COVID-19 has settled down into an endemic. That was well expected based on the prior history of infection/treatment/immunization.
The latest data show a continued death rate of approximately 450 per day, equating to around 8,000 per month. In perspective, going forward, that would be an endemic death toll of around 100,000 per year, or about 3-4 times that of influenza.
This is still serious, but we can expect that rate to continue to decrease.
You have probably seen an increased number of friends and family who have either contracted or re-contracted COVID-19 over the past few months. These infections have ranged from very minor cold-like symptoms to more severe and long-lasting infections, but thankfully due to the vaccinations, those infections have not led to hospitalizations or serious pathogenicity.
To assess this increase it is useful to look at the data on hospitalizations compared to vaccination status. This data is extremely hard to find, but the best information I have been able to find indicates that about 50% of the hospitalizations for COVID-19 are from those previously vaccinated. This problem with this data is that it does not include whether those vaccinated and hospitalized have received 1 dose, 2 doses or 1 or 2 boosters, so we really don’t have a good measure of the value of full vaccination. Further, there is no data that I can find on the percentage of deaths compared to vaccination status.
Nonetheless, with 50% of the hospitalizations from unvaccinated, and with upwards of 80% of the population having had at least a single dose of the vaccine, that means that you are at least 4 times more likely to be hospitalized if you have not had at least one shot. Some of the medical reports list this as 23 times more likely; those studies may have a better gauge of the levels of vaccination.
The bottom line is that COVID-19 has now become a serious, but “acceptable” disease with decreasing mortality linked to vaccine status.
WHAT SHOULD WE WORRY ABOUT NEXT?
With this stabilization of the COVID-19 virus, news attention has moved on to other potential epidemics. What should our level of concern be?
Monkeypox
There has been a total of just under 20,000 cases of Monkeypox identified in the US in 2022. These cases have resulted in ZERO deaths. It appears that transmission is limited, mostly through direct person-to-person physical contact in which the virus is spread through open sores or through the exchange of bodily fluids. There is little evidence for aerosol transmission and the infection level is far too low (at least as of now) to worry about variants that would create an unregulated epidemic. With surveillance and with available vaccines, this should be manageable by the CDC. I am not concerned.
Polio
This is different. Polio is quite infectious and at least 1% of infections can lead to paralysis and/or death. Although there is an extremely protective vaccine, there is also an extremely passionate anti-vaccine movement. If we assume that the resistance to polio vaccination parallels that of the resistance to COVID-19 vaccination, we will see an immovable fraction of the American public (as high as 20%) remaining unvaccinated. This will evidence itself first in school-age children who are unvaccinated, often in religious communities and associated schools. This is what has been seen in NY in the past month. The detection of Polio virus in the draining sewage water from a religious community is an indication of the spread of the disease.
In this case I am concerned. In some ways, the paralysis resulting from Polio is more traumatic than deaths, due to the extensive time, treatment, heartache, and care resultant.
This can be ameliorated if the public would take the disease seriously and ramp up immunization, but I fear the politicization of medical treatment has taken root too strongly in this country.
I will continue to follow the Polio data because it is something that has the potential of creating a significant health problem.