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Expand chart
Data: N.Y. Times; Cartogram: Kavya Beheraj/Axios

The U.S. and COVID-19 are settling into a long, but hopefully manageable future together.

The big picture: The worst of the pandemic is likely behind us, but the virus is here to stay. We’re entering a new phase — one in which the country’s overall experience with this virus will be less like having a heart attack, and more like managing a lifelong chronic condition.

  • Experts have been saying for a long time that there’s almost no chance COVID-19 would disappear. Rather, they’ve been expecting it to become endemic — meaning it will stick around, possibly forever, but at more predictable, manageable levels.
  • That transition appears to be happening right now.

By the numbers: The U.S. is averaging about 74,000 new infections per day. That is, unfortunately, a 4% increase over the past two weeks.

  • The CDC defines a “low” rate of COVID transmission, measured at the county level, as an average of fewer than 10 new cases per 100,000 people per day.
  • If you applied the same rubric to states, only four would qualify as having a low rate of transmission. In most of the country — nearly 40 states — the average infection rates are between 10 and 50 new cases per day per 100,000 people.

Experts disagree about what is or isn’t “over.” Former FDA Commissioner Scott Gottlieb has said over the past week that “we're close to the end of the pandemic phase of this virus.”

  • Even if cases increase this winter, he said, the number of vaccinated Americans, plus the fact that infected people will soon have access to two highly effective treatments, will prevent another cascade of death and suffering.
  • The other side: “One too many smart people has told me or said on TV this week that the pandemic is over,” Andy Slavitt, a former Biden adviser on COVID, said on Twitter.

Reality check: Both sides have a point.

  • The end of the pandemic phase isn't going to mean the end of COVID. There will still be rising and falling waves of infection.
  • They’ll probably be worse during colder weather, because people spend more time indoors, and in areas where vaccination rates are low. But they likely won’t be as big, or as deadly, as last winter or this summer.
  • Breakthrough infections will continue to occur, but only a small portion of those cases will be severe.

A lot of that basic framework is already here.

  • Vermont, for example — the most vaccinated state in the U.S. — has seen a significant spike in cases. It’s now averaging just over 50 cases per 100,000 people per day.
  • But its hospitals have not seen a rash of new COVID patients.
  • In the Mountain West, on the other hand, vaccination rates are lower, cases are consistently among the highest in the country, and more of those patients are in the hospital.

Between the lines: About 58% of the U.S. population is fully vaccinated.

  • Mandates and vaccines for kids may help nudge that number up, but it’s otherwise not moving. The vaccination rate increased by less than 1 percentage point last week, according to the CDC. Nationally, we’re a long way from the 70% or higher that experts had hoped to see.
  • Millions more Americans have some immunity because they had COVID, but experts say the protection from a vaccine is more durable.
  • "There is more than enough human wood for this coronavirus forest fire to burn," the University of Minnesota’s Michael Osterholm told NPR. He estimates that 70 million Americans are at risk from the virus.

The bottom line: As long as no new variant emerges — which is a big "if," but there doesn’t seem to be one heading for us right now — we have a pretty good idea of where we’re headed, and that overall landscape isn’t likely to change too dramatically.

Editor's note: This story has been corrected to note that Vermont now averages just over 50 cases per 100,000 people each day, not per capita.

Go deeper

Tina Reed, author of Vitals
15 hours ago - Health

U.S. on the lookout for Omicron cases

Illustration: Sarah Grillo/Axios

Laboratories across the U.S. are on the lookout for the new COVID-19 variant Omicron, which officials have said will almost inevitably be detected here.

Why it matters: The world is on high alert as scientists race to understand if the variant could be a game-changer in the pandemic. Early detection, in theory, gives officials more time to understand its characteristics and respond.

Omicron variant detected in more countries

The Galeao International airport in Rio de Janeiro, Brazi. Photo: Mauro Pimentel/AFP via Getty Images

Nigeria, Saudi Arabia and South Korea on Wednesday became the latest countries to report cases of the Omicron variant of COVID-19. They followed similar announcements made in Brazil and Japan on Tuesday.

Why it matters: The arrival of the "variant of concern" in more countries underscores the difficulties governments are facing as they seek to reopen economies stalled by nearly two years of pandemic restrictions in the era of global air travel.

Nov 30, 2021 - Health

FDA panel backs Merck's antiviral COVID pill

The Merck Cherokee Plant in Riverside, Pa. Photo: Paul Weaver/SOPA Images/LightRocket via Getty Images

An FDA advisory panel on Tuesday voted 13-10 to endorse an antiviral pill developed by Merck and Ridgeback Biotherapeutics to treat adults at high risk of becoming severely ill from COVID-19, despite concerns over its effectiveness and safety.

Why it matters: Oral antiviral drugs designed to prevent or treat COVID-19 could be key pandemic-fighting tools, if proven effective, especially as new variants emerge. If authorized, the Merck drug, known as molnupiravir, would be the first treatment of its kind to be made available in the U.S.