Some notes on international observations:
Israel: Cases are now stagnating at an incredibly low number: 7 day rolling average is 29 case per day, that's 0.3 cases per 100,000.
They have vaccinated over 80% of adults, AND they still require indoor masks. They have dropped most other restrictions.
If anything, this is a demonstration of the effectiveness of the Pfizer vaccine PLUS indoor masking.
Their 7-day rolling average of deaths has actually "spiked" -- It was down to just 1 death per day, it's back up to 2 for now. (Of course, many of those deaths may be lagging reports).
They will likely drop indoor masks once kids are widely vaccinated.
Israel is a 9 million person country, about the size and population of NJ. Per capita, if compared to the US, it would be as if the US was having about 60 deaths per day and 957 cases per day. Yes -- with the proper measures, this thing can be driven down to near zero.
UK is an interesting analysis. They have distributed vaccine at a slightly higher level than the US. They chose a different approach: delay the second shot, but distribute the first shot as widely as possible. They are still more age limited than the US, but qualifying age groups are adopting vaccination at rates of 90%+. While Israel relied exclusively on Pfizer, about 1/3rd of the UK population has received the Astra Zeneca vaccine (more than half of those vaccinated, have been vaxed with Astra Zeneca). While effective, studies have repeatedly shown Astra Zeneca is noticeably less effective, especially against newer variants.
Anyway, receiving at least 1 dose:
UK: 57%
US: 44.7%
Israel: 60.1%
And even more than Israel, UK has kept significant Covid restrictions in place. So based purely on first doses and restrictions, you'd expect the UK to be doing as well as Israel. But the reality is a bit more complicated:
Cases per day in the UK: They were under 2000 per day in early May, but since then, they have actually risen: Now 2600 per day. This is still a fairly low number, but represents 4 cases per 100,000. That's much closer to the 7.6 per 100,000 of the US than the 0.3 of Israel.
More notably, it's the same level as mid April: They have not seen any decline in cases in the last 5-6 weeks.
So what's happening in the UK?
1 -- They are NOT at herd immunity. They have plenty of vaccine suppression driving down numbers significantly, but clearly it's not herd immunity.
2 -- Astra Zeneca simply isn't as effective. The India variant is becoming prevalent in the UK. Both Pfizer and Astra Zeneca only provide 33% protection after the first dose. After 2 doses, Pfizer is 93% effective against the UK variant and 88% against the India variant. Astra Zeneca is only 60% effective against the India variant and 66% against the UK variant.
So to some degree, the continued sustained cases in the UK may be due to simply using a less effective vaccine -- much like the Yankees staff developed 9 positive cases even though they were fully vaxed.. but with the less effective JNJ.
3 -- Continuation of the same point -- As I said, especially against the India variant, 2 doses provide a LOT more protection than just 1 dose. Only 34% of the UK has 2 doses, compared to 39% in the US and 57% in Israel.
Now the good news for UK: While relying heavily on 1-dose of Astrazeneca compared to 2 doses of Pfizer, has led to a more sustained case level, it has been VERY effective against death. This is also due to the fact that UK is vaccinating over 90% of qualifying age groups, over 95% of seniors. Running about 10 points ahead of the US. In late January, they were averaging 1241 deaths per day -- Almost 2 deaths per 100,000 people per day. Their 7 day average is down to 6! That's 0.009 deaths per 100,000 per day.
The US: Late January, we were at 34670 deaths per day: About 1.05 deaths per 100,000 people. We are down to 543, about 0.16 per 100,000 per day. So US went from a death rate higher than the US, to a death rate much much lower.
So why has the UK been SO SUCCESSFUL at preventing death, even with a sustained case level? Because they have near universal vaccination of those over 50, and even 1 shot is providing protection against death.
Some lessons for the US:
We want to get to the herd immunity level of Israel, where we have under 1,000 cases per day, nationwide. We want to get to the death level seen in Israel and the UK: Where death has become exceedingly rare.
1. Sadly, the ship has sailed, but we would have benefited from keeping indoor mask mandates and vaccine passports.
2. The JNJ scare may have been a blessing in disguise in the US. Any vaccine is better than no vaccine. But as long as Moderna and Pfizer are widely available, they will provide superior protection to JNJ/Astrazeneca.
Let's say you need 80% immunity for true herd immunity: A vaccine that is "only" 60-70% effective will never provide 80% community immunity, even if everyone is fulled vaxed. So to the extent that the US is relying more on Pfizer and Moderna, it could help us potentially follow Israel's path more than the UK path, in terms of cases.
3. If we really want to quickly drive down cases as much as both the UK and Israel, we need greater vaccine adoption. We have 85% of seniors with at least 1 dose and 74% with 2 doses. Those numbers sound good, but UK and Israel is looking at 95%+ in those age brackets.
And we drop off in the 50-65 far more than they do.
I'm optimistic that we will largely squash Covid. But at our current rate, there will be another winter spike in low vax communities. Likely no where near as big and dangerous as the winter 2020-2021 spike. But there should be higher vax communities where Covid nearly disappears.