Millions of vaccinations, together with the end of the perilous holiday season, are having the effect I had hoped for: Finally, U.S. COVID-19 cases have entered what looks like a terminal decline.
Time to celebrate? Not quite. To get a sense of the suffering this disease has yet to visit upon humanity, we'll have to focus on other data.
Cases will no longer be a reliable leading indicator, for a number of encouraging reasons. For one, they'll be less likely to lead to deaths, as more elderly and otherwise vulnerable people get vaccinated. Also, testing is becoming increasingly convenient: When more people start doing at-home tests before traveling or going to work, more asymptomatic cases will be recorded.
What matters, then, is how the people affected are actually faring. Here are some indicators to watch:
Hospitalizations and related illnesses. Death isn't the only bad outcome for people who get COVID-19. People with cases severe enough to require hospitalization also experience other long-term health problems. Some require oxygen for months. Some experience symptoms — such as brain fog and severe fatigue — that bear a troubling resemblance to a condition called POTS, or postural orthostatic tachycardia syndrome. Worse, it seems that even mild cases can trigger POTS. I'm afraid these longer-term consequences will become the center of the story by this summer.
Suicides and overdoses. Whether or not people get infected, the long period of social isolation is taking a toll on their mental health. The opioid epidemic appears to have gotten worse, and suicide hotlines have been busier. Comprehensive official data on causes of deaths during the pandemic haven't come out yet. They'll merit attention when they do.
Variants. New variants of the virus can be problematic if they're more contagious, less contained by vaccines or (worst of all) both. Again, the health consequences matter more than the number of cases. That's why some of the research on the South African variant has been misleading: It looked primarily at mild cases in young people, which offers little insight into how the variant would affect most people (what's the mortality rate, the prevalence of long-term health issues?). For now, most vaccines seems to offer pretty good protection against bad outcomes. But we'll have to keep tracking variants and the vaccines' effectiveness against them.
In the meantime, aside from getting vaccinated, people will have to remain cautious. Double mask, anyone?
Cathy O'Neil is a Bloomberg Opinion columnist. She is a mathematician who has worked as a professor, hedge-fund analyst and data scientist. She founded ORCAA, an algorithmic auditing company, and is the author of "Weapons of Math Destruction."
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