Posted on by Dr. Francis Collins
At the end of last year, you may recall hearing news reports that the number of COVID-19 cases in the United States had topped 20 million. While that number came as truly sobering news, it also likely was an underestimate. Many cases went undetected due to limited testing early in the year and a large number of infections that produced mild or no symptoms.
Now, a recent article published in Nature offers a more-comprehensive estimate that puts the true number of infections by the end of 2020 at more than 100 million . That’s equal to just under a third of the U.S. population of 328 million. This revised number shows just how rapidly this novel coronavirus spread through the country last year. It also brings home just how timely the vaccines have been—and continue to be in 2021—to protect our nation’s health in this time of pandemic.
The work comes from NIH grantee Jeffrey Shaman, Sen Pei, and colleagues, Columbia University, New York. As shown above in the map, the researchers estimated the percentage of people who had been infected with SARS-CoV-2, the novel coronavirus that causes COVID-19, in communities across the country through December 2020.
To generate this map, they started with existing national data on the number of coronavirus cases (both detected and undetected) in 3,142 U.S. counties and major metropolitan areas. They then factored in data from the Centers for Disease Control and Prevention (CDC) on the number of people who tested positive for antibodies against SARS-CoV-2. These CDC data are useful for picking up on past infections, including those that went undetected.
From these data, the researchers calculated that only about 11 percent of all COVID-19 cases were confirmed by a positive test result in March 2020. By the end of the year, with testing improvements and heightened public awareness of COVID-19, the ascertainment rate (the number of infections that were known versus unknown) rose to about 25 percent on average. This measure also varied a lot across the country. For instance, the ascertainment rates in Miami and Phoenix were higher than the national average, while rates in New York City, Los Angeles, and Chicago were lower than average.
How many people were potentially walking around with a contagious SARS-CoV-2 infection? The model helps to answer this, too. On December 31, 2020, the researchers estimate that 0.77 percent of the U.S. population had a contagious infection. That’s about 1 in every 130 people on average. In some places, it was much higher. In Los Angeles, for example, nearly 1 in 40 (or 2.42 percent) had a SARS-CoV-2 infection as they rang in the New Year.
Over the course of the year, the fatality rate associated with COVID-19 dropped, at least in part due to earlier diagnosis and advances in treatment. The fatality rate went from 0.77 percent in April to 0.31 percent in December. While this is great news, it still shows that COVID-19 remains much more dangerous than seasonal influenza (which has a fatality rate of 0.08 percent).
Today, the landscape has changed considerably. Vaccines are now widely available, giving many more people immune protection without ever having to get infected. And yet, the rise of the Delta and other variants means that breakthrough infections and reinfections—which the researchers didn’t account for in their model—have become a much bigger concern.
Looking ahead to the end of 2021, Americans must continue to do everything they can to protect their communities from the spread of this terrible virus. That means getting vaccinated if you haven’t already, staying home and getting tested if you’ve got symptoms or know of an exposure, and taking other measures to keep yourself and your loved ones safe and well. These measures we take now will influence the infection rates and susceptibility to SARS-CoV-2 in our communities going forward. That will determine what the map of SARS-CoV-2 infections will look like in 2021 and beyond and, ultimately, how soon we can finally put this pandemic behind us.
 Burden and characteristics of COVID-19 in the United States during 2020. Pei S, Yamana TK, Kandula S, Galanti M, Shaman J. Nature. 2021 Aug 26.
COVID-19 Research (NIH)
Sen Pei (Columbia University, New York)
Jeffrey Shaman (Columbia University, New York)
Posted on by Dr. Francis Collins
Recently, there is a new and very hopeful COVID-19 number for everyone to track: the total number of vaccine doses that have been administered in the United States. If 80 percent of Americans roll up their sleeves in the coming months and accept COVID-19 vaccinations, we can greatly slow the spread of the novel coronavirus in our communities and bring this horrible pandemic to an end in 2021.
So far, more than 20 million people in our country have received one or two doses of either the Pfizer or Moderna vaccine. While this number is lower than initially projected for a variety of logistical reasons, we’re already seeing improvements in the distribution system that has made it possible to get close to 1 million doses administered per day.
If you want to keep track of the vaccine progress in your state over the coming weeks, it’s now pretty easy to do online. A fine resource is the vaccine information on the Centers for Disease Control and Prevention (CDC) COVID Data Tracker. It offers an interactive state-by-state map, as well as data on vaccinations in long-term care facilities. Keep in mind that there’s a delay of three to five days in reporting actual vaccinations from the states.
