mid-September, and then falling to about 1,200 now. We should expect that number to continue to drop for at least the next couple of weeks.

COVID-19 Risk Assessment (Revisited)

I’ll briefly revisit my previous post on COVID-19 risk assessment. I pointed in that post to data that show older Americans face much greater risks from COVID than younger ones, even unvaccinated children. The press has been well behind on this point. But, in the last couple of weeks, it has caught up and published a number of useful articles making the same point.

Lots of Americans, especially well-meaning liberals, still have difficulty with this point, despite pretty overwhelming evidence in its favor. Many still want to claim that unvaccinated children face greater (or even the greatest) risk. Insofar as they have reasons for this, it centers on the possibility that further data might show that mass vaccination increases the risk to unvaccinated children or the possibility that unvaccinated children face greater risk than others from ‘Long COVID.’

We now have more data on these two points. And the data confirm my initial conclusion that older Americans still face the greatest risk.

First, what data have come in on Long COVID suggests, if anything, that it’s less common (or at least not more common) among children than among others. What we have so far suggests Long COVID isn’t a special issue for younger people, but a general issue for everyone.

The Data

Second, we have the thornier issue of COVID-19 death rates by age in the era of mass vaccination. I’ll present these data the same way I did on August 26. And these data will include only deaths after August 26. So, we have here only deaths during the mass vaccination era, without any totals from 2020 or from the parts of 2021 before most American adults were vaccinated.

COVID-19 Data October 2021

In short, the data show what I expected. In the mass vaccination era, Americans 85 and older face lesser risk than they did 6 months ago. But they still face risks far greater than children. And, yes, risk among children has risen, but it’s still much less than risk among anyone else.

So, here’s what stands out to me about the data. I see a sharp rise in the proportion of deaths found among people age 18-39 and 40-64, as well as a rise in risk among people age 65-84. Why do we see these things? In short, because there are more unvaccinated people in those age ranges than among Americans 85 and older.

The basic conclusion, though, remains the same. Unvaccinated children face some risk, but far less than the risk faced by unvaccinated adults, immunocompromised people, and elderly Americans regardless of vaccination status. We should focus public policy on protecting some of these groups first.

The Situation in Iowa

Finally, there’s Iowa. In short, Iowa’s rise and decline roughly matches the national data. But, Iowa now lags several weeks behind the nation as a whole. This still misleads some people. Reaching our peak later than the nation led some to the idea that we were doing unusually well, while hitting the decline later than the nation led others to the idea that we were doing unusually bad.

Neither of those things is true. Iowa continues to sit a bit higher than the national average in case numbers and a bit lower in death numbers. Politically, neither Kim Reynolds nor Iowa Democrats are doing a very good job managing all this. But given the background advantages of the GOP in Iowa, the Democrats stand to lose out to a greater extent.

Liberal sources like Bleeding Heartland continue to discuss COVID as though it can be a winning issue for Democrats. Especially in the 2022 senate and gubernatorial races. That’s incredibly likely to flop as a strategy. Democrats haven’t sold the idea that the situation in Iowa is significantly worse than it is elsewhere. Nor will they sell it, largely because it’s not).

Next Steps

It’s never easy to tell where things are going. And it’s easy to generate both optimistic and pessimistic scenarios. The most pessimistic scenario, of course, would be that the delta variant either continues lingering at high case rates for months on end or gives way to a newer, more transmissible and/or more deadly variant.

Either of those scenarios is possible, but neither is especially likely. Between vaccination and infection, the US has built huge immunity levels by now. If case numbers remain high, it’ll likely be due to a wave of less serious infections without high rates of hospitalization or death. And if delta sticks around in its deadlier forms, it’ll likely hit small pockets of unvaccinated people.

And so, my best guess is that we’ll see a more optimistic scenario at play over the coming 6-8 months. Delta will probably be the last of the huge, deadly waves. Yes, I expect COVID-19 to stick around for some time. And the current decline might stop and even reverse a bit over the coming months. But I don’t think we’ll ever get back to where we were in January 2021 or even August 2021.

Of course, I might end up being wrong.