Two years into the pandemic, the coronavirus is killing Americans at far higher rates than people in other wealthy nations, a sobering distinction to bear as the country charts a course through the next stages of the pandemic.
The ballooning death toll has defied the hopes of many Americans that the less severe omicron variant would spare the United States the pain of past waves. Deaths have now surpassed the worst days of the autumn surge of the delta variant, and are more than two-thirds as high as the record tolls of last winter, when vaccines were largely unavailable.
With American lawmakers desperate to turn the page on the pandemic, as some European leaders have already begun to, the number of dead has clouded a sense of optimism, even as omicron cases recede. And it has laid bare weaknesses in the country’s response, scientists said.
“Death rates are so high in the States — eye-wateringly high,” said Devi Sridhar, head of the global public health program at the University of Edinburgh in Scotland, who has supported loosening coronavirus rules in parts of Britain. “The United States is lagging.”
Some of the reasons for America’s difficulties are well known. Despite having one of the world’s most powerful arsenals of vaccines, the country has failed to vaccinate as many people as other large, wealthy nations. Crucially, vaccination rates in older people also lag behind certain European nations.
The United States has fallen even further behind in administering booster shots, leaving large numbers of vulnerable people with fading protection as omicron sweeps across the country.
The resulting American death toll has set the country apart — and by wider margins than has been broadly recognized. Since Dec. 1, when health officials announced the first omicron case in the United States, the share of Americans who have been killed by the coronavirus is at least 63% higher than in any of these other large, wealthy nations, according to a New York Times analysis of mortality figures.
In recent months, the United States passed Britain and Belgium to have, among rich nations, the largest share of its population to have died from COVID over the entire pandemic.
“The U.S. stands out as having a relatively high fatality rate,” said Joseph Dieleman, an associate professor at the University of Washington who has compared COVID outcomes globally. “There’s been more loss than anyone wanted or anticipated.”
As deadly as the omicron wave has been, the situation in the United States is far better than it would have been without vaccines. The omicron variant also causes less serious illness than delta, even though it has led to staggering case numbers. Together, vaccines and the less lethal nature of omicron infections have significantly reduced the share of people with COVID who are being hospitalized and dying during this wave.
In Western Europe, those factors have resulted in much more manageable waves. Deaths in Britain, for example, are one-fifth of last winter’s peak, and hospital admissions are roughly half as high.
But not so in the United States. Record numbers of Americans with the highly contagious variant have filled up hospitals in recent weeks and the average death toll is still around 2,500 a day.
Chief among the reasons is the country’s faltering effort to vaccinate its most vulnerable people at the levels achieved by more successful European countries.
Among Americans 65 and over, 12% have not received either two shots of a Moderna or Pfizer-BioNTech vaccine or one Johnson & Johnson shot, which the CDC considers fully vaccinated, according to the agency’s statistics. (Inconsistencies in CDC counts make it difficult to know the precise figure.)
And 43% of people 65 and over have not received a booster shot. Even among the fully vaccinated, the lack of a booster leaves tens of millions with waning protection, some of them many months past the peak levels of immunity afforded by their second shots.
In England, by contrast, only 4% of people 65 and over have not been fully vaccinated and only 9% do not have a booster shot.
“It’s not just vaccination — it’s the recency of vaccines, it’s whether or not people have been boosted, and also whether or not people have been infected in the past,” said Lauren Ancel Meyers, the director of the University of Texas at Austin’s COVID-19 modeling consortium.
Unvaccinated people make up a majority of hospitalized patients. But older people without booster shots also sometimes struggle to shake off the virus, said Dr. Megan Ranney, an emergency physician at Brown University, leaving them in need of extra oxygen or hospital stays.
It is too early to judge how much worse the United States will fare during this wave. But some scientists said there were hopeful signs that the gap between the United States and other wealthy countries had begun to narrow.
As delta and now omicron have hammered the United States, they said, so many people have become sick that those who survived are emerging with a certain amount of immunity from their past infections.
Although it is not clear how strong or long-lasting that immunity will be, especially from omicron, Americans may slowly be developing the protection from past bouts with COVID that other countries generated through vaccinations — at the cost, scientists said, of many thousands of American lives.
“We’ve finally started getting to a stage where most of the population has been exposed either to a vaccine or the virus multiple times by now,” said Dr. David Dowdy, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health. Referring to American and European death rates, he continued, “I think we’re now likely to start seeing things be more synchronized going forward.”
While infection levels remain high in many states, scientists said that some deaths could still be averted by people taking precautions around older and more vulnerable Americans, like testing themselves and wearing masks. The toll from future waves will depend on what other variants emerge, scientists said, as well as what level of death Americans decide is tolerable.
“We’ve normalized a very high death toll in the U.S.,” said Anne Sosin, who studies health equity at Dartmouth. “If we want to declare the end of the pandemic right now, what we’re doing is normalizing a very high rate of death.”