There’s also a lot of useful information on the Johns Hopkins Coronavirus Resource Center’s Vaccine Tracker. Posting the daily updates is a team, led by William Moss, that draws on the expertise of data scientists, analysts, programmers, and researchers. The Hopkins team gathers its vaccination data from each state’s official dashboard, webpages, press releases, or wherever cumulative numbers are reported. Not all states publish the same vaccine information, and that’s what can make the Vaccine Tracker so challenging to compile.
The Hopkins team now presents on its homepage the top 10 U. S. states and territories to vaccinate fully the highest percentage of their residents. With another click, there’s also a full rundown of vaccine administration by state and territory, plus the District of Columbia. The site also links to lots of other information about COVID-19—including cases, testing, contact tracing, and an interactive tool about vaccine development.
In uncertain times, knowledge can be a source of comfort. That’s what makes these interactive COVID-19 resources so helpful and empowering. They show that, with time, safe and effective COVID-19 vaccines will indeed coming to everyone. I hope that you will accept your vaccine, like I did when given the opportunity. However, until we get to the point where most Americans are immunized, we must stay vigilant and keep up our tried-and-true public health measures such as wearing masks, limiting physical interactions (especially indoors), and washing our hands.
COVID-19 Research (NIH)
CDC COVID Data Tracker (Centers for Disease Control and Prevention, Atlanta)
Coronavirus Resource Center (Johns Hopkins University School of Medicine)
William Moss (Johns Hopkins University, Baltimore)
International Vaccine Access Center (Johns Hopkins Bloomberg School of Public Health, Baltimore)
Posted on by Dr. Francis Collins
This Saturday, October 31, marks an important milestone in American public health: the 80th anniversary of President Franklin Delano Roosevelt’s dedication of the campus of the National Institutes of Health (NIH) in Bethesda, MD. The President’s stirring speech, delivered from the steps of NIH’s brand-new Administration Building (now called Building 1), was much more than a ribbon-cutting ceremony. It gave voice to NIH’s commitment to using the power of science “to do infinitely more” for the health of all people with “no distinctions of race, of creed, or of color.”
“We cannot be a strong nation unless we are a healthy nation. And so, we must recruit not only men and materials, but also knowledge and science in the service of national strength,” Roosevelt told the crowd of about 3,000. To get a sense of what it was like to be there on that historic day, I encourage you to check out the archival video footage above from the National Archives and Records Administration (NARA).
These words from our 32nd President are especially worth revisiting for their enduring wisdom during a time of national crisis. In October 1940, with World War II raging overseas, the United States faced the prospect of defending its shores and territories from foreign forces. Yet, at the same time as he was bolstering U.S. military capacity, Roosevelt emphasized that it was also essential to use biomedical research to shore up our nation’s defenses against the threats of infectious disease. In a particularly prescient section of the speech, he said: “Now that we are less than a day by plane from the jungle-type yellow fever of South America, less than two days from the sleeping sickness of equatorial Africa, less than three days from cholera and bubonic plague, the ramparts we watch must be civilian in addition to military.”
Today, in the midst of another national crisis—the COVID-19 pandemic—a similar vision is inspiring the work of NIH. With the aim of defending the health of all populations, we are supporting science to understand the novel coronavirus that causes COVID-19 and to develop tests, treatments, and vaccines for this disease that has already killed more than 225,000 Americans and infected more than 8.6 million.
As part of the dedication ceremony, Roosevelt thanked the Luke and Helen Wilson family for donating their 70-acre estate, “Tree Tops,” to serve as a new home for NIH. (Visitors to Wilson Hall in Building 1 will see portraits of the Wilsons.) Founded in 1887, NIH had previously been housed in a small lab on Staten Island, and then in two cramped lab buildings in downtown Washington, D.C. The move to Bethesda, with NIH’s first six buildings already dotting the landscape as Roosevelt spoke, gave the small agency room to evolve into what today is the world’s largest supporter of biomedical research.
Yet, as FDR gazed out over our fledging campus on that autumn day so long ago, he knew that NIH’s true mission would extend far beyond simply conducting science to providing much-needed hope to humans around the world. As he put it in his closing remarks: “I voice for America and for the stricken world, our hopes, our prayers, our faith, in the power of man’s humanity to man.”
On the 80th anniversary of NIH’s move to Bethesda, I could not agree more. Our science—and our humanity—will get us through this pandemic and show the path forward to brighter days ahead.
Who We Are: History (NIH)
“70 Acres of Science” (Office of NIH History)
Coronavirus (COVID-19) (NIH)