The COVID-19 Global Pandemic

Even as more than 231 million people have received a first shot of vaccine in the U.S. and states and countries work to re-open, COVI9-19 rolls on, infecting hundreds of millions of people globally and killing millions. Although more than 70% of the total U.S. population has received at least the first dose of vaccine (82% of adults), the rate of vaccine hesitancy in some areas along with issues of ease of access to vaccination sites/appointments cast doubt on the possibility of stopping the spread of the dangerous Delta variant, which has grown rapidly in states with low vaccination rates. Some communities and organizations are recommending and even mandating the return of mask-wearing indoors along with vaccine, testing and safety protocol mandates to curb the continued spike in infections from the Delta variant. The return to school year has presented formidable challenges even as the Pfizer vaccine has recently received emergency authorization for children 5-11 years old. Currently, Pennsylvania, New York, all of the New England states, Puerto Rico, California and Hawaii lead the way in vaccination rates in the U.S. with more than 91% of people already receiving at least one dose. West Virginia is at the other end of the scale with only 64% of the population receiving one dose.

While the global infection rate has declined in some countries, it has exploded in others. Variants of the virus have contributed to record numbers of new cases globally with new hot spots emerging. This highly contagious virus kills some and spares others, presenting symptoms that are unprecedented and unpredictable. More than 20 months into the pandemic, masking, handwashing and social distancing continue to be important in combating the relentless advance of COVID-19. And while the CDC has once again advised mask-wearing indoors in areas of substantial or high transmission even by those who are fully vaccinated (currently 59% of the U.S. population), it is more important then ever for those who are not vaccinated to stay vigilant, continue to observe basic safety measures and get vaccinated in the race against the Delta variant which is proving to be more contagious and severe.

Global COVID Snapshot

World deaths from COVID have now officially surpassed 5 million (with experts estimating a much higher toll). India, United Kingdom, Brazil, Iran, France, Turkey and Russia have followed the U.S. as among the countries leading in infection rates. The infection rate in India exploded, overwhelming the health system as a second wave created a record daily number of infections before subsiding. Elsewhere in the world, Indonesia became a major hotspot while other countries in Asia, Africa and Latin America have seen alarming increases in infection rates and deaths with the spread of more virulent variants (the Delta variant the most prevalent, and now the new omicron variant). As the U.S. and other countries in the West struggle to emerge from the pandemic, countries and communities with limited access to vaccines are facing new threats from COVID-19 as more health systems are overwhelmed by rising infection rates. Austria became the first EU nation to impose a nationwide vaccine mandate. Resistance to vaccine and mask mandates continues to challenge progress in defeating this highly contagious virus.

U.S. Resurgence

On September 20, 2021, the US marked another grim milestone in the fight against COVID-19 recording more American deaths from COVID-19 than the Spanish flu in 1918 – making COVID-19 the most deadly pandemic in American History. More than 770,000 people in the United States have died from COVID-19 (the near equivalent of the entire population of the city of Seattle, WA). The re-opening of schools and other efforts to resume normal activities add new complications for local authorities. The U.S. has averaged more than 70,000 new infections every day in the past week, according to the CDC COVID data tracker. Rates rose sharply once again for several weeks as the Delta variant continues to strike the unvaccinated who represent the large majority of new cases and deaths (approximately 97%). Currently 10 states have vaccinated less than 50% of their population. Although the death toll had slowed as the country emerged from the Pandemic, it is still recording more than 700 deaths per day and threatening to pass even more grim milestones of lives lost to the pandemic. To put that number in perspective, if 1000 people die per day in the next 9 months, the fatality total in the U.S. from COVID-19 would reach more than 1 million.

Florida and Texas led the latest alarming surge in reported cases as hospitals were pushed to capacity, followed by a sharp rise in cases in western states. While the infection and death rates had subsided in recent weeks (a pattern that has been seen in the spread of the Delta variant) and an anti-viral treatment shows promise, the future trajectory of the pandemic continues to defy predictions as a new spike in cases now confronts us. As winter comes on with holiday gatherings, worrisome signs of a resurgence are appearing in a number of states, especially in areas with lower vaccination rates. Resistance to vaccines and mask wearing continues to be a significant factor in the level of infection rates (and deaths).

Vaccine Hesitancy

Although three successfully tested, safe and free vaccines are in widespread use after receiving emergency approval, the rate of vaccination has slowed. One of the three has now received full approval. There are currently 22 COVID-19 vaccines authorized and being administered across the world and a total of 91 in development. Health authorities are addressing vaccine hesitancy as a significant barrier to community immunization. There can be no doubt, however, that the wearing of masks, proper hand washing and social distancing remain critical weapons against infection for those who have not received the vaccine.  Even with the relaxation of mask wearing for the fully vaccinated, safety measures remain a matter of critical community responsibility among those not yet vaccinated. The science is clear. They work. Continuing the 3 steps of prevention and getting vaccinated at the earliest opportunity are both necessary to stop COVID-19. To learn more the global story of the pandemic, open the ” Trusted Resources” below and view COVID-19 Updates. Read the COVID-19 2020 report on our global work during the first year of the Pandemic.

