THENEWYORKER,OCTOBER18, 2021 13
COMMENT
WINTERFORECASTS
T
he coronavirus pandemic in the
United States appears, for the mo-
ment, to be in retreat. Since the start of
September, daily cases have dropped by
a third, and daily hospitalizations have
fallen by more than a quarter. COVID
deaths, which generally lag behind in-
fections by a few weeks, are now start-
ing to decline from their peak. There are
still areas of the country that are strug-
gling. In Alaska, where only half the pop-
ulation is fully vaccinated, hospitals are
at capacity and doctors have had to ra-
tion intensive care. But, nationwide, the
Delta wave is waning. The question now
is: What does the winter hold?
There are reasons for optimism. Sev-
enty-eight per cent of adults in the U.S.
have now received at least one dose of a
COVID vaccine, and recent mandates are
pushing this number higher. Millions of
vulnerable Americans are now getting
booster shots, and by Halloween Pfizer-
BioNTech’s vaccine may be authorized
for use among children aged five to eleven.
Earlier this month, Merck announced
that its antiviral drug molnupiravir
roughly halves the likelihood that peo-
ple with mild or moderate COVID will be
hospitalized or die. Because the drug is
administered orally—not by infusion or
injection, as monoclonal antibodies are—
it could dramatically change how COVID
is treated outside of hospitals, and result
in fewer people ending up inside them.
Meanwhile, rapid antigen tests, which
can help schools and workplaces open
more safely, appear to be on the brink of
widespread use. This progress is unfold-
ing against an epidemiological backdrop
in which at least a third of Americans
have been infected by the virus and carry
some level of natural immunity.
But there’s also a less promising sce-
nario. The U.S. has the lowest vaccina-
tion rate among wealthy democracies,
and has now fallen behind many poorer
nations, such as Uruguay, Cambodia,
and Mongolia. The anti-vaccine move-
ment remains a potent force. Last Mon-
day, protesters tore down a COVID test-
ing site in New York City. According to
the Kaiser Family Foundation, one in
six adults nationwide remains adamantly
opposed to vaccination; only a third of
parents say that they plan to get their
children inoculated immediately after
the vaccine is authorized, and a quarter
say that they “definitely” won’t. In the
U.K., ninety-seven per cent of people
over sixty-five are fully vaccinated; during
the Delta wave there, daily cases reached
ILLUSTRATIONS BY JOÃO FAZENDA
THE TALK OF THE TOWN
eighty per cent of record levels, but daily
deaths only eleven per cent. Just eighty-
four per cent of older Americans are
fully vaccinated, and cases and deaths
are more tightly coupled: both recently
reached around two-thirds of last win-
ter’s levels. “Are we going to have as bad
a surge this winter as last winter?” Ash-
ish Jha, the dean of Brown University’s
School of Public Health, asked. “I think
we can definitively say no. But what peo-
ple don’t appreciate about Delta is that
it finds pockets of unvaccinated people
and just rips through them. If you’re an
older person living in this country, and
you’re not vaccinated, it’s going to be a
very bad winter.”
During the past year and a half, the
virus repeatedly surprised us, prompting
public-health revisions, reversals, and mea
culpas. It’s never been clear why the virus
surges in one place and not another, why
it fades when it does, or how it will evolve
next. Any number of factors can intro-
duce uncertainty into our prognostica-
tions, and each threatens to push “nor-
mal” beyond yet another horizon. Still,
it’s possible to wrap our heads around
some of the biggest issues. One is in-
person contact. When societies open up,
rates of infection almost always increase.
In the U.S., most business closures and
strict capacity restrictions are ending;
in-person instruction has resumed at
schools and colleges; the weather is cool-
ing, and we are spending more time in-
doors. All this means that the virus will
have more opportunities to spread.
The consequences of that spread will
depend, in part, on how many people re-
main susceptible and to what extent im-
munity wanes. The passage of time may
