A Positive Covid Milestone
In a sign that the pandemic really is over, the total number of Americans dying each day is no longer historically abnormal.
https://www.nytimes.com/2023/07/17/briefing/covid.html

The United States has reached a milestone in the long struggle against Covid: The total number of Americans dying each day — from any cause — is no longer historically abnormal.

Excess deaths, as this number is known, has been an important measure of Covid’s true toll because it does not depend on the murky attribution of deaths to a specific cause. Even if Covid is being underdiagnosed, the excess-deaths statistic can capture its effects. The statistic also captures Covid’s indirect effects, like the surge of vehicle crashes, gun deaths and deaths from missed medical treatments during the pandemic.

During Covid’s worst phases, the total number of Americans dying each day was more than 30 percent higher than normal, a shocking increase. For long stretches of the past three years, the excess was above 10 percent. But during the past few months, excess deaths have fallen almost to zero, according to three different measures.

The Human Mortality Database estimates that slightly fewer Americans than normal have died since March, while The Economist magazine and the C.D.C. both put the excess-death number below 1 percent. Here is the C.D.C. data:

Estimates of weekly deaths above normal in the U.S.
A chart shows C.D.C. estimates of weekly death percentages of normal in the U.S. The average since March 2023 has been below one percent above normal.
The power of immunity
The progress stems mostly from three factors:

First, about three-quarters of U.S. adults have received at least one vaccine shot.

Second, more than three-quarters of Americans have been infected with Covid, providing natural immunity from future symptoms. (About 97 percent of adults fall into at least one of those first two categories.)

Third, post-infection treatments like Paxlovid, which can reduce the severity of symptoms, became widely available last year.

“Nearly every death is preventable,” Dr. Ashish Jha, who was until recently President Biden’s top Covid adviser, told me. “We are at a point where almost everybody who’s up to date on their vaccines and gets treated if they have Covid, they rarely end up in the hospital, they almost never die.”

That is also true for most high-risk people, Jha pointed out, including older adults — like his parents, who are in their 80s — and people whose immune systems are compromised. “Even for most — not all but most — immunocompromised people, vaccines are actually still quite effective at preventing against serious illness,” he said. “There has been a lot of bad information out there that somehow if you’re immunocompromised that vaccines don’t work.”

That excess deaths have fallen close to zero helps make this point: If Covid were still a dire threat to large numbers of people, that would show up in the data.

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One point of confusion, I think, has been the way that many Americans — including we in the media — have talked about the immunocompromised. They are a more diverse group than casual discussion often imagines.

Most immunocompromised people are at little additional risk from Covid — even people with serious conditions, such as multiple sclerosis or a history of many cancers. A much smaller group, such as people who have received kidney transplants or are undergoing active chemotherapy, face higher risks.

With vs. from
Covid’s toll, to be clear, has not fallen to zero. The C.D.C.’s main Covid webpage estimates that about 80 people per day have been dying from the virus in recent weeks, which is equal to about 1 percent of overall daily deaths.

The official number is probably an exaggeration because it includes some people who had virus when they died even though it was not the underlying cause of death. Other C.D.C. data suggests that almost one-third of official recent Covid deaths have fallen into this category. A study published in the journal Clinical Infectious Diseases came to similar conclusions.

Even so, some Americans are still dying from Covid. “I don’t know anybody who thinks we’re going to eradicate Covid,” Jha said.

Dr. Shira Doron, the chief infection control officer at Tufts Medicine in Massachusetts, told me that “age is clearly the most substantial risk factor.” Covid’s victims are both older and disproportionately unvaccinated. Given the politics of vaccination, the recent victims are also disproportionately Republican and white.

Each of these deaths is a tragedy. The deaths that were preventable — because somebody had not received available vaccines and treatments — seem particularly tragic. (Here’s a Times guide to help you think about when to get your next booster shot.)

Yet the number of Covid deaths has now dropped low enough that they are difficult to notice in the overall death data. They can be swamped by fluctuations in other causes of death, such as the flu or vehicle crashes.

Almost a year ago, President Biden angered some public health experts when he declared, “The pandemic is over.” He may have been premature to make that declaration. But the excess-deaths milestone suggests that it’s true now: The pandemic is finally over.

Related: Researchers are working to ensure developing countries don’t have to rely on wealthy nations for vaccines in a future pandemic, The Washington Post reports.

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Rise in new COVID-19 cases in Japan shows little sign of abating
https://www.japantimes.co.jp/news/2023/07/18/national/covid-cases-rise-continues/

COVID-19 cases in Japan are continuing their recent rise and taking a toll on the elderly in particular, with experts predicting the trend will continue amid high heat, declining population-level immunity and the start of the holiday season.

Health ministry statistics released Friday showed Japan’s ninth wave of coronavirus infections is continuing, with the average number of new cases reported by around 5,000 designated medical institutions in the week through July 9 standing at 9.14, up from 7.24 a week before.

Japan has seen a continuous, though gradual, increase in COVID-19 cases for eight straight weeks since May 8, when it downgraded the disease to a status on par with seasonal flu and scrapped a range of special COVID-19 measures, including the daily counting of cases.

The number of new hospital admissions for COVID-19 is also rising, standing at 6,096 in the week through July 9, up from 5,494 a week before and 4,484 four weeks before.

Cases were seen rising in 45 of the nation’s 47 prefectures, but the increases stand out in western Japan. Okinawa continues to see by far the highest number of patients per institution, at 41.67, though that is down slightly from 48.39 a week before. The Kyushu region has seen major increases, particularly in Kagoshima (17.18), Miyazaki (16), Saga (15.33) and Kumamoto (11.99) prefectures.

Shigeru Omi, the nation’s top coronavirus adviser, said other places in Japan could see an uptick in coming weeks.

“Okinawa has its own unique factors (that led to the current spike in infections),” Omi told an NHK news program Sunday. “It has a close-knit community, and the vaccination rate there is a bit lower (than in the rest of the country). But these factors alone cannot explain the recent spikes.

“The trend could spread northward from Okinawa and Kyushu.”

Omi also said that the trend is likely to continue a little longer, citing the normalization of social and business activities since May 8 and the increasing amount of time people are spending in indoor, less ventilated spaces because of the relentless heat outside. He also mentioned the fact that many people’s immunity is waning, as time has passed since prior infection or vaccination, as well as the prevalence of immunity-escaping variants.