Projected resurgence of COVID-19 in the United States in July-December 2021 resulting from the increased transmissibility of the Delta variant and faltering vaccination

What is already known about this topic? The highly transmissible SARS-CoV-2 Delta variant has begun to cause increases in cases, hospitalizations, and deaths in parts of the United States. With slowed vaccination uptake, this novel variant is expected to increase the risk of pandemic resurgence in the US in July-December 2021. What is added by this report? Data from nine mechanistic models project substantial resurgences of COVID-19 across the US resulting from the more transmissible Delta variant. These resurgences, which have now been observed in most states, were projected to occur across most of the US, coinciding with school and business reopening. Reaching higher vaccine coverage in July-December 2021 reduces the size and duration of the projected resurgence substantially. The expected impact of the outbreak is largely concentrated in a subset of states with lower vaccination coverage. What are the implications for public health practice? Renewed efforts to increase vaccination uptake are critical to limiting transmission and disease, particularly in states with lower current vaccination coverage. Reaching higher vaccination goals in the coming months can potentially avert 1.5 million cases and 21,000 deaths and improve the ability to safely resume social contacts, and educational and business activities. Continued or renewed non-pharmaceutical interventions, including masking, can also help limit transmission, particularly as schools and businesses reopen.

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Characterizing the spatiotemporal heterogeneity of the COVID-19 vaccination landscape

10.1101/2021.10.04.21263345 ◽

2021 ◽

Author(s):

Andrew Tiu ◽

Zachary Susswein ◽

Alexes Merritt ◽

Shweta Bansal

Keyword(s):

United States ◽

Vaccination Coverage ◽

Vaccination Campaign ◽

The United States ◽

County Level ◽

Spatial Clusters ◽

Southern Us ◽

The Us ◽

Target Locations ◽

County Scale

AbstractIt is critical that we maximize vaccination coverage across the United States so that SARS-CoV-2 transmission can be suppressed, and we can sustain the recent reopening of the nation. Maximizing vaccination requires that we track vaccination patterns to measure the progress of the vaccination campaign and target locations that may be undervaccinated. To improve efforts to track and characterize COVID-19 vaccination progress in the United States, we integrate CDC and state-provided vaccination data, identifying and rectifying discrepancies between these data sources. We find that COVID-19 vaccination coverage in the US exhibits significant spatial heterogeneity at the county level and statistically identify spatial clusters of undervaccination, all with foci in the southern US. Vaccination progress at the county level is also variable; many counties stalled in vaccination into June 2021 and few recovered by July, with transmission of the Delta variant rapidly rising. Using a comparison with a mechanistic growth model fitted to our integrated data, we classify vaccination dynamics across time at the county scale. Our findings underline the importance of curating accurate, fine-scale vaccination data and the continued need for widespread vaccination in the US, especially in the wake of the highly transmissible Delta variant.

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Projecting the impact of SARS-CoV-2 variants on the COVID-19 epidemic and social restoration in the United States: a mathematical modelling study

10.1101/2021.06.24.21259370 ◽

2021 ◽

Author(s):

Rui Li ◽

Yan Li ◽

Zhuoru Zou ◽

Yiming Liu ◽

Xinghui Li ◽

...

Keyword(s):

United States ◽

Vaccination Coverage ◽

Scale Up ◽

The United States ◽

Vaccine Effectiveness ◽

Potential Reduction ◽

The Us ◽

Alpha Variant ◽

The Impact ◽

Different Levels

Background: The SARS-CoV-2 Alpha variant B.1.1.7 became prevalent in the United States (US). We aimed to evaluate the impact of vaccination scale-up and potential reduction in the vaccination effectiveness on the COVID-19 epidemic and social restoration in the US. Methods: We extended a published compartmental model and calibrated the model to the latest US COVID-19 data. We estimated the vaccine effectiveness against B.1.1.7 and evaluated the impact of a potential reduction in vaccine effectiveness on future epidemics. We projected the epidemic trends under different levels of social restoration. Results: We estimated the overall existing vaccine effectiveness against B.1.1.7 to be 88.5% (95%CI: 87.4-89.5%) and vaccination coverage would reach 70% by the end of August, 2021. With this vaccine effectiveness and coverage, we anticipated 498,972 (109,998-885,947) cumulative infections and 15,443 (3,828-27,057) deaths nationwide over the next 12 months, of which 95.0% infections and 93.3% deaths were caused by B.1.1.7. Complete social restoration at 70% vaccination coverage would only slightly increase cumulative infections and deaths to 511,159 (110,578-911,740) and 15,739 (3,841-27,638), respectively. However, if the vaccine effectiveness were reduced to 75%, 50% or 25% due to new SARS-CoV-2 variants, we predicted 667,075 (130,682-1,203,468), 1.7m (0.2-3.2m), 19.0m (5.3-32.7m) new infections and 19,249 (4,281-34,217), 42,265 (5,081-79,448), 426,860 (117,229-736,490) cumulative deaths to occur over the next 12 months. Further, social restoration at a lower vaccination coverage would lead to even greater future outbreaks. Conclusion: Current COVID-19 vaccines remain effective against the B.1.1.7 variant, and 70% vaccination coverage would be sufficient to restore social activities to a pre-pandemic level. Further reduction in vaccine effectiveness against SARS-CoV-2 variants would result in a potential surge of the epidemic in the future.

