Sunday, December 31, 2023

Final COVID-19 update for 2023: mainly good news (at least on a comparative basis)


 - by New Deal democrat

Here is the status of the COVID-19 pandemic as of the end of 2023. It’s mainly “good news,” at least on the comparative scale. But as (now) per usual, we are in the midst of the Thanksgiving through New Year’s surge.

Let me start with infections, which these days can only be inferred from wastewater sampling. Per Biobot, we currently have as many infections as we did one year ago at this time (and three years ago as well, to the extent we can trust the skimpy early sampling). In fact, only the original Omicron explosion was signficantly worse than where we are now:

Also as per usual for this time of year, the Northeast (Yellow in the graph below) and the Midwest (light purple) are the worst affected regions, probably because they are the coldest regions, leading to much more indoor gathering:

But if infections are just as bad as they have been for 2 of the past 3 years at this time, hospitalizations are running only about 70% of last year’s levels at this time (first and last bars below):

And deaths are running at about 60% of last year’s at this time:

The comparisons are even better when we compare hospitalizations over the entire pandemic:

Hospitalizations are only about 30% of what they were at this time at the end of 2020, and only about 20% of what they were during the Omicron wave.

Deaths are 10% or less of where they were at year end 2020 or year end 2021:

To put some numbers on it, for the 9 months starting April 1 through December 31 each year (measured by the closest reference week),
 - in 2020 there were 367,000 deaths
 - in 2021 there were 289,000 deaths
 - in 2022 there were 96,000 deaths
 - in 2023 so far there have been 39.000 deaths. This will probably rise to about 42,000 once updates are complete for the last 3 weeks of December.

That’s a decline of almost 90% from the first year of the pandemic.

Last year at this time the BA.4&5 variants were fading, as an alphabet soup of new candidates created more infections. Within a month, XBB had emerged the clear winner:

XBB remained the dominant variant almost all this year. Only in the past month has it been supplanted by JN.1:

Although there won’t be another update until Friday, as I type this JN.1 probably accounts for about 2/3rd’s of all new infections - which would be equivalent to the entire recent surge.

To summarize: COVID has become endemic. Very little in the way of mitigation remains, either by mask-wearing or uptake of the newest booster shot. Despite this, hospitalizations are much improved, and deaths a shadow of what they were early in the pandemic. Some of this is probably better treatments, like Paxlovid, some is better care generally with better understanding of the virus, and much of it is doubtless that a population that has almost universally suffered at least one infection, and many if not most have been vaccinated multiple times, is far harder for the virus to waylay. Some, alas, is also that the most vulnerable have already been killed by the virus, so they aren’t around now.

I will continue to update from time to time in 2024 if something of particular significance happens.