The Washington PostDemocracy Dies in Darkness

In 32 states, 1 in 100 seniors have died of covid. Will this wave break the trend?

Joanna Martinez, a funeral home worker, puts on personal protective equipment before transporting the body of a covid patient. (Shannon Stapleton/Reuters)

We’re used to this pattern by now. Cases drop and we wonder if, finally, the pandemic is behind us. Then they rise again and we wonder how bad it will be.

As the totals surge, we embrace a new hope: Maybe this will be the surge in which the benefits of the vaccines will finally be felt, significantly tamping down the number of people who get seriously ill or die. So far that hope hasn’t manifested.

In June, the delta variant arrived, with data from Britain suggesting that a spike in cases there wasn’t accompanied by a surge in deaths. That offered some hope, but since that surge began, nearly 200,000 people in the United States have succumbed to covid-19.

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Since the pandemic began, 32 states have seen 1 percent of their population age 65 and over die of covid. These are estimates, overlaying data from the Centers for Disease Control and Prevention, updated through the week of Dec. 11, on The Washington Post’s state-level data and then compared with Census Bureau figures on population by age. But in many states it’s not really very close. In Mississippi, for example, about 15 out of every 1,000 residents age 65 and older has died of the coronavirus — just under 1.5 percent.

And now a new wave is beginning. Spurred by the highly contagious omicron variant, new cases in the United States have more than doubled in the past three weeks. In some places like D.C. and New York, daily case totals are hitting highs unseen since the beginning of the pandemic.

So, again, we hope: Is it the case that omicron is less dangerous than prior iterations of the virus? Is preliminary data from South Africa, showing a flat level of deaths following the eruption of the variant, an indicator of what Americans might expect? Or are we simply in that lull, the period between when people start getting sick and when they start dying?

Since the beginning of the pandemic, there’s been a fairly consistent relationship between new cases and new deaths. Shift the curve of new deaths by 21 days, and its surges overlap neatly with the number of new cases. In other words, about three weeks after the number of new cases begins to rise or fall, so does the number of deaths.

Since the beginning of this year, the number of new covid-19 deaths on a given day has been equal, on average, to 1.4 percent of the number of new cases three weeks prior. That ratio has shifted around a bit and is lower than it was a year ago, which is a good sign. But it still would suggest that, if omicron is like delta or the original virus, we could see more than 2,100 deaths a day by early January.

Maybe something’s different this time. More Americans are vaccinated now than in early July, when the last surge started — but, for many of those people, the effects of vaccination have probably waned. The omicron variant could be less dangerous — but we don’t yet know if that’s the case. Americans are more cognizant of the dangers of the virus — but that doesn’t seem to have done much to slow the spread in the past.

For months, the country has been in this liminal space between broad immunity to the virus and complete vulnerability. Millions of Americans are protected against the virus through immunization (and, in some cases, prior infection), but not enough to slow the spread. Because those most likely to be infected are unvaccinated, and because the unvaccinated are less likely to take precautions against infection, and because vaccination rates overlap with politics and politics overlaps with communities, it suggests that the only thing that might be different in this wave is the virus itself.

America, unlike the coronavirus, largely hasn’t changed.