Yes, Charles Blow, Cases of COVID-19 Are Increasing in the North, Decreasing in the South

 It would be easy, and fun, to dunk on New York Times columnist Charles Blow for being mystified “by how these southern states have such low rates of Covid when many of their governors haven’t followed CDC guidance. Someone please explain this to me.”

But there’s something a bit saddening that the public-health recommendations, coverage of the pandemic, and discourse about COVID-19 have been so unclear that they left a Times columnist befuddled by case data and a map that doesn’t fit his preconceived notions.

First, Blow is looking at a map of the U.S. with each county color-coded by the average number of daily cases per 100,000 people in the past week. The southeastern states are dominated by white and light yellow, indicating lower average numbers of daily cases; patches of orange and red are in the northeast and west, and counties in the Rocky Mountain west are deep red and maroon, indicating the highest average number of daily cases.

The short answer is that the southern states have already had the Delta variant pass through, and between past infection and vaccination rates, there just aren’t that many new, unprotected bodies for SARS-CoV-2 to jump into anymore. As I have covered, over and over and over and over again, the Delta variant tore through the southern states in the tail end of summer, as intense heat and humidity sent more people indoors for the relief of air conditioning. The virus is more likely to spread indoors, and confirmed cases of infection from outdoor exposure are few and far between. As New York Times columnist David Leonhardt wrote in May, “the share of transmission that has occurred outdoors seems to be below 1 percent and may be below 0.1 percent, multiple epidemiologists told me.” Temperatures in the northern states in summer were more pleasant, so residents spent more time outdoors, where COVID-19 transmission was less likely to occur.

Autumn is bringing colder weather, particularly to the more northern states, so people in the north are spending more time indoors. More time indoors means more people are in situations where they are more likely to catch the virus. So we’re going to see the number of infections in the northern states increase and stay high, probably through the winter — or at least until the virus runs out of people to jump into because everyone either has protection from vaccination or protection from past infections.

But even until then, an increasing number of infections is not necessarily a public-health disaster. This is not because one part of the country is better than another. It is advantageous to have more people vaccinated; vaccinated people are less likely to end up in the hospital or ICU or die. But week by week, we’ve seen the rate of COVID-19 hospitalizations increase here and there in northern states. It does not take a lot of unvaccinated people to fill up a region’s hospitals, even if your overall vaccination rate is high, as in states such as Vermont and Massachusetts. And as we saw with the late Colin Powell, even a fully vaccinated person can succumb to COVID-19 or its complications if they are old enough or have significant enough other health issues, like Powell’s multiple myeloma.

In fact, if there’s any bad news on the COVID-19 front in the U.S. amidst a steadily improving picture, it’s that while new cases and hospitalizations are down significantly from late summer, our death rate is still around 1,000 per day — the seven-day moving average is currently 1,073. That’s better than the near-2,000 level in late September, but . . . clearly, the U.S. still has an unfortunately high number of people who are either unvaccinated and vulnerable to the virus, or vaccinated but still vulnerable because of age or other health problems.

Blow’s mystification is a good time to observe that the number of new cases is probably no longer the most useful measurement of the severity of the pandemic. Fully vaccinated people can catch the virus. In most cases, infected fully vaccinated people have mild symptoms, and in some cases, no symptoms at all.

Nationwide, our hospitals are operating with plenty of space. As of this morning, 77 percent of the hospital beds are being used, and just 6.1 percent of those beds are being used for COVID-19 patients.