The Fourth Surge

Since it was first identified in India in December 2020, the Delta variant has spread to more than one hundred thirty countries. Having already wreaked havoc elsewhere, including India and the United Kingdom, it has quickly become the dominant strain of the virus in the United States. Delta’s rise coincided with a lull in vaccinations, the lifting of mask mandates and social-distancing restrictions, and a long-awaited return to pre-pandemic socializing and travel. Almost a year and a half into the pandemic, the country has made great strides in testing for, vaccinating against, and treating COVID-19. But the missteps and confusion surrounding the “fourth surge” are a reminder that, in a time of renewed uncertainty about the future of the pandemic, U.S. health and government officials need a coherent and coordinated response—one that incorporates effective outreach to those who still aren’t vaccinated and a clear path forward for those who are.

The Delta variant appears to be about twice as contagious as the original strain of the virus. On July 27, amid rising Covid case numbers and hospitalizations, the CDC updated its guidelines on mask-wearing, recommending that people in high-transmission areas wear a mask in public indoor spaces, even if they’re fully vaccinated. The new guidelines confused and frustrated pandemic-fatigued Americans who had counted on vaccines to usher in a summer of quasi-normalcy. But although more than half the U.S. population had received at least one dose of a vaccine by July, new cases were still on the rise, especially in Southern states with low vaccination numbers. According to the latest data from the CDC, average daily hospital admissions among Americans under fifty have hit a pandemic high.

All this comes at a time of deep uncertainty and fractious debate over how best to return to “normal”: whether that’s mandating vaccination or regular testing for health-care workers, soldiers, or teachers, or requiring students to be vaccinated or wear masks in order to return to school. It also comes as hospitals in the South—especially in Louisiana, Arkansas, and Mississippi—are being overwhelmed with Covid patients. The response from state governments has been mixed and contradictory. Arkansas Gov. Asa Hutchinson tried to walk back a bill he signed this spring that bans mask mandates in his state. In Texas, Gov. Greg Abbott is pushing to allow children to return to in-person school without any mask or vaccine requirements, despite the CDC’s call for “universal indoor masking by all students.” Florida Gov. Ron DeSantis has chalked up his state’s record-breaking rise in infections to “Covid season.” But as Alexis C. Madrigal reported in the Atlantic, Florida is on track to have “twice as many people hospitalized now [as] during any previous wave, when essentially no one was vaccinated.”

Even in the midst of the Delta surge, there are spots of good news. Despite much-publicized breakthrough cases, vaccines are working and remain our best defense against the virus. The Biden administration could boost the stalled vaccine campaign by expediting the FDA approval process. (As of August, the vaccines still have only “emergency use authorization,” leaving room for public doubt about their long-term safety.) The government could also roll out a program making rapid antigen tests widely available for home use and expand its support for public-private partnerships such as those that provide free rides to vaccine appointments. Perhaps the most difficult and important task for public officials is to combat pandemic fatigue among the vaccinated and unvaccinated alike—and to keep reminding the country that our collective crisis requires a collective response.