Good morning. Cases are rising again in the U.S., even as the vaccine campaign accelerates. We explain why.
An 83-year-old woman received a vaccine at home in Yonkers, N.Y., this week.Stephanie Keith/Reuters
Caution vs. optimism

The news about the state of the pandemic in the U.S. has been largely positive in the past few months. The vaccines are highly effective, and millions of people are receiving doses each day. Cases, hospitalizations and deaths have fallen sharply from their January peaks.

But infections are rising again. The U.S. has averaged 65,000 new cases a day over the past week — a 19 percent increase from two weeks ago. That puts the country close to last summer’s peak, though still far below January levels.
By The New York Times | Sources: State and local health agencies

As those numbers make clear, the pandemic isn’t over yet. And it may get worse in the next few weeks. But there are still strong reasons to be optimistic about Covid’s trajectory in the U.S.
What’s driving cases up?

Several factors are fueling the upturn, Apoorva Mandavilli, a Times science reporter, told us. A more contagious variant (the one first identified in Britain, called B.1.1.7) is spreading. Some mayors and governors have continued to lift restrictions and mask rules. Many Americans are behaving less cautiously. And vaccinations have not gotten the country near herd immunity.

Many experts aren’t surprised. “For literally a month and a half, we’ve all been predicting that the second half of March is when B.1.1.7 would become the dominant variant in the United States,” says Dr. Ashish Jha, dean of the Brown School of Public Health. “And sure enough, here we are.”

The increase is not distributed equally. “New York and New Jersey have been bad and are not getting better, and Michigan’s cases are rising at an explosive rate,” Mitch Smith, a Times reporter covering the pandemic, said.

Hospitalizations are also rising rapidly in Michigan, with Jackson, Detroit and Flint among the metro areas experiencing the highest rates of new cases in the country.

The outlook is more encouraging in much of the West and South, though cases have started to tick up in Florida, where officials in Miami Beach instituted a curfew this month to prevent crowds of spring breakers from gathering.

Still, Mitch noted, “compare the country to where we were in January, it’s hands-down way better.”
Short-term worry, longer-term optimism

What happens next? Cases could continue to rise in the coming weeks, Apoorva says. Between vaccinations and prior infections, half the country may have some form of immunity to the virus, according to Jha: “That still leaves a lot of vulnerable people who can get infected.”

But the success of the country’s ongoing vaccination drive should keep deaths and hospitalizations well below their January peaks. Many of the people at the greatest risk of severe illness have already been inoculated, which means new cases are likely to be concentrated among younger and healthier people.

And there are many reasons to expect the state of the pandemic to improve as summer approaches. More and more Americans will get vaccinated. The arrival of warmer weather will let more people spend time outside, where the virus spreads less easily. And cities and states could blunt some new cases by keeping indoor mask mandates.

Caution in the immediate term and hope in the longer term can make for difficult public health messaging. President Biden walked that line this week, celebrating expanded vaccine access while warning that “reckless behavior” could lead to more infections.

The solution, Jha believes, is honesty. “There’s been this debate throughout the whole pandemic: Should we be more optimistic or should we be more pessimistic? My personal strategy has been to just be honest with people,” he says. “Be honest with people and give it to them straight. I think most people can handle it.”

In other virus news:

Researchers in Britain are exploring the possible benefits of pairing doses from different Covid vaccines.
An elite New York City hospital repeatedly billed patients more than $3,000 for a Covid test.
The New York Times
Me: Elite = Elite who can afford to pay