Intended for healthcare professionals


Covid-19: US cases rise while vaccinations increase

BMJ 2021; 372 doi: (Published 29 March 2021) Cite this as: BMJ 2021;372:n850

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  1. Janice Hopkins Tanne
  1. New York, USA

The US reported more than 61 000 cases of covid-19 per day in the past week, an increase of 12% over the average two weeks ago, even as vaccinations were increasing to about 2.5 million a day, according to the New York Times.1

Cases are high and rising in 26 states and are increasing in three other states that had a low number of cases. As of 28 March, there have been more than 30.2 million cases of covid-19 and 548 000 deaths in the US.

The US is in a race between vaccinating people and the increasing number of cases, a particular worry as variants are spreading. So far, about one third of Americans (91 million) have had at least one dose of the approved vaccines: the two dose Pfizer BioNTech and Moderna vaccines and the single dose Johnson and Johnson vaccine. Most states expect to meet President Joe Biden’s promise of making all Americans eligible for vaccination by 1 May.2

The Biden administration announced a $10bn (£7.23bn; €8.48bn) investment to expand access to vaccines, especially to communities that are hardest hit and at high risk. The funding will increase vaccine access to communities of colour, rural areas, and populations with low incomes.3

There are concerns, however, that Johnson and Johnson may not be able to deliver the 20 million doses of its vaccine promised by the end of this month, and might not be able to ship the doses before late April.4 The Food and Drug Administration gave an emergency use authorization for a Catalent Pharma plant in Indiana to produce and ship the Johnson and Johnson vaccine, increasing the supply.5

Many states have been reopening fully and lifting rules on mask wearing and crowds despite warnings from Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, and Rochelle Walensky, director of the Centers for Disease Control and Prevention. They both urged people to continue wearing masks, keeping their distance, and avoiding crowds.

Fauci said he was often asked if the US was turning the corner on the pandemic. He said, “My response is that we are at the corner. Whether or not we turn the corner remains to be seen. We do have a lot of challenges in front of us regarding the high level of daily infections.” Walensky said she was enthusiastic about the pace of vaccinations but said, “What concerns me is what is happening with the spring breakers and people who are not continuing to implement prevention strategies.”6 After Florida lifted most of its restrictions, large numbers of young people gathered in Miami Beach last week during spring break (a vacation period for students), prompting the city to declare a state of emergency and call in armed police to break up crowds.7

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