COVID-19: Where we were, where we are and what could come next

While the national COVID-19 rates are declining, the U.S. is still far from the pandemic lows it recorded in early summer 2021 before the more highly transmissible delta variant became the dominant coronavirus strain. 

As of Oct. 12, the seven-day average COVID-19 case count is dropping in 27 states, flat in 15 and up in eight. 

Every infection offers the SARS-CoV-2 virus a chance to mutate, and while most mutations are harmless, with just 56 percent of the country's population fully vaccinated, there is still ample opportunity for a more efficient version of the virus to emerge. That's a lesson the nation learned from delta, which became dominant in the U.S. over the two weeks ended July 3, according to the CDC. As the variant completed its takeover, President Joe Biden on July 4 said the country was "closer than ever" to becoming independent from the virus. 

Public health experts and officials may be one degree more reluctant to forecast winter 2021-22, given how delta defied optimism. 

"I think we've all been here before, and we've all been humbled in the past," a senior Biden official told The Washington Post. While public-facing commentary may be diminished, models and predictions from international research groups and the medical community provide some directional guidance on what the last months of 2021 may hold. 

Here are nine points on how low cases, hospitalizations and deaths dipped pre-delta dominance, where those data points stand today in comparison, and what projections show and experts say about COVID-19 through the end of 2021. 

Where we were 

1. COVID-19 cases in the U.S. hit a pandemic low in early June 2021, with a seven-day average of 20,008 cases reported June 1, according to the CDC.

2. COVID-19 hospitalizations in the U.S. hit a pandemic low during the week ending July 3 at 545 hospitalizations nationwide, data on cumulative hospitalizations from the CDC shows. That marks the lowest number since April 19, when states were ordered to open eligibility for COVID-19 vaccines for all U.S. residents age 18 and older. 

3. COVID-19 deaths hit a low on July 10, with a seven-day average of 192. 

Where we are 

4. As of Oct. 8, there is a seven-day average of 92,622 COVID-19 cases nationwide, according to the CDC. This marks a 363 percent increase from the low recorded June 1. The total number of newly reported cases on Oct. 9 was 106,296. 

5. As of Oct. 2, the most recent CDC data available, there were 1,724 COVID-19 hospitalizations nationwide. This marks a 216.3 percent increase from the low recorded in July.

6. The CDC reported 2,196 new COVID-19 deaths on Oct. 9. The moving average for new deaths was 1,465 as of Oct. 8, marking a 663 percent increase from the July 10 low. 

7. About 56 percent of the country's population had been fully vaccinated as of Oct. 9, while about 65 percent had received at least one dose. 

What could come next 

8. Forecasts from the COVID-19 Forecast Hub, a central repository of models and predictions from more than 50 international research groups, show that the projected downward trajectory of COVID-19 cases, hospitalizations and deaths through Jan. 1, 2022, largely rests on whether a new, 1.5-times more transmissible variant emerges and accounts for 1 percent of circulating viruses by Nov. 15. The lack of a new variant and change in virus transmissibility would contribute to cases, hospitalizations and deaths dropping regardless of whether vaccination for children under 12 is approved and in progress. (Find bar graphs illustrating the different scenarios here.)

9. COVID-19 + flu 

During the 2020-21 flu season, widespread COVID-19 mitigation measures largely suppressed flu activity, with just 1,675 cases reported from Sept. 28, 2020, through May 22, 2021, according to the CDC. Now, health officials are concerned the lack of protective immunity acquired last year coupled with eased COVID-19 mitigation measures and stalled vaccination could set the U.S. up for a severe 2021-22 influenza season. 

If that does turn out to be the case, health officials worry the country may see a "twindemic" of both COVID-19 and the flu that places further strain on hospitals already overburdened with unvaccinated COVID-19 patients. It's also possible for people to become co-infected with both the flu and COVID-19, and researchers still aren't sure how common this could be or how it may affect the severity of either illness, according to the CDC

As of Oct. 7, about 8 percent of U.S. adults had received their flu shot, though this influenza vaccination season is just getting started, a spokesperson for the National Foundation for Infectious Diseases told Becker's. Meanwhile, recent survey data from the CDC and National Foundation for Infectious Diseases indicates about 44 percent of U.S. adults are unsure about or don't plan on getting their flu shot this season. 



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