As U.S. COVID Cases Rise, Deaths Could Hit Some States Harder Than Others

As new COVID case numbers rise in the U.S., experts have told Newsweek the an uneven uptake of vaccines in different parts of the country could mean some areas more protected from hospitalizations and deaths than others.

U.S Centers for Disease Control and Prevention data from Tuesday showed that the seven-day moving average of new COVID cases had increased from 24,141 on July 13, up from 21,379 the day before.

But with 160.1 million people in the U.S. now fully vaccinated, the country as a whole is no longer in the situation it was in January when a smaller proportion of the population had received shots, and it surpassed 300,000 daily COVID cases, and recorded more than 4,000 deaths in one day.

Dr. David Lee Thomas, a professor of medicine at the Johns Hopkins University School of Medicine and director of the Division of Infectious Diseases, told Newsweek that vaccination "changes the expression" of COVID infections by reducing the number of severe cases, hospitalizations, and deaths.

"The effects of the vaccines on mortality and hospitalizations are crystal clear," he said. "Both are reduced markedly."

Jagpreet Chhatwal, an assistant professor at Harvard Medical School and a disease modelling researcher, told Newsweek that in California, for example, cases are likely to rise following the lifting of restrictions, but said that "we should focus on hospitalizations and deaths—not cases."

He said: "Because of COVID-19 vaccination, we expect more and more cases to shift from severe to mild, therefore the case count doesn't imply the same as last year."

And this effect is likely to continue. Future COVID projections for the U.S. based on modelling "indicate a pronounced effect from the vaccines," Jeffrey Shaman, a professor in the Department of Environmental Health Sciences at the Columbia University Mailman School of Public Health, told Newsweek—assuming they are as effective against current variants as they were in phase 3 clinical trials.

But due to relatively low levels of vaccination in some parts of the country, not everywhere will benefit form the vaccines' effect on the link between cases, hospitalizations and deaths.

Chhatwal said: "states with lower vaccination coverage are very much prone to seeing new outbreaks that could increase new COVID-19 case count, hospitalizations, and deaths." COVID deaths are known to lag behind diagnoses by up to four weeks.

The effect of low vaccine rates can be seen in CDC data. It showed over last week that states where more than half of their populations were fully vaccinated reported around a third the average COVID case rate of states that had fully vaccinated less than half their population, according to a CNN analysis.

Alabama, Mississippi and Arkansas had fully vaccinated fewer than 35 percent of their populations, and were found to be in the top 10 states for the highest case rates in the U.S. last week.

Dr. Howard Jarvis, an emergency medicine physician in Springfield, Missouri, told CNN on Monday that all of his sick patients at the time were unvaccinated.

This comes amid the spread of the Delta variant, which appears to be more transmissible than past forms of the virus. CDC data shows it now makes up nearly 58 percent of U.S. cases.

Dr. Arnold Monto, professor of epidemiology and global public health at the University of Michigan and acting chair of the U.S. Food and Drug Administration's Vaccines and Related Biological Products Advisory Committee, told Newsweek: "We are seeing surges in those states which are not as well vaccinated as other states… that is what we're seeing now, and Delta's taking over."

However, across the country as a whole, the number of deaths and hospitalisations won't reach the heights of past waves.

According to Monto, younger people are generally less likely to get vaccinated than older people and in some places are driving infection rates.

But as older and high-risk people are still better vaccinated in those areas, hospitalizations and deaths may rise slower than before.

COVID vaccine
A COVID vaccine being administered in Los Angeles, California, in February 2021. Over 160.1 million people in the U.S. have been fully vaccinated. Mario Tama/Getty