A combination of public health efforts and rising vaccination rates have cut the pace of the spread of COVID-19 in the U.S. Daily confirmed case increases, which reached a rate as high as 225,000 two months ago have dropped to under 100,000. New fatal cases per day which rose at a rate of over 4,000 some days have dropped below 2,000 recently. Nevertheless, according to the Bing COVID-19 Tracker, 529,527 Americans have died, which is a fifth of the world’s total. Confirmed cases in America have reached 29,258,941, about a quarter of the global figure. And, many doctors and public health experts believe the current case count is much higher because testing efforts have been weak. Now, a primary question about the disease is whether there will be a “fourth wave” of rapid spread. Epidemiologists and public health officials have specific concerns about what might trigger this.

The first of the three waves was in March and April when New York City was the epicenter. Another hit in summer and battered the South, Plains States, and part of the western U.S. The third, and most deadly occurred after the Thanksgiving and Christmas holidays and continued well into January.

Vaccination rates should help prevent a fourth wave. A total of 17% of Americans have been received at least one dose of vaccine. About 9% have received two doses. A total of 116,355,405 doses have been delivered across the country. From these 87,912,323 shots have been given. Vaccines offer particularly strong protection. The Pfizer and Modena vaccines are over 94% effective after two doses, which are usually given three to four weeks apart.

One cause of deep concern is that 16 states do not require residents to wear masks–if Texas, which will drop its mandate in days, is included. Mask wearing has been considered a cornerstone of COVID-19 disease protection.

According to The Guardian, Dr Peter Hotez, a vaccine researcher and dean for the national school of tropical medicine at College of Medicine in Houston, Texas stated “Everybody’s focused on the big declines in the number of cases, pretending the plateau is not really substantive, and oblivious to the impact of B117,” a highly transmissible variant first identified in the UK.” While the current rise of 50,000 cases a day seems low compared to January, it is too high for COVID-19 to be brought under control.

Another portion of the argument is the new variants may spread faster. And they may be somewhat resistant to current vaccines. It is too early for scientists to give a certain answer to the vaccine effectiveness question.

Dr. Anthony Fauci made related comments in a CNN interview:

“If you look at, right now, the curves of the diminution of infections that are going down, it’s reached the point where the last seven days have plateaued. We’ve been to this scene before, months and months ago when we tried to open up the country and open up the economy, when certain states did not abide by the guidelines, we had rebounds that were very troublesome.”

The “reopening” of Texas was joined in the news last week by reports of a number of large events around the country where people did not wear masks. While no one can say what the exact odds are for a fourth wave, the threat is clearly present.

Click here to see COVID-19: This Is America’s Worst Hotspot

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