The most crucial question for Biden—and for the country—is how long the overall decline can endure.
Biden has described the task at hand as a “wartime” effort against the pandemic, but the success of his cause will rest on factors partially out of his control. The Biden administration is now running a race of vaccination versus variants—it must continue to suppress transmission, and vaccinate people, before more transmissible variants of the virus emerge. The winner of this race will depend on three unknowns: mitigation, evolution, and vaccine distribution.
Since the pandemic began, two trends have defined the virus’s behavior. First, when cases and hospitalizations start to fall in a region, they continue on that path for some time. Second, when a community has a high level of ongoing infection—when the virus is simmering in the background but not yet boiling over and overwhelming hospitals—a new surge will soon start up again. Today, several key metrics are in decline, but overall community transmission remains at high levels.
Those high levels of ongoing infection make the standard tools of mitigation—social distancing, masks, and work-from-home orders—even more important to avoid continued deaths. Yet the allure of vaccination is beginning to stymie mitigation policy in some places. In Arizona, for instance, Governor Doug Ducey has opposed implementing any new mitigation efforts, because vaccinations are imminent—even though only about six doses have been administered for every 100 Arizonans, according to Bloomberg.
“The vaccine is the only solution. It is the first solution that has presented itself since January 27 [of last year], when we saw the first case,” Ducey, a Republican, has said.
Ducey is not alone in resisting mitigation efforts; local leaders from both parties are loosening some of the restrictions they implemented at the peak of the winter surge. Chicago, Baltimore, and Washington, D.C., have resumed some indoor dining, or are planning to resume it soon, as has the state of Michigan. Yet the virus has not been eradicated from those areas. In the District of Columbia, hospitalizations are below their peak, but still significantly higher today than they were at any point over the summer.
At the same time, the coronavirus is mutating in predictable but alarming ways. As my colleague Sarah Zhang has written, the virus has developed more-infectious variants in several different places around the world. The variant that emerged in the United Kingdom may be more than 50 percent more transmissible than the coronavirus strain that dominates in the U.S. (British Prime Minister Boris Johnson claimed on Friday that the same strain may also be 30 percent more lethal.) So far, these variants seem to respond to the vaccine, but without widespread mitigation efforts, the risk increases that the virus will develop even more transmissible and lethal variants. The most immediate risk is that these new variants cause another surge of infection, and death, before mass vaccination can increase the number of Americans with protective immunity.