As the US nears 500,000 Covid-19 deaths, Americans hold the key to steering the course of the pandemic

On the brink of a devastating milestone — 500,000 US Covid-19 deaths — the US is at a crossroads in the course of this pandemic.

While numbers of new cases and hospitalizations go down, reports of new, highly contagious variants go up.

And while vaccinations slowly increase, some Americans say they won’t get a Covid-19 vaccine — hurting the chances of herd immunity and hindering a return to normal life.

“I am worried about this variant — the B.1.1.7 variant (first found in the UK),” said Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine.

“If that takes over, the numbers are going to start to spiral up again. There’s no end to what the death toll will look like unless we can vaccinate ahead of it.”

Where we stand with vaccinations

More than 44.1 million Americans have received at least one dose of their two-dose vaccines, according to the US Centers for Disease Control and Prevention.

About 19.4 million have been fully vaccinated. That’s about 5.9% of the US population — far less than the estimated 70% to 85% of Americans who would need to be immune to reach herd immunity.

Some states are still grappling with vaccine delays after severe weather walloped much of the country last week.

But the US will likely be caught up by the middle of this week, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

“Obviously it is a setback because you’d like to see the steady flow of vaccine getting out there to get into people’s arms, but we can play pretty good catch-up,” Fauci told NBC on Sunday.

To speed up vaccinations, some experts have suggested delaying second vaccine doses to get more first doses into people’s arms.

Both vaccines on the US market — developed by Pfizer-BioNTech and Moderna — require two doses, the second of which are intended to be administered 21 days and 28 days after the first, respectively.

Fauci told CNN Sunday the US is currently sticking with the vaccine schedule that is backed up by data from clinical trials.

“The science points directly towards continuing with what we know … from the clinical trial,” he said.

Good news (for now) on cases and hospitalizations

Nationwide, the rates of new Covid-19 cases, hospitalizations and deaths are declining.

The number of patients hospitalized with Covid-19 has fallen for the 40th day in a row, according to the COVID Tracking Project.

Daily deaths have declined 24% this past week compared to the previous week, according to data from Johns Hopkins University.

And daily new cases have dropped 23% over the same time period, according to Johns Hopkins. (But testing is also down by 17%, according to the COVID Tracking Project.)

“I’m very hopeful about where we are,” said Dr. Ashish Jha, dean of the Brown University School of Public Health. “Now we have a couple road bumps ahead.”

Those road bumps include several worrisome coronavirus variants.

About 1,700 cases of variant strains first spotted in the UK, South Africa and Brazil have been reported in the US, according to the Centers for Disease Control and Prevention.

But that figure is probably nowhere near the actual number of variant cases in the US, since the US has lagged behind dozens of other countries in genome sequencing per 1,000 Covid-19 cases.

CDC Director Dr. Rochelle Walensky said the US has ramped up sequencing to find variants and will keep doing so.

The vast majority of variant cases so far involve the highly contagious B.1.1.7 variant first detected in the UK.

Experts with the University of Washington’s Institute for Health Metrics and Evaluation said over the weekend that while the B.1.1.7 strain likely accounts for less than 20% of current infections in the US, that number will likely soar to 80% by late April.

‘Now is not the time to let your guard down’

What happens next largely depends on personal responsibility and how many people get vaccinated, the IHME team said.

“Managing the epidemic in the next four months depends critically on scaling up vaccination, trying to increase the fraction of adults willing to be vaccinated above three-quarters, and strongly encouraging continued mask use and avoiding situations where transmission is likely, such as indoor dining, going to bars, or indoor gatherings with individuals outside the household,” the team wrote.

The American Medical Association, the American Hospital Association and the American Nurses Association also pleaded for Americans to help quash the pandemic.

“With new, more contagious variants of the virus circulating throughout the U.S., now is not the time to let your guard down and scale back on the measures that we know will work to prevent further illness and deaths — wearing masks, practicing physical distancing, and washing hands,” a joint statement said.

Why we could be wearing masks next winter, too

Some Americans have discovered an unexpected perk to wearing masks in the winter — they protect against brutally cold air, not just against coronavirus.

And Americans might be wearing them next winter, when some health experts say Covid-19 might flare up again.

Fauci hopes that doesn’t happen, he said, adding it’s “possible” people may be wearing masks in 2022.

There may be other ways everyday life will be different from the past, said infectious disease specialist and epidemiologist Dr. Celine Gounder.

“I do think we’re looking at some new normals. I think the handshake, for example, is probably going away,” she said.

“I do think masks in the cough/cold/flu season in the winter months would make a lot of sense. That clearly, really insulated the Southeast Asian countries from some of the worst of this, understanding the importance of wearing masks.”

For those who have already been vaccinated, health experts say you should keep wearing a mask. That’s because it takes weeks for vaccines to fully kick in and because vaccines don’t guarantee you won’t pass coronavirus on to others.

“It’s estimated that about 70% of Americans must be vaccinated before we get to herd immunity through vaccination,” CNN medical analyst Dr. Leana Wen said. “That’s the point where enough people have the immune protection that the virus won’t spread anymore.”

And slowing the transmission of coronavirus also hinders the chances of the virus mutating further.

“The evidence was pretty compelling by last March or April that uniform wearing of masks would reduce transmission of this disease,” National Institutes of Health Director Dr. Francis Collins told Axios on HBO on Sunday.

The politicization of face masks probably led to many unnecessary deaths, he said.

“A mask is nothing more than a life-saving medical device, and yet it got categorized in all sorts of other ways that were not factual, not scientific and frankly, dangerous,” he added. “And I think you can make a case that tens of thousands of people died as a result.”