State of Affairs: July 26, 2021

In the United States, cases continue to rise with a 170% increase in the past 14 days. Every state has significant case growth, but the surge continues to be driven largely by severe outbreaks in the South. Today, Arkansas is the leader (60 daily cases per 100,000) followed by Louisiana (52 per 100,000) and Florida (49 per 100,000).

When will we peak? We don’t really know. The CDC published projections last week and the models were widely dispersed. In other words, we don’t know whether we’re at the beginning, middle, or end of this wave. If we follow the UK or South Africa Delta curves, we still have another 1.5 months of incline until we peak. Test positivity rates (an early indicator of what’s to come) continues to increase and are well above 5%, so I don’t think we will reach out peak in the next week or two.


Transmission (which takes into account testing and cases) also continues to rise. 18 states are in “high transmission” (red) category and 14 are in “substantial transmission” (orange). No states are in “low transmission” (blue), but there are a number of counties that are blue.


Hospitalizations also continue to rise and we are up 58% in the past 14 days. Nevada takes the prize for most hospitalizations (30 per 100,000), followed by Missouri (27 per 100,000) and Florida (26 per 100,000).

Among the highest vaccinated states (Vermont, Massachusetts, Maine, Rhode Island), hospitalizations remain stagnant while cases rise. I’m hopeful that this trend will continue.


As of July 19, 2021, more than 161 million people in the United States had been fully vaccinated against COVID-19. The seriousness of Delta has motivated some groups, as daily vaccination rates are slowly increasing. On July 25 (yesterday), 779,000 doses were administered compared to July 13 when we administered 339,000 doses. Unfortunately, at this pace, it will take another 8 months to cover 75% of the US population.

During the same time, CDC recorded 5,914 breakthrough cases where someone was hospitalized or died. CDC does not report all symptomatic breakthrough cases (i.e. non-hospitalized), so we need to look at the local level too. For example, in Los Angeles County, 0.13% of the vaccinated tested positive. In San Diego, case rates among vaccinated also continue to remain low while unvaccinated cases continue to increase. Vaccines seem to be holding up.

Some more good news

We’re starting to see the Delta leaders (UK, South Africa, Netherlands, etc.) come down from their peaks, which is fantastic news. Every epi curve comes down, even with Delta.

Unfortunately, the United States is not there yet.

Have a wonderful week, YLE