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Evaluating the Impact of SARS-CoV-2 Variants on the COVID-19 Epidemic and Social Restoration in the United States: A Mathematical Modelling Study

Frontiers in Public Health ◽

10.3389/fpubh.2021.801763 ◽

2022 ◽

Vol 9 ◽

Author(s):

Rui Li ◽

Yan Li ◽

Zhuoru Zou ◽

Yiming Liu ◽

Xinghui Li ◽

...

Keyword(s):

United States ◽

Vaccination Coverage ◽

Scale Up ◽

The United States ◽

Vaccine Effectiveness ◽

Potential Reduction ◽

The Us ◽

Vaccine Booster ◽

The Impact ◽

Different Levels

Background: Multiple SARS-CoV-2 variants are still rampant across the United States (US). We aimed to evaluate the impact of vaccination scale-up and potential reduction in the vaccination effectiveness on the COVID-19 epidemic and social restoration in the US.Methods: We extended a published compartmental model and calibrated the model to the latest US COVID-19 data. We estimated the vaccine effectiveness against the variant and evaluated the impact of a potential reduction in vaccine effectiveness on the epidemics. We explored the epidemic trends under different levels of social restoration.Results: We estimated the overall existing vaccine effectiveness against the variant as 88.5% (95% CI: 87.4–89.5%) with the vaccination coverage of 70% by the end of August, 2021. With this vaccine effectiveness and coverage, there would be 498,972 (109,998–885,947) cumulative infections and 15,443 (3,828–27,057) deaths nationwide over the next 12 months, of which 95.0% infections and 93.3% deaths were caused by the variant. Complete social restoration at 60, 65, 70% vaccination coverage would increase cumulative infections to 1.6 (0.2–2.9) million 0.7 (0.1–1.2) million, and 511,159 (110,578–911,740), respectively. At same time it would increase cumulative deaths to 39,040 (5,509–72,570), 19,562 (3,873–35,250), 15,739 (3,841–27,638), respectively. However, if the vaccine effectiveness were reduced to 75%, 50% or 25% due to new SARS-CoV-2 variants, there would be 667,075 (130,682–1,203,468), 1.7 (0.2–3.2) million, 19.0 (5.3–32.7) million new infections and 19,249 (4,281–34,217), 42,265 (5,081–79,448), 426,860 (117,229–736,490) cumulative deaths to occur over the next 12 months. Further, social restoration at a lower vaccination coverage would lead to even greater secondary outbreaks.Conclusion: Current COVID-19 vaccines remain effective against the SARS-CoV-2 variant, and 70% vaccination coverage would be sufficient to restore social activities to a pre-pandemic level. Further reduction in vaccine effectiveness against SARS-CoV-2 variants would result in a potential surge of the epidemic. Multiple measures, including public health interventions, vaccination scale-up and development of a new vaccine booster, should be integrated to counter the new challenges of new SARS-CoV-2 variants.

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Epidemiological Differences in the Impact of COVID-19 Vaccination in the United States and China

Vaccines ◽

10.3390/vaccines9030223 ◽

2021 ◽

Vol 9 (3) ◽

pp. 223 ◽

Cited By ~ 1

Author(s):

Monia Makhoul ◽

Hiam Chemaitelly ◽

Houssein H. Ayoub ◽

Shaheen Seedat ◽

Laith J. Abu-Raddad

Keyword(s):

United States ◽

Vaccine Coverage ◽

Scale Up ◽

The United States ◽

The Us ◽

High Incidence ◽

Vaccine Impact ◽

Infection Disease ◽

The Impact ◽

Actual Vaccine

This study forecasts Coronavirus Disease 2019 (COVID-19) vaccination impact in two countries at different epidemic phases, the United States (US) and China. We assessed the impact of both a vaccine that prevents infection (VES of 95%) and a vaccine that prevents only disease (VEP of 95%) through mathematical modeling. For VES of 95% and gradual easing of restrictions, vaccination in the US reduced the peak incidence of infection, disease, and death by >55% and cumulative incidence by >32% and in China by >77% and >65%, respectively. Nearly three vaccinations were needed to avert one infection in the US, but only one was needed in China. For VEP of 95%, vaccination benefits were half those for VES of 95%. In both countries, impact of vaccination was substantially enhanced with rapid scale-up, vaccine coverage >50%, and slower or no easing of restrictions, particularly in the US. COVID-19 vaccination can flatten, delay, and/or prevent future epidemic waves. However, vaccine impact is destined to be heterogeneous across countries because of an underlying “epidemiologic inequity” that reduces benefits for countries already at high incidence, such as the US. Despite 95% efficacy, actual vaccine impact could be meager in such countries if vaccine scale-up is slow, acceptance is poor, or restrictions are eased prematurely.