Health Inequity

The pandemic has proven especially lethal in predominantly Black and other neighborhoods of color that face systemic inequality including lack of access to quality health care. According to the COVID Racial Data Tracker, COVID has had a particularly deadly impact on Black, Indigenous, Latinx and other people of color with Black people dying at twice the rate of white people. Authorities also are seeing significant disparities in vaccination rates from zip code to zip code within communities, often reflecting economic and social inequities in those same populations. As it attacks poor communities in the U.S. and globally, it also exhibits catastrophic growth in countries with large concentrations of urban poverty or with the most fragile health systems. In both rich and poor countries, the virus exposes and exploits every weak point in the health infrastructure. Where you live may determine whether you live or die.

Health inequity retains its deadly potential in communities of color with poor health care access as vaccine distribution lags dangerously behind better-resourced neighbors. And that is why the COVAX pillar of access is still critical as the only global effort to ensure that people in all corners of the world will get access to COVID-19 vaccines when they are available, regardless of their wealth. The COVAX initiative, however, faces many challenges of supply, logistics, and bureaucracies, as many under-resourced countries have made little progress with vaccinations because the manufacture and distribution of vaccines still has not met their growing need. As an example of the global vaccine inequity, only 6% of the people in Africa have received a vaccine. The global pandemic is far from over with new variants and new outbreaks emerging in many countries. The COVID-19 Pandemic has brought new attention to the health equity crisis on a national and global scale.

Latest CDC Updates – Unmask the Facts

The Centers for Disease Control has endorsed booster shots of the Moderna and the Johnson & Johnson Covid-19 vaccines, following an earlier approval of booster shots of the Pfizer-BioNTech vaccine and making it possible for all adult Americans to receive the extra dose.

In addition, new CDC guidelines allow people to “mix and match” which COVID-19 vaccine they take as a booster. A booster for Pfizer and Moderna recipients is now recommended 6 months after the second dose for people 65 and up and some younger adults. A booster for the Johnson & Johnson COVID-19 vaccine is recommended for people 18 and older at least two months after their initial dose. READ MORE.

The FDA updated the Emergency Use Authorization of the Pfizer-BioNTech COVID-19 vaccine to include children 5-11 years old. This pediatric vaccine is administered as a two-dose primary series, 3 weeks apart, but uses a lower dose (10 micrograms) than that one for individuals over the age of 12 (30 micrograms). As of 11/2, CDC formally recommends this vaccine to children 5-11 years old. READ MORE.

New Antiviral Pill

Early studies of Merck & Co’s experimental oral COVID-19 antiviral drug, molnupiravir, show the pill to be effective against known variants of the coronavirus. The investigational medicine significantly reduced the risk of hospitalization or death in the trials. At the interim analysis, the antiviral reduced the risk of hospitalization or death by approximately 50%. READ MORE.

Surges in COVID-19 Hospitalizations in West

A surge in unvaccinated COVID-19 patients requiring hospitalization has nearly crippled some health systems. Some states have enacted “crisis care standards” in their clinics this week, which means that scarce resources such as ICU beds will be given to patients who are most likely to survive. Public health leaders in Idaho, one of the least vaccinated states in the country, recently expanded health care rationing statewide, and hospital systems in Alaska and Montana have enacted similar crisis standards. READ MORE

FDA Approval

The FDA granted full approval to PfizerBioNTech’s COVID-19 vaccine (Comirnaty) for people 16 and older. It is the first COVID-19 vaccine to move beyond an emergency use authorization (EUA) in the United States. FDA endorses the Pfizer vaccine as safe and effective at reducing adverse health effects of COVID-19 infection, including hospitalization and death. As with all vaccines, FDA will continue safety monitoring of the vaccine to evaluate longer term health outcomes. The vaccine continues to be available under EUA for adolescents 12 through 15 years old, as well as for an additional mRNA dose for certain immunocompromised individuals. READ MORE

Vaccines Effective

A recent study with 4,217 participants shows that during the last eight months, full vaccination was 80% effective in preventing SARS-CoV-2 infection among frontline workers, further affirming the highly protective benefit of full vaccination. The vaccine effectiveness estimates declined from 91% before Delta to 66% since the Delta variant became predominant. This trend should be interpreted with caution because the effects might also be declining as time elapsed since vaccination increases. READ MORE…

Masks

The CDC has updated its mask guidance to encourage vaccinated people living in areas with “substantial” and “high” transmission of COVID-19 to wear masks in public indoor spaces. The CDC also recommends that all individuals attending K-12 schools (staff, students, etc.) wear masks regardless of their vaccination status. This new guidance comes from research that suggests that vaccinated individuals, if infected with the Delta variant, may have a role in spreading the disease to unvaccinated populations. Get the Facts. Get the Shot. READ MORE…

Delta Variant

The Delta variant spreads quickly. As the CDC director recently stated, “if you get sick with the Alpha variant, you could infect about two other unvaccinated people. If you get sick with the Delta variant, we estimate that you could infect about five other unvaccinated people — more than twice as many as the original strain.” While some vaccinated people have contracted COVID-19 through the Delta variant, authorized vaccines continue to prevent severe illness, hospitalizations, and death from the virus.

Disclaimer: This project was funded in part by a cooperative agreement with the Centers for Disease Control and Prevention grant number 1 NU50CK000588-01-00. The Centers for Disease Control and Prevention is an agency within the Department of Health and Human Services (HHS). The contents of this resource center do not necessarily represent the policy of CDC or HHS and should not be considered an endorsement by the Federal Government.