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National interest may require distributing COVID-19 vaccines to other countries

Scientific Reports ◽

10.1038/s41598-021-97544-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Tiziano Rotesi ◽

Paolo Pin ◽

Maria Cucciniello ◽

Amyn A. Malik ◽

Elliott E. Paintsil ◽

...

Keyword(s):

United States ◽

Quantitative Analysis ◽

Vaccination Coverage ◽

Herd Immunity ◽

The United States ◽

Sir Model ◽

Sharp Reduction ◽

Trade Offs ◽

Self Interest ◽

The Us

AbstractAs immunization campaigns are accelerating, understanding how to distribute the scarce doses of vaccines is of paramount importance and a quantitative analysis of the trade-offs involved in domestic-only versus cooperative distribution is still missing. In this study we use a network Susceptible-Infected-Removed (SIR) model to show circumstances under which it is in a country’s self-interest to ensure other countries can obtain COVID-19 vaccines rather than focusing only on vaccination of their own residents. In particular, we focus our analysis on the United States and estimate the internal burden of COVID-19 disease under different scenarios about vaccine cooperation. We show that in scenarios in which the US has reached the threshold for domestic herd immunity, the US may find it optimal to donate doses to other countries with lower vaccination coverage, as this would allow for a sharp reduction in the inflow of infected individuals from abroad.

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PATRO children, a multi-center, non-interventional study of the safety and effectiveness of Omnitrope® (somatropin) treatment in children: update on the United States cohort

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2020-0360 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Philippe Backeljauw ◽

Bradley S. Miller ◽

Richard Levy ◽

Kenneth McCormick ◽

Hichem Zouater ◽

...

Keyword(s):

Diabetes Mellitus ◽

United States ◽

Human Growth ◽

The United States ◽

Hormone Deficiency ◽

Moderate Intensity ◽

Interventional Study ◽

Increased Risk ◽

The Us ◽

Report Data

Abstract Objectives Omnitrope® (somatropin, Sandoz Inc.) is one of several recombinant human growth hormones (rhGH) approved in the United States (US) for use in pediatric indications, including growth hormone deficiency (GHD) and idiopathic short stature (ISS). We report data on the effectiveness and safety of Omnitrope® in the US cohort of the PATRO Children (international, longitudinal, non-interventional) study. Methods All visits and assessments are carried out according to routine clinical practice, and doses of Omnitrope® are given according to country-specific prescribing information. Results By September 2018, 294 US patients were recruited; the two largest groups were GHD (n=193) and ISS (n=62). Across all indications, HSDS improvement (ΔHSDS) from baseline at three years was +1.0 (rhGH-naïve, +1.2; pre-treated, +0.7). In pre-pubertal patients, ΔHSDS from baseline at three years was +0.94 (rhGH-naïve, +1.3; pre-treated, +0.7). Following three years of treatment, ΔHSDS from baseline was +1.3 in rhGH-naïve GHD patients and +1.1 in rhGH-naïve ISS patients. In pre-pubertal rhGH-naïve patients, ΔHSDS from baseline was +1.3 and +1.2 in GHD and ISS patients, respectively. Overall, 194 patients (66.0%) experienced adverse events (AEs; n=886 events); most were of mild-moderate intensity. Five patients (1.7%) had AEs that were suspected to be treatment-related (n=5 events). All reported neoplasms were benign, non-serious, and considered unrelated to rhGH therapy. No AEs of diabetes mellitus or hyperglycemia were reported. Conclusions Omnitrope® appears to be well tolerated and effective in the majority of patients, without evidence of an increased risk of developing unexpected AEs, diabetes mellitus, or new malignancies during treatment.

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Epidemiological differences in the impact of COVID-19 vaccination in the United States and China

10.1101/2021.01.07.21249380 ◽

2021 ◽

Author(s):

Monia Makhoul ◽

Hiam Chemaitelly ◽

Houssein H. Ayoub ◽

Shaheen Seedat ◽

Laith J Abu-Raddad

Keyword(s):

United States ◽

Vaccine Coverage ◽

Scale Up ◽

The United States ◽

The Us ◽

High Incidence ◽

Vaccine Impact ◽

Infection Disease ◽

The Impact ◽

Actual Vaccine

Background: The objective of this study was to forecast the impact of COVID-19 vaccination in the United States (US) and China, two countries at different epidemic phases. Methods: A mathematical model describing SARS-CoV-2 transmission and disease progression was used to investigate vaccine impact. Impact was assessed both for a vaccine that prevents infection (VEs = 95%) and a vaccine that prevents only disease (VEp = 95%). Results: For VEs = 95% and gradual easing of restrictions, vaccination in the US reduced the peak incidence of infection, disease, and death by >55% and cumulative incidence by >32%, and in China by >77% and >65%, respectively. Nearly three vaccinations were needed to avert one infection in the US, but only one was needed in China. For VEp = 95%, benefits of vaccination were half those for VEs = 95%. In both countries, the impact of vaccination was substantially enhanced with rapid scale-up, vaccine coverage >50%, and slower or no easing of restrictions, particularly in the US. Conclusions: COVID-19 vaccination can flatten, delay, and/or prevent future epidemic waves. However, vaccine impact is destined to be heterogeneous across countries because of an underlying epidemiologic inequity that reduces benefits for countries already at high incidence, such as the US. Despite 95% efficacy, actual vaccine impact could be meager in such countries, if vaccine scale-up is slow, acceptance of the vaccine is poor, or restrictions are eased prematurely.

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The United States and the Iranian Nuclear Programme

10.3366/edinburgh/9780748682638.001.0001 ◽

2018 ◽

Author(s):

Steven Hurst

Keyword(s):

United States ◽

Decision Making ◽

Domestic Politics ◽

The United States ◽

Nixon Administration ◽

Comprehensive Plan ◽

The Us ◽

Nuclear Issue ◽

The Relationship

The United States, Iran and the Bomb provides the first comprehensive analysis of the US-Iranian nuclear relationship from its origins through to the signing of the Joint Comprehensive Plan of Action (JCPOA) in 2015. Starting with the Nixon administration in the 1970s, it analyses the policies of successive US administrations toward the Iranian nuclear programme. Emphasizing the centrality of domestic politics to decision-making on both sides, it offers both an explanation of the evolution of the relationship and a critique of successive US administrations' efforts to halt the Iranian nuclear programme, with neither coercive measures nor inducements effectively applied. The book further argues that factional politics inside Iran played a crucial role in Iranian nuclear decision-making and that American policy tended to reinforce the position of Iranian hardliners and undermine that of those who were prepared to compromise on the nuclear issue. In the final chapter it demonstrates how President Obama's alterations to American strategy, accompanied by shifts in Iranian domestic politics, finally brought about the signing of the JCPOA in 2015.

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‘To see oursels as ithers see us’: Reflections on Scottish Independence from the United States

Scottish Affairs ◽

10.3366/scot.2014.0036 ◽

2014 ◽

Vol 23 (3) ◽

pp. 381-388 ◽

Cited By ~ 5

Author(s):

Euan Hague ◽

Alan Mackie

Keyword(s):

United States ◽

The United States ◽

The Us ◽

Scottish Independence ◽

The Uk ◽

Scottish Diaspora

The United States media have given rather little attention to the question of the Scottish referendum despite important economic, political and military links between the US and the UK/Scotland. For some in the US a ‘no’ vote would be greeted with relief given these ties: for others, a ‘yes’ vote would be acclaimed as an underdog escaping England's imperium, a narrative clearly echoing America's own founding story. This article explores commentary in the US press and media as well as reporting evidence from on-going interviews with the Scottish diaspora in the US. It concludes that there is as complex a picture of the 2014 referendum in the United States as there is in Scotland.

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Palestine Unbound

Journal of Palestine Studies ◽

10.1525/jps.2018.47.3.130 ◽

2018 ◽

Vol 47 (3) ◽

pp. 130-134

Keyword(s):

United States ◽

Human Rights ◽

Task Force ◽

The United States ◽

Donald Trump ◽

Tel Aviv ◽

The Us ◽

Intention To Move ◽

Arab Israeli Conflict ◽

The U.S

This section, updated regularly on the blog Palestine Square, covers popular conversations related to the Palestinians and the Arab-Israeli conflict during the quarter 16 November 2017 to 15 February 2018: #JerusalemIstheCapitalofPalestine went viral after U.S. president Donald Trump recognized Jerusalem as the capital of Israel and announced his intention to move the U.S. embassy there from Tel Aviv. The arrest of Palestinian teenager Ahed Tamimi for slapping an Israeli soldier also prompted a viral campaign under the hashtag #FreeAhed. A smaller campaign protested the exclusion of Palestinian human rights from the agenda of the annual Creating Change conference organized by the US-based National LGBTQ Task Force in Washington. And, UNRWA publicized its emergency funding appeal, following the decision of the United States to slash funding to the organization, with the hashtag #DignityIsPriceless.

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